Ep 64 - Innovations in Clear Aligner Therapy with Dr. Maz Moshiri

Welcome to The Golden Age of Orthodontics, hosted by Dr. Leon Klempner and Amy Epstein. In today’s episode, we're thrilled to be joined by Dr. Maz Moshiri, a faculty member of Align Technology since 2013 and co-founder of the Aligner Intensive Fellowship. This online residency has helped nearly 5,000 orthodontists worldwide master the art of clear aligners. Dr. Maz dives deep into the future of orthodontics, sharing his insights on the latest innovations in aligner technology, the integration of AI and CBCT, and the critical role of balancing clear aligners with fixed appliances. He also provides a thoughtful discussion on Orthodontic Service Organizations (OSOs), weighing the pros and cons of joining one and highlighting the importance of choosing the right OSO for long-term success. Whether you're an industry veteran or a newcomer, this episode offers invaluable perspectives on staying ahead in the rapidly evolving world of orthodontics. Remember, there has never been a better time to be an orthodontist. 

IN THIS EPISODE: 

• (2:51) Amy introduces Dr. Maz Moshiri, and he discusses the current state of clear aligners and customized digital braces 

• (8:29) Dr. Maz shares his thoughts on AI and machine learning 

• (13:47) Dr. Maz discusses the integration of CBCT

• (15:44) Dr. Maz discusses how graduates are prepared to enter the field of orthodontics and how he determines whether to use clear aligners or exercise the option of fixed appliances in his practice

• (22:19) Dr. Max shares his insights on the future of the OSO model and the importance of choosing the right OSO if joining is your decision

KEY TAKEAWAYS: 

• Direct print aligners also allow you to vary the thickness of the aligner and defined areas, which changes the biomechanics and can increase stiffness. This is intriguing because it may make the aligners more effective clinically, potentially using fewer attachments.

• AI will not replace an orthodontist. For your patient to achieve the desired goals, you need the correct diagnosis and the doctor involved in tracking the progress.

• It is beneficial for an orthodontist to have several resources available to move teeth because one way does not fix all problems. Having options is also beneficial for a patient.

EPISODE TRANSCRIPT

What follows is an AI-generated transcript. The transcript may contain errors and is not a substitute for watching the video.

Dr. Leon Klempner: (00:00:00) So Amy and I have been doing this podcast for about four years now. And one of the perks of producing this podcast is getting to talk to the most productive and forward thinking or those in the industry. And today's no exception. We've got the ultimate aligner insider to share his insights and his thoughts about the future of ortho, the latest innovations in aligner technology, and pretty much anything you want to know.

So, uh, you don't want to miss this one. Stay tuned. Our golden age of orthodontics podcast sponsors make it possible. For us to bring you new episodes. Lightforce Orthodontics is revolutionizing orthodontic care with cutting edge custom bracket technology that offers personalized digital treatment plans that are fast, precise, and uniquely tailored to your patient's needs.

Take advantage of the new standard of care with 3D printed fully customized brackets combined with indirect bonding (00:01:00) and digital planning. You can learn a lot more and take advantage of some special offers by visiting our. Partner page at pplpractice. com. 

Narrator: The future of orthodontics is evolving and changing every day, but although the way to achieve practice growth has changed, there's never been a better time to be an orthodontist.

Let's get into the minds of industry leaders, forward thinking orthodontists and technology insiders to learn how they see the future of the orthodontic specialty. How will digital orthodontics, artificial intelligence, clear aligner therapy, remote monitoring, in house printing, and other innovations.

Change the way you practice. Join your host, Dr. Leon Klempner and Amy Epstein each month, as they bring you insights, tips, and guest interviews focused on helping you capitalize on the opportunities for practice growth. And now welcome to the golden age of orthodontics with the co founders of people and practice, Dr.

Leon Klempner and Amy Epstein. 

