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Winning brackets

 Dr. Ching-Chang Ko and graduate student Christina Bonebreak Jackson are forming a company based on Jackson's work on 3-D printing in orthodontics.

With Dr. Ching-Chang Ko standing near her, Christina Jackson holds a 3-D printed orthodontic piece on her index finger.
Dr. Ching-Chang Ko and Christina Jackson show off a 3-D printed orthodontic piece.

When Dr. Ching-Chang Ko first saw Christina Bonebreak Jackson’s application to the UNC-Chapel Hill School of Dentistry, he knew he wanted someone with her unique background to learn orthodontics. After all, few of the other 230 applicants in the 2014 class had a bachelor’s of science degree in mechanical engineering from MIT.

Ko, the chairman of the department of orthodontics who has an engineering degree himself, knew the potential someone with that background could bring to orthodontics.

“We only accept six applicants, which means she is excellent,” he said. “Her background caught my eye. I have a doctoral degree in engineering, and very few orthodontists have that background. I felt that her background matched mine, so I have tried to mentor her.”

Ko suggested that 3-D metal printing in orthodontics might make a good subject for Jackson’s required first-year research projects. She took the idea and ran with it – so much so that the pair are forming their own company based on Jackson’s work.

“3-D metal printing is a relatively new technology and hasn’t been used to make orthodontic appliances and brackets,” Jackson said.  “We’ve taken the results of my thesis research on the accuracy of 3-D printing and we’re designing new orthodontic appliances which can only be made through 3-D printing, not with conventional manufacturing.”

THE PROCESS

Most orthodontic brackets are created by taking molds of the mouth, building the brackets to fit the teeth, and having the orthodontist make periodic adjustments to the brackets.

Jackson’s process significantly decreases the time to make brackets while increasing their accuracy. Instead of a mold of the patient’s teeth, Jackson takes a digital scan of the mouth and feeds the data into the 3-D printer. The new brackets are custom-fitted to the patient and don’t require regular adjustments.

“What it will hopefully mean is that you get a faster treatment because you have a custom bracket,” said Jackson, who earned her doctorate of dental medicine at Harvard University School of Dental Medicine before coming to Chapel Hill to get a second master’s degree and a certificate in orthodontics. “That would help you move your teeth in just the right way the first time and you wouldn’t need the orthodontic adjustments. Right now, orthodontists use a one-size-fits-all bracket and make adjustments to the wires to get them in the perfect position. In the custom bracket, all of that is taken care of in the bracket itself.”

Ko thinks patients could see cost savings with the process, since molds are not required to be made first. The 3-D process only takes a couple of days, compared to brackets made from molds, which usually take about two weeks to create.

Jackson said she was familiar with design software and techniques from her time at MIT, so the project was a natural fit. Since her parts were manufactured by firms in the Research Triangle, she would often go to watch their production to understand the process better.

“Because 3-D metal printing hadn’t really been studied in orthodontics before, we wanted to see what we were capable of making,” she said. “So, I designed my own system.”

Currently, the process is patent-pending and requires FDA approval. Once it clears those steps, Ko, Jackson and their respective spouses hope to form a company to create the new appliances. Because Ko plans to continue teaching, while Jackson will practice orthodontics and see patients, they are already reaching out to business incubators to assist in managing the company.

Jackson’s work received a lot of attention. She won the 2017 Charley Schultz Resident Scholar Award from the American Association of Orthodontists and her work is expected to be published soon.