What Is SureSmile?
SureSmile is a digital orthodontic system that combines 3D imaging with robotic wire-bending technology to create custom archwires for braces. The archwire is the metal wire that threads through your brackets and applies the force that moves your teeth. In conventional orthodontics, your orthodontist bends this wire by hand using pliers. SureSmile replaces that manual step with a robot that bends the wire according to a computer-generated plan.
The system was developed by OraMetrix (now part of Dentsply Sirona) and has been used in orthodontic practices since the early 2000s. It is designed to fit into the workflow of the orthodontics page treatments that use fixed brackets, whether metal or ceramic. The goal is to improve the accuracy of wire shapes so that each bend delivers a more predictable force to each tooth.
SureSmile does not replace the orthodontist. Your specialist still diagnoses your bite problem, plans your treatment, and monitors your progress. The technology serves as a tool that helps the orthodontist execute that plan with a higher level of geometric precision than hand-bending typically allows.
How SureSmile Works
SureSmile relies on three connected technologies: 3D scanning, digital treatment planning software, and a robotic wire-bending machine.
3D Scanning and Digital Modeling
The process starts with a detailed 3D scan of your teeth, gums, and jaw. This scan may come from an intraoral scanner (a small wand placed inside your mouth) or from a cone beam computed tomography (CBCT) scan, which is a type of 3D X-ray. The scanner captures thousands of data points and builds a precise digital model of your mouth.
This digital model shows the exact position, angle, and rotation of every tooth. It also maps the surfaces of your brackets after they are placed. The result is a virtual replica of your mouth that the software uses to plan each stage of tooth movement.
Digital Treatment Planning
Your orthodontist uses the SureSmile software to set the final target position for each tooth. The software then calculates the wire shapes needed to move teeth from their current positions to those targets. Your orthodontist reviews and adjusts this plan on screen before any wire is manufactured.
This planning step is interactive. The orthodontist can rotate the 3D model, check the bite from multiple angles, and modify individual tooth positions. Once the plan is approved, the prescription is sent electronically to a manufacturing facility.
Robotic Wire Bending
At the manufacturing site, a robot bends the archwire according to the digital prescription. The robot works in three dimensions, placing bends at exact locations along the wire with sub-millimeter precision. Traditional hand-bending relies on the orthodontist's skill and visual judgment, which introduces some variability. The robot removes much of that variability.
The finished wire is shipped to your orthodontist's office, typically within a few days. Your orthodontist then places the wire into your brackets at your next appointment. Because the wire is pre-shaped for your specific anatomy, fewer in-office adjustments may be needed over the course of treatment.
Clinical Applications
SureSmile robot-bent wires are used in several types of orthodontic treatment involving fixed brackets.
Crowding and Spacing
Crowding occurs when teeth overlap because the jaw does not have enough room. Spacing is the opposite, with gaps between teeth. SureSmile wires can be programmed to deliver specific forces to individual teeth, which may help align crowded or spaced teeth in a controlled sequence. The digital plan allows the orthodontist to prioritize which teeth move first and in what direction.
For mild to moderate crowding, SureSmile treatment typically follows a similar timeline to conventional braces. In more complex cases, the precision of the wire bends may help reduce the number of wire changes needed throughout treatment.
Bite Correction (Malocclusion)
Malocclusion means the upper and lower teeth do not fit together properly. Common types include overbite, underbite, crossbite, and open bite. SureSmile can be used as part of treatment for these conditions because the wire shapes can account for vertical, horizontal, and rotational tooth movements simultaneously. [1]
Complex bite cases often require additional tools such as elastics (rubber bands), temporary anchorage devices, or even jaw surgery. SureSmile wires work alongside these tools. The technology does not replace them but may improve the efficiency of the wire-driven portion of treatment.
Lingual Braces
Lingual braces are brackets placed on the inside (tongue side) of the teeth. Bending lingual wires by hand is especially difficult because the wire shapes are more complex and the working space is smaller. SureSmile's robotic bending is particularly useful here, since the robot can place precise bends that would be very challenging to reproduce manually.
Patients who choose lingual braces for cosmetic reasons may benefit from the consistency that SureSmile brings to this technically demanding approach.
Evidence and Effectiveness
SureSmile has FDA clearance as a Class II medical device, meaning the FDA has reviewed it and determined it is safe and effective for its intended orthodontic use. FDA clearance is different from FDA approval. Clearance typically applies to devices that are similar to ones already on the market, while approval involves a more extensive review process usually reserved for higher-risk devices.
Published research on SureSmile shows generally positive findings regarding treatment efficiency, though the evidence base has limitations. Several studies have compared SureSmile treatment times to conventional orthodontics. These studies typically report modest reductions in treatment duration, often in the range of a few months. However, many of these studies are retrospective (looking back at past records rather than following patients in real time), which limits the strength of the conclusions.
Digital technology, including robotic wire bending, is part of the evolving landscape of orthodontic care. Many orthodontists now use digital tools to improve precision and efficiency. Patients are encouraged to discuss available technologies with their orthodontist to determine what fits their specific case.