Dr. Leon Klempner: (00:02:00) Welcome to the golden age of orthodontics. I'm Leon Klempner, CEO of people in practice, a board certified retired orthodontist. I'm the director of ortho at Mount Sinai hospital here in New York, part time faculty in the graduate department at Harvard and the founder of an international nonprofit called the smile rescue fund for kids can learn more about that at smile, rescue fund.

org. And today as usual, I'm joined by my daughter and my partner, Amy Epstein. 

Amy Epstein: Yep. Amy Klempner Epstein. Um, I'm the COO of people in practice. I have an MBA in marketing and 20 years of marketing and public relations experience. And my dad and I joined up to provide the tried and true tenants of multinational brand marketing to the orthodontic industry and deployed obviously at a hyper local level.

Today, we're thrilled to have Dr. Maz Mushiri with us. Dr. Mushiri has been a faculty member at Align Technology since (00:03:00) 2013. If you don't know him, he is the co founder of the Aligner Intensive Fellowship, an online residency that has educated nearly 5, 000 orthodontists worldwide on the proper treatment planning and the proper use of clear aligners.

Currently, he serves as Clinical Assistant Professor in the Orthodontic Residency Program at the Center for Advanced Dental Education at St. Louis University with a focus on clear aligners. He also serves on the Clinical Advisory Board of Orthodontic Partners and as an Associate Editor for the Voice of an Expert column for the AJODO Clinical Companion.

Dr. Mashiri is a diplomat of the American Board of Orthodontics, as well as a fellow of the American College of Dentists, the International College of Dentists, and the Pierre Fauchard Academy. Dr. Mashiri, Maz, so nice to have you here. Thank you very much for joining us today. 

Mazyar Moshiri DMD, MS, FICD: It's a pleasure to be here. I appreciate you having me.

All right, 

Dr. Leon Klempner: Maz. So, um, (00:04:00) Let's start with the fact that we're no longer in the practice of your father's orthodontists orthodontic practice, right? Although you are in practice with your father, but, but in general, things have changed a lot over the years. Um, I'd like to just start with getting your feelings about the current state of clear aligners.

Uh, perhaps talk a little bit about, uh, the advent of customized digital braces, light force, for example, one of our, our, our podcast sponsors. So everything's moving digitally. Um, so tell me what, what your thoughts about, uh, where cleared aligners are. Will be, let's say five years, 10 years. What, what's the, what, what are your thoughts about it?

Mazyar Moshiri DMD, MS, FICD: So, you know, um, I've been in practice almost 20 years with my father. Um, and when I (00:05:00) joined him, we weren't doing any clear liners back then. Uh, all of our brackets were, you know, analog brackets, meaning that we had, uh, the same bracket went on every single patient. We had a full time lab technician that was making all of our appliances in house.

We were putting in separators, placing bands, taking impressions. You know, making everything solder, bringing the patient back in, the separators back in all these things that were in the name of providing patient care, but potentially there was a better way of doing it. And that generally is what happens with time and technology is that we make enhancements or improvements to the way we deliver treatment to our patients.

Clear liners was kind of our first foray into that, uh, for our practice. It was more of. We have a very high TMD patient population, and we treat them with removable splints to get them pain free first, and if they had an indication for detailing their occlusion, to then put those adult patients, primarily adult, into (00:06:00) braces was, uh, You know, possible.

We did a great job with it, but there seemed like it could be a better way if a clear liner could be effective in doing that. And that was our kind of our foray into that, if you will. But man, we made a lot of mistakes in the beginning and it was not going as predicted. And we had a lot of. Bumps and bruises in terms of learning how to use the appliance properly.

And then eventually got to where now we're very comfortable with it. And it's about 50 percent of what we do in our practice. Uh, 50 percent of our starts are clear liners and the rest would be, you know, fixed appliances or expanders or things of that nature. Um, As it pertains to clear aligners, for the longest time now, we, of course, have had stereolithic models where you suck down a piece of plastic on, you make that aligner through that manufacturing process.

Uh, but again, is that the most efficient way to make an aligner potentially, uh, with the advent of direct printing? I think that a lot of the companies we're seeing for A economic reasons is probably going to be better for (00:07:00) them not to have to make a stereolithic model and just throw it in the trash.

