By Dr. Anthony Schiro, DDS, MS and Dr. Carly Schiro, DDS, MS, board-certified orthodontists at Ascend Orthodontics

Every spring the two of us close the office for a few days and head to the American Association of Orthodontists Annual Session. It is the largest orthodontic meeting in the world, and it is where the research that will shape how we treat our patients and where a lot of cutting edge ideas gets presented first. Between the two of us, this year's meeting added up to about 35 hours of coursework. Below is a summary that actually matters for families in Loveland, Fort Collins and Louisville.

In-house aligners keep getting better

We have designed and made Ascend Aligners in our own lab for a while now, and one of the sessions we both sat in on compared in-house aligner production with outsourced systems head to head. The short version: when the orthodontist controls the design and the printing, adjustments happen in days instead of weeks, and the reduced time can potentially reduce overall treatment time and result in a better outcome when there is an unexpected change during treatment. In another session we attended, which was built on the year's award-winning research paper on aligner biomechanics, we dug into why some tooth movements track exactly as planned and others don't. That is the kind of detail that shows up in how we stage your trays.

Expansion is not just for little kids anymore

A narrow upper jaw used to be something we could only correct with a palatal expander while a child was still growing. Several sessions this year covered miniscrew-anchored expansion, which you will hear called MARPE. It uses small temporary anchors in the palate so the bone itself widens, which opens the door for teens and adults who were told they missed their window. We also heard the latest research on how expansion relates to breathing and sleep in growing kids, which is one more reason we look at the whole face and airway at a first exam, not just the teeth.

Aligners can handle harder cases than they used to

Two of the courses we attended were specifically about clear aligner treatment in cases that need extractions or jaw surgery. Five years ago those were braces-only cases. They are not anymore, as long as the biomechanics are planned carefully before the first tray is made. That planning is where we spend our time, and it is why we are comfortable offering aligners to patients who were told elsewhere that aligners would not work for them.

Treating underbites and overbites without surgery, and when it is the right call

Both of us attended sessions on non-surgical approaches to Class II and Class III bites using temporary anchorage devices, the same small anchors used in MARPE. Dr. Anthony co-authored a paper on exactly this kind of mechanics, Biomechanics of Severe Open-Bite Treatment with Temporary Anchorage Devices, published in the Journal of Clinical Orthodontics in 2024, so this is familiar ground for us. The major takeaway from the lecture is that camouflage treatment works beautifully for some patients and is the wrong answer for others, and the difference is in the diagnosis. We will always tell you which one you are.

General Buzz

There was a lot of excitement at the meetings about artificial intelligence. We sat in on those sessions too. The useful takeaway right now is software can help us read 3D scans and simulate tooth movement faster, but it can't replace an experienced orthodontic team.

What this means for you

If you have been told your case needs surgery, that you are too old for expansion, or that aligners will not work for you, come in for a free consultation at any of our three offices. We're excited to share and continue to grow our knowledge base to give our patients in Fort Collins, Loveland, and Louisville CO the best possible care.