First Impressions

Exploring the New iTero® Element™ Scanner with Dr. David Couchat


The iTero Element Scanner is the latest intra-oral imaging technology from Align Technology, Inc. Powered by a new touchscreen interface, the system offers a sleek, minimalist appearance. Both the software and hardware have been reengineered and redesigned from the base up. Another noteworthy change is the elimination of the foot-pedal, with all of the scanning inputs driven from the redesigned wand.

We recently caught up with Dr. David Couchat, a French orthodontist and frequent lecturer for Invisalign®, to talk about the new scanner. Dr. Couchat has been involved with the beta-testing of the iTero Element Scanner, and has been using it on his Invisalign cases for a number of months.

Great Expectations
The first thing everyone should know is that the new system is a complete rebuild. The hardware, software and interface are all brand new. Esthetically the new machine is very modern. Just having the machine in the office creates some expectations about the level of care they’re about to receive. They see us using this amazing piece of technology and think, ‘wow, they must be the top of the top’ to be using something this sophisticated.

When I have an oral surgeon or a fellow orthodontist in the room, they’re always very curious about the system. But in many ways, it has the same impression on them as it does on the patients. It creates a level of expectation that sets the tone for everything.

The Patient Experience
What really sets the iTero Element Scanner apart is the experience. Most patients have had at least one PVS impression taken in their lifetime. When we explain the digital process, and how there’s not going to be any tray or putty, it puts them in a good mood. Once we start, it takes us about five to ten minutes to complete a full arch scan. Even for the most difficult cases where there’s a lot of crowding, it takes us ten minutes, maximum. 

 It doesn’t get said often. But there are times when the conventional impression can be painful. When you’re removing an impression, especially if there’s a lot of crowding, it can put a lot of pressure on the teeth. It can feel like you’re trying to extract all their teeth! Or just as bad is when you get a bubble in the alginate and you need to put the patient through the process again. Not only do you feel like you’re wasting their time, and your time, but you’re subjecting them to what’s a pretty horrible procedure.

But the scan is just the first part of the patient experience.

The Invisalign Outcome Simulator has quickly become an amazing resource for us. Seeing the final outcome simulated is a big deal for the patient. It tells them they made the right choice in coming to us. It’s also a tremendous educational tool. Let’s say I mention that we’ll need to extract an incisor. When they can see the condition right there, and how the teeth will look, they can understand what we want to do, but more importantly, why we want to do it. They can see what we’re seeing, and what we’d like to accomplish.

Really, it gives the patients a sense of assurance and a sense of control. Most patients trust what we’re saying. But when they can see it for themselves, they can feel like they’re involved in the process. As a result, they can reach a conclusion easier and begin moving forward with confidence.

The Practice Experience
The impact on every aspect of the practice can’t be ignored. The entire office runs better. Let’s face it, conventional impressions can cause a lot of stress. It’s a procedure that nobody on the team likes doing. When you’ve got a waiting room full and you start falling a little behind, having to retake an impression can throw a whole day into chaos. There was always an underlying fear that something would go wrong, and we’d need to start over, or even worse, recall a patient for a second impression. With the iTero Element in the office, everyone’s stress level is much lower!

Everyone on my team likes working in a peaceful environment. Nobody wants the stress. By eliminating the conventional impression, we’ve not only eliminated most of the stress the patient experiences, but also for everyone on my staff. It’s such a refreshing way to start the appointment and the overall patient relationship.

Is there a learning curve? Sure. It takes a little bit of getting used to watching the screen as you take the impression. But it’s something everyone on my team was able to master in a few weeks. The video feed makes it easier to see what you’re doing. It’s still far easier than a conventional impression.

The handpiece is really lightweight. It’s easy to turn on and turn off with the push of a button. The French team provides us excellent support. If we ever have a question or problem, they’re always available to us.

End Results
None of the above would matter if the system didn’t deliver the end results. We do about 50 to 60 scans per month, and we’ve never had to do a remake in the ten years since we’ve had the system. It definitely improved my production times, my productivity, and it’s improved the clinical outcomes.

We couldn’t even do Invisalign without our element (iTero Element Scanner) because to me, it’s the base.  If you want to do Invisalign, in my mind, you must have a digital scanner. It’s ridiculous to not be using this technology in 2016. To me, it’s like a smart phone. You could use your old rotary phone, but why would you?

I’m afraid of coming across as too enthusiastic in my praise, but it really is amazing. It’s faster. It’s easier. Patients are impressed. It saves us time, it saves us money. It allows me to give my patients a better experience when they’re in the office, and to do a better job for them from a clinical standpoint. I’m so happy I got the digital impression system; it’s a very good investment.


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