But if they can actually direct print the aligner, that's going to really help the economics of manufacturing for them. But at the day, is it in the best interest of the patient again? And that's the big question mark for me. I don't know that yet. But I do believe that all the material science will be invested in trying to get that to eventually get to where that's very feasible.

Uh, certain companies like graphy, for example, are showing shit memory with their aligners. And so that's very intriguing that if that's feasible, do you have to give as many trace to a patient to achieve the same amount of tooth movement, let's say. Uh, being able to direct print aligner also allows you to vary thickness of the aligner and defined areas, which changes the biomechanics and can increase stiffness in certain areas, which is again, very intriguing because that may make the aligners more effective clinically, uh, potentially using less attachments to some extent.

And so I think that's the future of clear aligners is, uh, potentially direct printing of the aligner and material science, changing the materials of (00:08:00) the aligners, because ultimately that's just, I can. Fixed appliances, Ni Ti, TMA, steel and steel, we use those at different phases of treatment for different reasons.

That may be the case now with clear aligners moving forward. So I think that's extremely exciting to kind of see the evolution of that. 

Amy Epstein: For sure. Do you see in terms, there's material science for sure, but do you see a role for AI and machine learning in advancing clear aligner therapy or in terms of treatment planning, for example?

Mazyar Moshiri DMD, MS, FICD: Um, I want to say yes, but I've I've been lecturing for almost 15 years on clear aligners and inevitably you will go and you'll go to an audience of doctors that will say the sky is falling because AI is going to take over the role of the orthodontist and Invisalign, for example, uh, is doing a lot of machine learning.

After we scan the data and this and the other. And I'm just going to be honest about it. I have not seen a change in the efficacy (00:09:00) of an aligner over the past 15 years. The doctor's not involved. The doctor, it all begins with diagnosis. And if you don't have the right diagnosis, you're not going to have the right outcome at the day.

And the points between A and Z is where the doctor is still has to be involved. And so, um, I don't think that AI can replace the doctor and I don't think an AI can diagnose your patient properly or achieve your treatment goals for what you need for that patient. For example, uh, there's so much nuance that goes into.

That's actually happening right in the beginning to have the final outcome that I just don't see that happening now that we're, I do see maybe, uh, facilitation is for potentially choosing the right type of attachments, the type of movement we desire. So maybe we set up the train plan, move the T31 to be built in over corrections that at times are needed, which is designing a force system with a digital plan.

To deliver that to the patient in an appropriate way and then having the attachments be automated in such a way that supports the movements better. Maybe that's something (00:10:00) I see improving with time. Uh, and that definitely has happened over time. Is it perfect? No, not even close. Uh, but it's getting better and better over time.

But not to a point where I think also you could submit a case and say, Oh, this is gonna come back. It's gonna be awesome. I'm gonna go to my patient. They have a great outcome. That's, I don't see that happening for a very, very long time, uh, unless it's somehow capable of sometime in the future that you can just repeat the pattern of how a doctor over time diagnosis repeatedly.

On a, on a high angle case on a class three case on a, on a deep like case. And there's a pattern there that can be repeated on how the doctor diagnosis, maybe if that can be learned somehow, but we're talking, I mean, my, in my estimate, that's like 20, 30, 40, 50, a hundred years from now, I don't see that being anywhere in my career of, of being something that I think I would take advantage of outside of the attachments, I think as an 

Dr. Leon Klempner: opinion.

So, you know, um, AI is, is, uh, (00:11:00) Fascinating topic to me. I've been doing a lot of reading about it and thinking about it and, uh, and one of the things that I hear, uh, from some of the orthos on some of the Facebook groups and some of the, you know, my personal discussions with some of them has to do with a fear of.

Large companies leading brand, for example, um, housing so much data that at some point in time that data could be utilized in a way that can, in the best scenario, help orthodontists in terms of. Choosing a treatment plan. For example, let's say you submit a treatment plan and you get back a, uh, we'll use Invisalign as an example, a ClinCheck.

