Dr. Björn Ludwig
• Dr. Björn Ludwig, DMD, PhD Orthodontist and Researcher
• Private Orthodontic Practice, Traben-Trarbach, Germany
• Saarland University, Homburg/Saar, Germany Kyung Hee University, Seoul, Republic of Korea University of Gothenburg, Sweden Trinity College Dublin, Ireland
• Clinical and scientific focus: Digital Orthodontics, 3D Diagnostics, Skeletal Anchorage, CAD/CAM, 3D Printing and Direct-Printed Aligners
• Digital Orthodontics, Individualized Care and Shape Memory Aligners
1. The orthodontic market is rapidly evolving with digital workflows and advances in clear aligner therapy. From your clinical perspective, what do you see as the most significant trend shaping orthodontics today, and what role do technologies such as Shape Memory Aligners play in this evolution?
For me, digital orthodontics still starts with diagnosis.
Today we can understand our patients in much greater detail — increasingly in three dimensions where this additional information is clinically relevant. Teeth, roots, bone, skeletal relationships and anatomical boundaries can become part of one diagnostic environment.
And this is fundamental, because diagnosis must determine treatment — not the software, not the company, not the printer and not the material.
But after diagnosis, something equally exciting is happening: we can increasingly individualize the appliance itself.
With directly printed Shape Memory Aligners, we are no longer simply adapting a standardized plastic sheet over a model. We can modify the aligner itself — its thickness, geometry, trimline, pressure areas and additional biomechanical features — according to the clinical problem.
For me, this is the real evolution:
better diagnosis first, followed by a more individualized appliance.
The appliance should adapt to the patient — never the patient to the appliance.
2. Having worked with various clear aligner systems over many years, what has been the most meaningful clinical difference you have experienced with Shape Memory Aligners compared with conventional aligners?
The biggest difference for me is freedom.
Direct printing allows us to be much more creative.
We can individualize thickness, geometry, pressure areas and trimlines, but we can also integrate auxiliaries such as hooks, tubes, bite ramps, advancement elements or other biomechanical features into the appliance.
And I think we are still at the beginning of what is possible.
Instead of asking:
“What can I achieve with this standardized aligner?”
we can increasingly ask:
“What appliance would I like to create for this specific patient and this specific biomechanical problem?”
That is a completely different way of thinking.
Of course, greater freedom also means greater responsibility. Creativity without diagnosis and biomechanics is just technology.
But for me, being able to let our clinical creativity enter the digital design of the appliance is one of the most exciting aspects of direct printing.
3. As an orthodontist treating patients on a daily basis, what practical improvements have you observed when using SMA in terms of treatment predictability, clinical efficiency, or chair time?
For me, one of the biggest advantages is immediacy.
I sometimes call it an instant aligner concept.
We can scan the patient, reassess the clinical situation, modify the setup, design the appliance and manufacture exactly what we need.
This becomes particularly valuable when something does not develop according to the original digital plan.
Instead of continuing with many aligners that were designed weeks or months earlier, we can rescan, rethink and react immediately.
That is very close to how I want to practice orthodontics:
patient-centered, customized and adaptive.
I would be cautious about promising that SMA automatically makes every movement more predictable or eliminates refinements. The clinical evidence is promising, but biology remains biology.
For me, the real efficiency is not simply saving chair time.
It is reducing the distance between seeing a clinical problem and being able to react to it.
4. From your experience, what aspects of new orthodontic technologies matter most to patients? In particular, what benefits have you observed that SMA can provide in terms of comfort, treatment experience, and patient satisfaction?
I think what patients want most is honesty.
They want to know what we recommend, why we recommend it, what the alternatives are, and also where the limitations of our knowledge are.
Patients are usually much less impressed by the name of a printer, software or material than we are.
What I find encouraging about Shape Memory Aligners is that scientific research has developed unusually quickly alongside the technology. Within a relatively short period, we have seen research on material behavior, force delivery, shape memory, accuracy, aging, biocompatibility and increasingly clinical outcomes.
That does not mean all questions are answered. They are not.
And we also have to acknowledge findings concerning surface aging, manufacturing variability and other material-related questions.
But I strongly prefer a technology where innovation and critical scientific evaluation develop simultaneously.
Patients deserve new possibilities.
They also deserve honesty about the evidence behind them.
5. Looking ahead over the next five to ten years, how do you expect orthodontics to evolve with AI, digital workflows, and new material technologies? What role do you believe technologies such as SMA will play in that future?
Everybody is talking about AI and 3D printing, and of course both will become major parts of orthodontics.
But I believe two other developments will become just as important:
individualized patient care and authenticity.
Digitalization should not make every treatment more standardized. Ideally, it should allow us to become more individual.