It is worth noting that no large-scale randomized controlled trials have compared SureSmile directly to conventional hand-bent wires across diverse patient populations. The existing evidence suggests potential benefits, but more rigorous research would strengthen the conclusions. Patients should understand that the technology is well-established in clinical use, even as the academic evidence continues to develop.
Benefits and Limitations
Like any orthodontic technology, SureSmile has clear strengths and some limitations worth understanding before you begin treatment.
Advantages
The main advantage is precision. A robot can place bends at exact locations along the wire, reducing the variability that comes with hand-bending. This may lead to more predictable tooth movement, especially for complex cases with teeth that need to rotate or move in multiple directions at once.
Digital treatment planning gives the orthodontist a detailed preview of the expected outcome. Both provider and patient can review the plan before any physical wire is made. This level of visualization is widely considered to improve communication and help set realistic expectations.
Some orthodontists report that SureSmile cases require fewer wire changes and fewer adjustment appointments. For patients with busy schedules, fewer office visits can be a meaningful practical benefit. Fewer adjustments may also mean less cumulative chair time over the course of treatment.
- Sub-millimeter wire-bending accuracy reduces human variability
- 3D treatment planning allows both patient and provider to preview expected results
- Fewer wire changes may mean fewer office visits in some cases
- Compatible with metal, ceramic, and lingual bracket systems
Limitations
SureSmile does not work with clear aligner therapy. It is designed specifically for fixed bracket systems. Patients who prefer aligners would need to consider a different digital system, such as Invisalign or a competing aligner product.
The technology adds steps to the workflow. The orthodontist must take a 3D scan, use the planning software, and wait for the wire to be manufactured and shipped. In straightforward cases, some orthodontists may find that hand-bending a wire in the office is faster and equally effective.
Cost can be higher than conventional braces because the digital scanning, software licensing, and robotic manufacturing add expenses. Whether the potential time savings justify the added cost depends on the individual case. Not every orthodontic practice has invested in SureSmile, so availability varies by region.
Finally, the technology is only as good as the treatment plan behind it. A poorly designed plan will produce a precisely bent but incorrectly shaped wire. The orthodontist's diagnostic skill and clinical judgment remain the most important factors in treatment success.
- Not compatible with clear aligner treatment
- Manufacturing and shipping time adds a delay between appointments
- Higher cost compared to conventional hand-bent wires in many practices
- Limited availability; not all orthodontic offices offer SureSmile
Cost and Availability
SureSmile treatment typically costs between $4,000 and $8,000, though costs vary by location, provider, and case complexity. This range generally falls slightly above the cost of conventional metal braces, which often range from $3,000 to $7,000. The difference reflects the added expense of 3D scanning, digital planning software, and robotic wire fabrication.
Dental insurance policies that cover orthodontic treatment usually cover SureSmile at the same level as conventional braces, since the brackets and overall treatment category are the same. However, coverage varies widely between plans. Check with your insurance carrier to confirm your specific benefits, including any lifetime orthodontic maximum. [2]
Many orthodontic practices offer payment plans that spread the cost over the length of treatment. Ask your provider about financing options during your initial consultation. Some practices also accept health savings accounts (HSAs) or flexible spending accounts (FSAs), which allow you to pay with pre-tax dollars.
Availability depends on whether your local orthodontist has purchased the SureSmile system and received training on its software. Not every practice offers this option. If you are interested in robot-bent wires, call ahead or check the practice's website before scheduling a consultation.
What to Ask Your Orthodontist
Asking the right questions helps you understand whether SureSmile is a good fit for your case. Below are questions to bring to your consultation.
Start by asking whether your orthodontist offers SureSmile and how many cases they have treated with the system. Experience with the planning software matters, because the quality of the digital treatment plan directly affects the quality of the wire. Ask whether your specific type of bite problem is well-suited to robot-bent wires or whether conventional wires would work equally well.
Ask to see the 3D treatment plan before you commit. A good orthodontist will walk you through the digital simulation, showing you where your teeth are now and where they are expected to end up. This is also a good time to ask about the estimated number of wire changes and office visits.
Finally, ask about total cost, what is included in that fee, and how SureSmile pricing compares to conventional braces at that same practice. Understanding the cost difference helps you weigh the potential benefits against your budget.
- How many SureSmile cases have you completed?
- Is my specific bite problem a good candidate for robot-bent wires?
- Can I review the 3D treatment plan before starting?
- How many appointments will I need compared to conventional braces?
- What is the total cost, and how does it compare to your conventional braces fee?
- Does your office offer payment plans or accept HSA/FSA funds?
Find an Orthodontist Near You
If you are considering SureSmile or other advanced orthodontic technology, the first step is a consultation with a qualified orthodontist. An orthodontist can evaluate your teeth and bite, explain which treatment options fit your case, and help you decide whether digital wire bending adds value for your situation. Visit the orthodontics page to search for an orthodontist in your area and schedule a consultation.
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