And then there might be a ability to To push a button and (00:12:00) have the AI tell you that you, based on the data, you have a 75 percent chance of success. However, if you make these changes. You will have a 92 percent chance of success. Do you see that in the realm of, of possibilities moving down the road? 

Mazyar Moshiri DMD, MS, FICD: I think that there's so much that happens.

The answer is potentially, but I think there's so much that happens between the aligner delivery and the finish, uh, that data is not seen that, uh, facilitate what it actually takes to finish a case. So for example, it could be elastics could be an example of that, that we could predict that we're going to have rubber bands in this case.

And we would end up, maybe we don't use them, or we have other cases where we didn't predict we need a rug bands, but we ended up using them and we ended up modifying the tray to get the outcome we needed clinically. Um, and so there's still enough nuance between those (00:13:00) variables that I feel like anything like that, like guardrails or, you know, uh, you know, helping hands.

To help direct decisions may be useful, but end of the day, nothing replaces experience and from the doctor's perspective. Um, and so, you know, I know for like a new grad coming out where you just don't know at that point, you know, you don't have to be dangerous. You're still trying to figure everything out that maybe it would be useful for, uh, that type of a clinician to some extent, or somebody who.

As an experienced doctor would say that once all of a sudden they're doing aligners later in their career, maybe guide them in a certain direction, but on a day to day basis, I don't see that really, um, providing me much benefit, for example, uh, because I feel like my experience is what lends me the most benefit versus having those type of tools available to me at the, at the moment, at the moment.

The one thing that, as we're talking about this, that maybe could give better guidance potentially is integration of CBCT into these technologies, which is starting to happen. And I think the better and better that gets in terms of actually knowing, (00:14:00) because sometimes you see the roots go through the cortical bone and you're like, is that really happening?

Or can that even really happen? Because there's so much cortical bone resistance that what the software is predicting may not be a reality. But as that data aggregates over time, and potentially that gives us better guardrails as to actually not moving teeth where they shouldn't go. I think that will give us really a very powerful benefit long term in terms of seeing things we weren't seeing before, or that we were Lack of a better word, ignoring before, you know, and not understanding or kind of like, you know, uh, blind eye to it, uh, getting a good clinical outcome, but where were the roots at some point in the belt, you know, until you flap the patient, you don't really see it if they're symptomatic, you wouldn't know it, let's say.

So, 

Dr. Leon Klempner: yeah, you know, you mentioned, uh, new graduates coming out and, and, um, I was just curious because I know that. Um, that you, you are involved at the, in the residency program at SLU and, and I'm involved at Harvard and, (00:15:00) um, I'm, I'm interested in your, uh, perspective in terms of preparing our residents for the real world when, when they get out and.

Are you doing anything differently or, or how are you preparing residents to effectively use clear aligners because, you know, we all know the demand is there and, and the reality, uh, is that. They're going to need to be addressing this issue, but from an educational standpoint, um, what, what do you, what do you, what, what, what are you doing at SLU is I guess my question in terms of preparing residents.

Mazyar Moshiri DMD, MS, FICD: So my angle on that is I've always thought. That somebody could not be successful at clear liner therapy unless they were honestly successful using fixed appliances, because there is, uh, an analogous, (00:16:00) uh, comprehension or thought process that needs to occur with regards to not only diagnosis, because that's so important, uh, but also biomechanics to some extent as well.

Uh, for example, um, you know, going to the treat course. Uh, when I was a resident, it was one of the most important weeks of my life, uh, because of the understanding of, uh, forces that happens with tip back bends or anchorage control, vertical control, things of that nature that need to be applied to fix the appliances, but then also then apply.

Analogously to clear aligners as well and understanding people in opposite forces and designing attachments and so forth. Um, and so I really try to, when I teach clear aligners, go through the approach through a diagnostic process and a biomechanic process and not just talk about the bells and whistles of any system.

