The patient goal of shortening orthodontic treatment time is not new. It has only been in the last several years that orthodontists have had practical, cost-efficient options to meet this long-held patient desire. I view offering accelerated treatment as critical to the future success of my practice, particularly at a time when adult starts are outpacing slow growth in overall treatment starts.
I have tried several devices designed to accelerate treatment in my practice. When considering control, predictability, ability to be used with both braces and aligners, cost efficiency and case outcomes, I consider the gold standard to be Propel’s Excellerator drivers.
The Propel drivers are used to perform a procedure developed at NYU, called micro-osteoperforation (MOP) which stimulates the patient’s own biological inflammatory response resulting in faster bone remodeling and accelerated tooth movement.[1]
Micro-osteoperforation is typically applied once or twice during treatment, with each application consisting of multiple perforations as dictated by the dentition and treatment plan.
The procedure is performed chairside, and after a minimal learning curve, a single application takes literally minutes. Anesthesia can be administered via compound topical or local infiltration, with patients experiencing little to no discomfort and returning to normal activities immediately post appointment.
The results of this simple procedure are profound. My clear aligner patients are able to change trays in three to seven days, shortening treatment time considerably. The Propel Excellerator drivers work equally well with fixed appliances to unlock difficult, time-consuming movements, such as large space closures. Propel gets cases finished much faster than would otherwise be expected.
Adding power to ‘excelleration’
The heart of Propel’s technology is the patented tips, which are made from surgical stainless steel and have a unique thread pitch designed specifically for the MOP procedure. I had been getting great results with the Excellerator RT, which combines replaceable tips with a reusable driver.
Late last year, I had the opportunity to try the Excellerator PT (Power Tip), which marries Propel’s proprietary tip design with a specially configured cordless torque driver. During this pre-launch trial, I saw immediate advantages to this latest addition to the Excellerator Driver family.
The components of the Excellerator PT system include: a powered handpiece with charging station, a contra-angle head attachment and single-application tips.
The handpiece itself has a simple intuitive interface and digital display. It has clearly marked buttons for:
- Power (on/off)
- Torque
- RPM
- Forward/reverse
- Start/stop
The digital display indicates settings for when the device is in reverse mode, battery power, settings for torque (from 10 to 30 N-cm) and speed in RPM’s (low, med, high). It should be noted that the speed of the Excellerator PT handpiece is higher than that of other standard cordless torque drivers.
I always use the power driver offered by Propel at the highest RPM setting. Typical MOP applications involve multiple perforations, so that extra speed is very important for efficiency.
The driver itself is easy to operate, smooth, comfortable ergonomically speaking and quiet. The contra-angle attachment provides convenient full-mouth access. Performing MOP in the posterior regions is certainly facilitated by the contra-angle, which can be rotated for optimal orientation.
Another compelling argument for the Excellerator PT is that its smooth fluid operation provides increased patient comfort during the procedure. Once the gingiva is penetrated, the rotational speed gently draws the tip forward to create the perforation in the cortical plate eliminating the need for manual perpendicular force. While the device is very quiet, I have found that leaving suction running in the patient’s mouth further enhances the patient experience by completely covering the motor noise.
Based on my experience with the Excellerator PT, Propel is continuing to advance the gold standard in acceleration, by expanding clinician choices within its Excellerator Driver offering.
Note: This article was published in Ortho Tribune U.S. Edition, Vol. 11, No. 1, AAO Preview Edition 2016. A complete list of references is available from the publisher.
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I am an orthodontist who is interested in propel handpiece unit. What is the unit cost? Cost of a screw? Thank you.