We will have better diagnostics, more AI-supported analysis, better monitoring and increasingly patient-specific appliances.
I therefore believe appliances such as directly printed Shape Memory Aligners are part of a much larger development toward individual appliance design.
The future may not be one aligner system, one bracket system or one appliance.
We will probably combine aligners, fixed appliances, skeletal anchorage and digitally designed auxiliaries much more freely according to the individual biomechanical problem.
But technology cannot make the ethical decision for us.
AI can analyse. Software can simulate. A printer can manufacture. A material can deliver forces. But the orthodontist remains responsible for deciding what should actually be done to the patient.
That responsibility will become more important, not less.
“I strongly prefer a technology where innovation and critical scientific evaluation develop simultaneously.”
6. In your opinion, what factors are most important for an emerging orthodontic technology to achieve widespread clinical adoption worldwide? How important are clinical evidence and real-world treatment experience in that process?
For me, the two key words are evidence and responsibility.
A new technology needs reproducible manufacturing, biological safety, a manageable clinical workflow and independent clinical evidence.
Laboratory studies are important because they teach us about mechanical behavior, accuracy, force delivery and biocompatibility.
But ultimately, we have to know what happens in real patients.
We now have encouraging clinical data for directly printed aligners, including from our own work, but I still consider this a developing evidence base.
We need more prospective studies, more direct comparisons, longer observation and independent research.
At the same time, there is an ethical dimension that is very important to me.
Digital dentistry can easily become device-driven:
I have this scanner, so I scan. I have this printer, so I print. I have this aligner system, so I treat with aligners.
For me, the order must always be the opposite:
Diagnosis creates the indication.
The indication determines the biomechanics.
Only then do we choose the appliance and the material.
Innovation and skepticism are not opposites.
If we truly believe in a technology, we should also be willing to ask the difficult questions about it.
7. In your opinion as an orthodontist, in which types of cases or clinical situations does SMA demonstrate its greatest value?
At the moment, I particularly appreciate it where individualization, flexibility and rapid adaptation are important.
Finishing is an obvious example.
At the end of a complex treatment, we may only need a few highly specific movements. Producing a short, individually designed sequence can be much more logical than entering another large standardized treatment workflow.
The same is true for relapse cases, retreatments, limited corrections and hybrid treatments.
These are situations where I often do not need an entire system.
I need a specific appliance for a specific problem.
And if the clinical situation changes, I want to be able to change the appliance immediately.
That is where directly printed SMA becomes particularly attractive.
But again:
I do not want to find patients for an appliance. I want to find the right appliance for the patient.
8. Has your clinical approach changed after gaining experience with SMA? Could you share an example where it influenced your treatment planning?
Yes.
It has made me more comfortable thinking in shorter, adaptive treatment phases.
I may solve the difficult biomechanical part with skeletal anchorage or a fixed appliance and then finish with a small number of directly printed aligners.
Or I may rescan during treatment and manufacture only what the patient actually needs at that moment.
For me, that is a major advantage of an independent digital workflow.
We can plan carefully but still remain flexible.
A perfect digital simulation made at the beginning of treatment is still only a simulation. The biology has not happened yet.
I therefore increasingly like the principle:
Do not manufacture the entire future if the biology has not happened yet.
Direct printing makes this type of patient-centered adaptation much easier.
9. If you had to give orthodontists who have not yet tried SMA one reason to consider it, what would that be?
Independent, patient-centered customization.
That would be my one reason.
For me, the most exciting aspect is not simply that the material has shape-memory properties.
It is that direct printing allows the orthodontist to design the appliance around the individual patient.
Thickness, geometry, trimline, auxiliaries, staging and timing can all become part of the clinical concept.
And when the clinical situation changes, the appliance can change with it.
I would not tell colleagues to try SMA because it is automatically better, faster or more predictable than every conventional aligner. We need evidence before making statements like that.
I would tell them to try it because it provides another level of independence and freedom in appliance design.
And that summarizes my view of digital orthodontics quite well:
better diagnosis, individualized patient-centered treatment, more freedom in appliance design — but the clinical and ethical responsibility always remains with us.
10. Meet Graphy at DDS State of the Art Conference 2026
The conversation around the future of digital orthodontics continues at DDS State of the Art Conference 2026, taking place on October 16–17, 2026, in Antwerp, Belgium.
Graphy will participate in the conference, bringing its direct 3D printing technology and Shape Memory Aligner (SMA) to the global digital dentistry community. The event will provide an opportunity to explore how advances in digital workflows, material technology, and patient-centered appliance design are shaping the next generation of orthodontic treatment.
DDS State of the Art Conference 2026
Date: October 16–17, 2026
Location: Antwerp, Belgium
Discover the next evolution of digital orthodontics with Graphy and Shape Memory Aligner.