The bells and whistles don't matter. What matters is the actual fundamental diagnosis and the fundamental biomechanics. And if you understand those (00:17:00) things, you can manipulate almost any aligner system to do what you need to do and the bells and whistles will just hopefully make you a more efficient clinician to some extent because they hopefully help you to delegate certain things that you're having to think through or do on your own, uh, at some point in time.

Um, but, you know, for example, I use Invisalign, I'm a speaker for them and I get compensated as a speaker for them. But I also use ULAB in my office to make in house aligners. I get zero compensation from them. And to be further apart as far as I'm concerned in terms of like kind of what they offer in terms of tools, but I use them both because it's better for my patient.

And to be able to do that, though, takes an acumen. Of understanding diagnosis and, you know, uh, appropriate two minute attachments. And so that's really what I focus on with the residents is trying to go bare bones basics, but all sorts of diagnosis and all starts with really bottom mechanics. I try to draw analogies between fixed appliances all the time when I'm lecturing, saying like, I'm going to bend into reverse curvacy in the clincheck.

I don't expect that this is going to (00:18:00) look like this in the patient's mouth. I do this in fixed appliances in this situation. I'm doing it with the aligner in this situation. So I always try to go back and forth. Between fixed appliances and aligners, because I think that's how you really bridge the gap there from learning because it's not, I'm not in a miscellaneous, you know, I'm an orthodontist.

And so having the, uh, having the acumen to understand going through those different appliances, there's tools for us is very important and not to think that they can go and have a 99%. In business practice, you're going to be a great orthodontist, like you, you could do that potentially, but you're in some situations where you need braces, you know, so you're going to have to really understand how to go between both appliances and what you're using.

Dr. Leon Klempner: So, so just as a quick follow up at my own curiosity is that I don't know many people that have more experience. Using aligners and then you do or Jonathan does. Uh, so I'm curious, like what is your criteria for moving to fixed appliances? Like what, what is (00:19:00) your limit in terms of what you're going to treat with aligners, uh, before you, you consider using brackets?

Mazyar Moshiri DMD, MS, FICD: My main, um, kind of hurdle or handcuff, if you will, is, uh, the vertical dimension in terms of if I have a very brachycephalic deep bite patient. Okay. Where there's no growth remaining and minimal crowding, because if I don't have enough crowding, I can't proclaim the teeth to open the bite. I'm really depending on just pure intrusion to open the bite.

Uh, and those are really probably the most challenging cases for a clear liner to deal with. Uh, extraction cases that have minimal crowding can also be quite challenging because there's a significant amount of space closure involved, but there's minimal crowding. So like a Bimex protrusive type case. Um, again, that's probably a little bit easier than a deep bite patient.

I just gave you, but it's just, why would I want to do it is almost the question because I know it's going to take more time when I can do it with braces and get a, uh, potentially equal or better outcome in a less amount of time in that (00:20:00) extraction example. And what, why would I want to put a patient through that and just, you know, it burn them out because the aspect of clear line treatment, just like with fixed appliances, but probably more grinds to psychology.

How long is that patient into your treatment? How long do you have them engaged in your treatment? You know, I feel like it's going to take longer than 18 months with a clear aligner. Then I'm probably talking them into braces at that point. Because at that, you know, I have more control over the case, you know, and with.

Uh, braces, it potentially could take 18 months as well, or maybe a little bit longer, but I just feel like I'm not going to lose that patient as easily as psychologically with a clear liner. Torque is another one. If someone's like a class two diff too, again, they treat decently well potentially because that isn't really torque or proclination you're getting.

In terms of what you're seeing clinically, but it just takes a longer time to express. It can take up to two years again to treat that class to dip to type patient. And so what I rather just get it over with, with a fixed appliance for them. So that's really where that decision comes into play is (00:21:00) clinical quality of outcome, you know, efficacy of movement and treatment time are really kind of where I kind of draw the line there.

