Why the Eltz Institut?

The Eltz Institut is the right partner for complex misalignments of the teeth and jaws for three reasons. We combine (1) expertise with (2) state-of-the-art technology through (3) precise processes – and in this way create medical magic that sets standards worldwide.

Expertise counts

With complex malocclusions, experience matters more than ever. Our medical team has specialised in combined orthodontic and surgical treatment (orthognathic surgery) for many years. Together with the world's best surgeons, we carry out research into new methods in this field. We treat around 100 cases every year. In case you are wondering whether that is a lot or a little: it is the number that many other orthodontists treat in their entire career.

In doing so, we work with the best oral and maxillofacial surgeons in the country. Close coordination is essential here. During treatment, we therefore make sure that both the oral and maxillofacial surgeon and the orthodontist know the essential aspects of the diagnosis and treatment. They must also be in complete agreement about the proposed treatment and how it is to be carried out, so that the patient has full confidence in the treatment at all times.

Unique processes

With five process steps, we set the standard in combined orthodontic and surgical treatment:

• 5D diagnostics: "Planning makes perfect", as the saying goes. The orthodontist and the oral and maxillofacial surgeon therefore need to gain a precise overview of the initial situation before they treat the teeth and jaws. We are particularly thorough here and have developed our 5D diagnostics. The five dimensions of our diagnostics are: digital 3D cone beam CT, digital scan, digital panoramic X-ray, digital cephalometric X-ray, digital extraoral and intraoral facial photos.
• Software: Only a few centres in Europe are technically able to carry out the next steps. We import the data sets created during diagnostics into special software (Dolphin) and combine them. Specifically, we integrate the 3D scan of the teeth into the three-dimensional image of the jaws from the 3D CBCT and then “drape” the patient's photo over this digital bone structure. Teeth (3D scan), bone (3D CBCT) and skin (photos) are now precisely combined in a single data cube. 
• Virtual surgery: Now the orthodontist simulates the orthodontic treatment and the surgeon operates on the patient virtually. We can marvel at the results and discuss them directly with our patients.
• 3D printing: Based on this virtual operation, we use our modern 3D printers to print exact splints of the final result of the operation. Splints are a kind of template or dental splint that is placed in the patient's mouth during the operation. They enable the surgeons to achieve the planned position of the jaw as precisely as possible.
• Digital wires: In addition, based on the planned result, we produce exact robot-bent wires that are fitted at the patient's first orthodontic appointment after the procedure.

Technology

For combined orthodontic and surgical treatment to lead to the best possible dream smile with the highest possible level of safety, certain technological foundations are necessary. This is where the Eltz Institut is leading the way in Europe.

"Planning makes perfect", as the saying goes. And it is no different with combined orthodontic and surgical treatment. You therefore need to gain a good overview of the initial situation before correcting teeth and jaws – and then be able to translate this planning into reality:

• 3D cone beam CT
• Digital scan
• Digital panoramic X-ray
• Digital cephalometric X-ray
• Digital extraoral and intraoral facial photos
• 3D printing
• Special high-tech software for combined orthodontic and surgical treatment

3D cone beam CT scanner

With the help of a 3D cone beam CT scanner, the final position of your tooth roots in the bone can be planned three-dimensionally for the first time, which means that damage to the periodontium can be avoided.

Incidentally, as one of the first orthodontic centres in Europe, this device also enables us to simulate operations in advance and show the changes to the face. Especially in combination with jaw surgery, this allows us to achieve a depth of diagnostic planning that is unique.

Digital panoramic X-ray

On the one hand, the panoramic X-ray helps us to assess your teeth and tooth roots, your jaw joints, your sinuses and the general condition of your bones, as well as how your teeth are positioned in the jaw.

On the other hand, the X-ray also gives us clues about possible difficulties in your treatment: is there perhaps a tooth hidden in the jaw that has not yet erupted (i.e. is not yet visible) and therefore has to be removed before teeth are moved into that space? Are there abscesses, cysts or tumours (rare, of course, but this has to be checked too)? Are there teeth that we must not move under any circumstances, such as implants, bridges or baby teeth? Do we see any risks for your tooth roots, which might not survive treatment?

This information already gives us another good basis for planning your treatment. But we still need considerably more information – such as the cephalometric X-ray.

Digital cephalometric X-ray

When your teeth are moved through the bone with orthodontic treatment and shifted into a new position, we need to know in advance how your teeth are anchored in the bone. Your teeth may only be moved to where there is a healthy periodontium and, above all, sufficient bone. After all, even after your braces, your teeth should once again be securely surrounded by bone in order to prevent receding gums and to ensure that you keep your teeth in the long term. 

We use the second X-ray, the so-called lateral cephalometric X-ray (FRS) for this.

Using this two-dimensional X-ray taken from the side, we assess how your jaws are positioned in relation to each other and how your front teeth sit in the bone when viewed from the side. This allows us to estimate how thick the layer of bone is around your incisors, for example. We also work out in which direction your teeth may – or, above all, may not – be moved. We must absolutely avoid moving your teeth outside the safe jawbone. Otherwise, your gums could recede, your periodontium could be damaged and, in the worst case, you could even lose some of your teeth.

Digital intraoral and extraoral facial photos

Photographs of your face (extraoral photos) help us to plan your treatment. While the photo taken from the side provides information about your profile, your lip closure, your lip position and your facial type, the frontal photo is used to examine disproportions and shifts in symmetry. In other words: we look at the actual reason why your smile is not yet Hollywood-ready. To make teeth end at the same level, for example, we can move some teeth upwards – or others downwards. These are the decisions we have to make.

Photographs of the inside of the mouth (intraoral photos) are used, on the other hand, to document the initial situation and later show you the progress of your treatment.

Any questions?

Thanks to our many years of know-how and our network, our technical equipment and our modern processes, the Eltz Institut is regarded as one of the world's leading points of contact for complex malocclusions. We will be happy to provide further information and to see you for a consultation.