In 2-D digital images, a pixel is a single point in the image. It has two coordinates to locate it in space, and additional values for grayscale or color.
A more complex, Euclidean sort of cousin of the pixel is the voxel- in 3-D! Each also has coordinates describing its location and other factors as needed by software designers.
Pixel and Voxel were also an obscure Vaudeville act who plied the Borscht Belt up until the 1920's, when talking films stole much of their audience away. Well, then again, maybe it was the jokes:
Pixel: "My father killed a hundred men in the war."
Voxel: "What was he, a machine gunner?"
Pixel: "Nope, a cook..."
Anyway, wending our way around from talk of straight men to the issue of straight teeth, there is one serious flaw in our orthodontic treatments even at this point in the science: maintaining the results all depends on human nature. "Wear your retainer, you little blackguard!" and similar stern admonitions are not always sufficient to change human behavior. And as we learned in June 4th's Orthodontic Retention and Invisalign, teeth will move again. It's inevitable and inexorable.
In the past two decades, orthodontists have taken, in some case types, to bonding retainer wires onto the insides of the lower front six teeth, or perhaps even the uppers too. This approach has problems. The inward forces of the muscles used in closing our mouths still are greater than the outward forces of the tongue, such that over long periods of time the middle back teeth move inwards. So it's possible to have a straight six up front, but a crowded jumble in the back. Also I have been seeing more and more cases where the bonded wires bend and distort over time, leading to crowding in spite of the "fixed" retainers.
The real trouble is, as soon as we go to take an "analog" impression for new retainers, we capture any crowding and misalignment that has crept in since the original orthodontics was completed. We lose that near-perfection that had been attained. The alternative is then to go back and move teeth all over again; even if this is minor, it will inevitably be expensive.
Invisalign's Vivera retainer system is a brilliant solution to these issues. Even if a patient had conventional orthodontics- which is still the best way to treat many complex case types- Vivera can be used to retain that final result. The system starts with a highly accurate impression of both arches of teeth, although we may be digitally scanning this in the near future. The impressions are sent to Align Technology's facilities where they are never poured into stone models of the teeth, but are instead converted into voxels by a micro-CT scan. Here's the brilliant part- a precise set of voxel-based coordinates now exist of the patient's teeth in their ideal position. This digital information can be used indefinitely! No changes can creep in over time. Clear shell type retainers are then manufactured in sets of four. They are meant to last a year, but in patients who do not grind excessively they can last far longer than that.
So now we have an ability to make retainers at any time that new ones are needed that are the same from year to year as long as:
-The patient wears them without too long of a gap in time where serious changes could occur, and
-Align Technologies remains in business (a good bet for the forseeable future!), and
-The patient maintains their teeth from a restorative and periodontal standpoint so that major treatments due to decay and tooth loss are not necessary.
Everything will stay put! Vivera retainers are quite comfortable too. And fluoride for decay prevention or tooth whitening materials for bringing the shade back up to par can be placed inside. Perks!
Now, back to our regularly scheduled programming:
Pixel: "What did the termite say when he walked into the bar?"
Voxel: "Is the bar tender here?"
Pixel: "Why do male deer need braces?"
Voxel: "Because they have buck teeth..."
Maybe missing out on the Vaudeville era wasn't such a bad thing after all...
Pixel and Voxel! Ha ha ha! You seem to have missed NOTHING of the Vaudeville era Dr. Rick!
Thanks for the interesting walk through teeth technology!
Posted by: Dorothy Shapland | August 21, 2010 at 06:27 PM
Many people feel the pain at the beginning when starting Invisalign to be too much. It was painful at first, but after a while you get used to it, and towards the end you’re feeling satisfied that you’re hurting as you know your teeth are moving into their final positions and you cannot wait to finish.
Posted by: dentist veneers | October 12, 2010 at 02:49 AM
Wow! I guess I've learned something out here! Amazing! Luckily, my parents are blessed with good teeth, and so I have good teeth too! And never did I experience having any teeth problems at all. But still, I have to take care of my teeth like Pixel and Voxel! Hahahaha!
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