And it's mainly deep overbites, minimal crowding, extraction cases that have minimal crowding. Or, uh, patients with significant torque needs are the other type of cases where I try to steer 

Amy Epstein: away from. So, let me jump in and ask a non clinical question, because I'm the non clinical one here. Um, and it, you know, in your bio that, that we talked about in the beginning of the show, the, uh, orthodontic partners, you sit on their clinical advisory board.

So, let's talk a little bit about that. Um, What are your thoughts on how, um, OSOs and organizations like orthodontic partners are going to be impacting the future of orthodontics? And I say that knowing that, you know, we're seeing how it's impacting the future of orthodontics, but it's really, um, on the ground, at least with our clients.

We get sort of mixed feedback. It ebbs, it flows. You know, there's, (00:22:00) um, some that love the model and some that hate the model. And if you go to the AO and you listen to the lectures, there's some that love the model, some that hate the model. And, um, so I, and in terms of where you see from this point forward, I Um, O.

S. O. Is impacting the future of orthodontics. Talk to me about your perspective there. 

Mazyar Moshiri DMD, MS, FICD: I think it's very important that we look at it pragmatically and understand that there's no perfect solution, meaning that you're going to find people in private practice that love it. You're going to find people in private practice that also hate it.

And it's going to be the same with an OSO model. And that's just the way life is. I mean, there's not going to be anything that really is, you know, perfect, you know, unless it's like a bowl of like salted caramel Oreo ice cream. Maybe that's like perfect, but you know, as far as it goes and many things, there's gonna be pluses and minuses to it.

So, um, with the OSO model, what I'm seeing is for practicing myself, why did we choose to do that? We got to a scale in (00:23:00) terms of our practice got big enough. Where we were having problems managing our practice. And so I wanted to have outside help. I knew my dad was going to retire and he slowed down. I knew my sister was going to get pregnant, have children, which she has.

And that, you know, she has a growing family. So she was going to be here less. And I just needed help to run this business. And to have someone come buy it from me, I could have also done that, but to have a resident go out of school and take out an X million dollar loan and have a bank approve that when they have X hundred thousand dollars in debt is going to be less and less feasible.

Uh, and so for us, that was our solution to help manage and bridge that gap. Now I am bringing on an associate in January. Which I'm thrilled about, who's a kiddo and I call him a kid. He's almost 30 that I treated as my ABO board patient 15 years ago. Uh, and so he's come full circle to joining us now, but now I can have him on a pathway to partnership within the OSO.

That's much more (00:24:00) reasonable for him in terms of he can still have a buy in, but it's not X million dollars of, you know, low nannies take out. I can also grant equity. So he has equity in the business. And that's a model for him to be able to get into a practice, get his experience, and if he enjoys being or gotten willing that he wants to be an owner of this practice, meaning you have shares of the company, you can't.

In America, unless you own something, ultimately, you know, I think that's the, that's the disparity. What we see within OSOs is that you become a full time associate and some docs, you know, may want that, you know, you know, this new generation of doctors, they may want to work three days a week and not have the responsibilities ownership, and they may just want to get, you know, a 300, 000 salary, for example, uh, in.

Call it, call it a great day. Right. And not have to take any of the stress at home with them. Others may want more, you know, but are they going to want to take the risk of starting a business or buying a practice is that's really hard to do as well. And so there's a place for that for the new docs coming (00:25:00) out.

And so how that shapes things, my concern with the shaping of it, where I see the biggest issue, As if there's a doctor that is in their fifties or sixties that wants to use the OSO to hang it up, but they're not putting in the proper diligence to apprentice somebody to take over their practice and to carry on the quality of care.

And that's what concerns me the most. And so I think it's important that the group you join, if you decide to do that, if you're looking into that, and if it matters to you, which it should. Has a pathway for that to happen for a proper handoff and that. The groups out there aren't the type that are accepting people.

I want to go to the beach next year because that's where the clinical quality of care everything falls apart. And so, um, selfishly speaking, again, I'm part with our partners, but that's what drew me to their model is that it's younger doctors that join. If you look at some of the doctors, they're not in their sixties and seventies.

We're younger doctors that have like a 10, 15 year career ahead of us, at least (00:26:00) that we want to have a proper handoff and training of people. So for example, my associate coming in, that's what drew me to that model, uh, is to help me in my practice. But yet had a pathway for me to eventually transition down a responsible way is my name's on the door.

So it's mature orthodontics. It's my father's legacy. It means a lot to me that that's done in the right way. We have a good name in our community. I don't want that to fall to shambles, you know, so those things are already concerned about because, again, there's no perfect solution. I know there's. Good OSOs and there's going to be bad OSOs and obviously there's money involved.

And so that clouds things at all times. And so there has to be a good CEO on board as you get integrity, good values for the group. And that just takes a lot of trust and the ability to understand what you're getting into. 

Amy Epstein: Yep. Well, that all makes sense. And as we learn more and more about the OSOs out there and the different needs of the our client base has are going through transitions all the time.

And so it's good to have that perspective and be able to pass (00:27:00) it along to our clients. 

Mazyar Moshiri DMD, MS, FICD: Yeah. My, my, my biggest concern is that patient based on what happens longterm and that hopefully the doctors doesn't want to hang it up. I think that's where I get concerned about the whole model. 

Amy Epstein: Yeah. Yeah. The institutional knowledge goes away and then, then what, so, 

Mazyar Moshiri DMD, MS, FICD: uh, 

Amy Epstein: it has been a pleasure talking to you, Maz.

Thank you so much for joining us today. If our listeners would like to learn more about what you do, learn more about the aligner intensive fellowship or, um, orthodontic partners or anything, how might they be able to get in touch with you? 

Mazyar Moshiri DMD, MS, FICD: So, uh, my email address is Moshiri Maaz, M O S H I R I M A Z at gmail.

com. That's my personal email address. And I welcome people to always email me personally. I'm, uh, I, I'm neurotic on my email. I tend to keep 20 in my box at all times. If it gets more than that, I get frantic about it. 

Amy Epstein: Ooh, my inbox would make you go crazy. My inbox would, Would send you (00:28:00) to an asylum. 

Mazyar Moshiri DMD, MS, FICD: It's a good and a bad thing.

My wife is on it. I was like, I can't put things to rest. I have to take care of them and put them or like categorize them to a different folder. But 

Amy Epstein: yes,

that's the advice. That's the best practice. That is the way to do it. It's not easy. I'll 

Mazyar Moshiri DMD, MS, FICD: tell you. But no, I appreciate the opportunity to be honored to meet you both, uh, via this format and of course, you know, some of the meetings upcoming. So thank you. 

Amy Epstein: Sounds good. 

Mazyar Moshiri DMD, MS, FICD: Thanks a lot. I appreciate it. Thank you.

Amy Epstein: You can subscribe or download other episodes of the Golden Age of Orthodontics on Apple Podcasts. Spotify, SoundCloud, YouTube. If you want to see us or wherever you get your podcasts and if you enjoyed it, we'd appreciate you telling a colleague for more information about people in practice, you can visit our website at pplpractice.

com. 

Dr. Leon Klempner: And if you'd like to reach me, you reach me at. (00:29:00) Leon at PPL practice. com. Um, I have, uh, gone through my inbox and try to keep it tight. I use a, an app called, uh, so called same box, same box, same box, which, which is, is useful, but anyway, um, if you're looking for, um, a deal on customized brackets, Uh, Lightforce is sponsoring this podcast and you can go to our partner page at pplpractice.

com for more information there. Um, if you want to learn more about aligners, you got to contact Moz. I don't think there's anybody more suitable to help you along that path. And remember that for forward thinking orthodontists, it really has never been a better time to be an orthodontist. We're in the golden age, take advantage of it.

So long for now.

Narrator: Thank you for (00:30:00) tuning in to the Golden Age of Orthodontics. Subscribe now on Apple Podcasts, Spotify, or visit our website at thegoldenageoforthodontics. com for direct links to both the audio and video versions of this episode.