Social media apps generally opened up new markets though of their existing user bases as sellers. Perhaps chatgpt could know everything in your house, if you don't actually use it, and pair you with a neighbor that needs it!
Yes. Not interacting with neighbors is something that can happen naturally, but working hard to not is an entirely different thing.
Knowing your neighbors is a good thing. Even if it's just a friendly hi. You don't have to hang out, but if there's ever something you need like "did I leave the sprinkler on" or "did I leave the stove on" or "borrow a cup of sugar", it helps being on speaking terms with a neighbor rather than your first interaction with them is because you need something.
Caveat being that you live next door to Epstein or similar where not knowing them will be beneficial when the police come asking questions.
So shouldn't this really be something that could be opened sourced. I think I've seen a few write ups of people that did their own, but seems like a highly functional implementation could be democratized.
It is definitely not that simple for a number of reasons.
Yes, aligners and retainers in theory may be printed on some commercially available hardware. At your own risk, because you will be printing a medical device and you will need:
1. A treatment plan: simulated movement of teeth at every step, taking into account all forces. That’s specialized software or external lab service.
2. Precision. You put too much pressure at the wrong angle and you will need a surgery to fix the damage, because the tooth root moved in wrong direction.
3. Plastic. You cannot use ordinary 3D printer ink. You need a plastic that can survive the chemical environment in your mouth, maintain the pressure, and you probably want it to look good (no discoloration etc).
4. Finish: Align Tech, Straumann etc do not stop after 3D printing, there are few other steps involved to make sure there’s no sharp edges etc.
5. Maybe you will need attachments (to focus pressure in the right direction on certain teeth) or wires.
Align Tech is Apple of clear aligners, but now competition exists, producing aligners at scale is commercially more efficient, considering all the risks and required qualifications, and of course the best materials for aligners are patented and not sold OTC to everyone.
Disclosure: I worked at Align 10 years ago and later was CTO of European DTC competitor.
How many of these risks and problems are exaggerated in scope and potential due to both a desire for a regulatory moat and a general fear of litigation in the medical space?
That is to say, how good is “good enough” when done at small-scale in developing nations or medically underserved communities?
1. There‘s always a reason or two for the treatment. The problems with bite may affect your health in various ways. There’s aesthetic component in it, sometimes even cultural preferences for how your teeth should look like. But let’s say patient cannot afford to care about final position when signing up for the treatment. They just trust the doctor saying they need it. Failure mode: patient is unhappy with outcome and will ruin your business from marketing perspective.
2. Let‘s say the practice does it in old way, with impressions - no intraoral scanner. The scanner of impressions still needed, but it can be cheaper. Someone needs to build it and achieve required accuracy (let’s say, 50 μm). Who? Why? Failure mode: bad scan leads to aligners not fitting your teeth from day 1. Oops.
3. Let‘s say someone builds a good OSS alternative to OrthoCAD (Who? Why?), so that orthodontist on site could build a treatment plan and export it into series of 3D models for printers. Failure mode: good treatment plans are rarely possible or output is garbage (aligners do not fit, cause pain etc)
4. Maybe some company develops good plastic or patent expires, so that it is possible to produce it in India, China or other inexpensive location with strong industrial base. That would be cool, otherwise: non-compliant plastic breaks in patient’s mouth, decomposes with patient ingesting some toxic chemicals or is simply not strong enough to move teeth in desired position, so you have problem with 2nd aligner.
5. Maybe you get to this point, but you still need a printer that can maintain the same precision in printing. And you need a good cutting and finishing process. Someone needs to build such device. Failure modes are similar to the mentioned above.
6. The ortho supervision sounds easy, but how many patients in developing countries do even have a possibility to see orthodontist? They are definitely not in position to treat themselves.
So, in this process, what is good enough exactly? Who and why would drive the costs down while building an on-site solution?
These kinds of things can slowly move your bone structure over time. After all, that is their entire point. You don't want to accidentally mess up your teeth and jaw even more.
This would be what I'd worry about. How many of us do any metrology on our printed artefacts? It's really easy to get a subtly warped print and without having some sort of calibration of the process I wouldn't want to make any accuracy claims whatsoever.
IIRC, yes. It’s been some time ago, I don’t know how manufacturing looks now. It’s different process compared to 3D printing at home. It doesn’t mean it should be different, it just has to maintain certain properties. I’m not chemical or bioengineer to go into detail of it :)
Yes just the safe to be in the mouth and for it to handle significant pressure from teeth biting changes this from simple 3D filliment to something much more involved during the design and regulatory processes.
I did Invisalign a few years ago. Manufacturing the retainers is surely only a small part of the puzzle.
They used a specialized sort of 3D camera on a stick to get an incredibly accurate model of my mouth, any open source solution would need an equivalent. And you’d also need open source code from somewhere to work out which teeth need to move where and at what stage in the treatment.
While both were originally companies based in Israel, the technology behind the Kinect is different.
iTero scanners (owned by Align Technology) use parallel confocal imaging via red light lasers. Their newer models also use Multi-Direct Capture techniques.
Kinect used a Light Coding technique, an infrared projector and camera. It was developed by a company called PrimeSense, which was later purchased by Apple.
They also use this camera system when creating implants. After the implant post was installed, they scan your mouth to determine the optimum shape for your crown (that goes on the post).
Even with just regular crowns. I've had a few root canals as I've gotten older. They scanned the old tooth, brought into 3d modelling software, modified it for purpose, checked it's resulting fit against neighboring teeth, and then sent it to a mill right in the office and had it glued into my head in less than a hour.
My doctor knows I'm into this so he always does it right next to me and turns the PC monitor so I can watch the entire process. The software is so simple almost anyone could use it. Generating a medically correct result is obviously where all the skill lies.
Dry heaving would have been great. I would regularly vomit from impressions. My orthodontist would just prepare two sets if impression trays, cause the first one was going to go in the medical waste bin.
Impressions for invisilign (when I did it, about a million years ago) weren't so bad though. Unfortunately invisilign resulted in an open bite for my molars, which I really should go back to an orthodontist to address, but I'd rather not.
Sure, but it's a more or less a formulaic process. There's not on the fly decision making or emergency responses like in orthopaedic surgery or any other surgical design. You make a mold or scan of teeth. Calculate the adjustments, make the retainer, repeat. With a more widely available tooling the process could be even more monitored. i.e. Bi-weekly instead of monthly molds for faster and more precise results.
>The difficult part is not the manufacturing, but knowing how to do it properly so you don’t harm the patient.
And yet I read plenty of horror stories of bad orthodontic results. Ask me how I know.
Went to 3 different orthodontist to fix what a bad orthodontist did to me when I was a kid, and each gave me a completely different treatment plan. I feel like being an orthodontist is just eyeballing and patching your way as you go to an acceptable resolution.
Absolutely. I'm sure some high-IQ high-functioning autists like John Carmack or Palmer Luckey could fix their teeth at home with some alligners they 3d printed in their garage better than a sloppy orthodontist, but that obviously doesn't scale to gen-pop.
It's not even just 3d printing skill, but understanding the physiology of how the bone and teeth will restructure themselves over time to know the right amount of pressure to apply to encourage that remodeling, without so much pressure to cause damage - there is a huge amount of scientific research there! (That I'm sure some orthodontists probably pay more detailed attention to than others).
I don't doubt a high-IQ high functioning autist could self-teach this, but there's a ton of background there.
Certainly it's not impossible to DIY, but it's more difficult than just popping some aligners on your 3d printer.
Manufacturing them requires a resin printer and a vacuforming setup, but that's still the easy part. It's a whole system with a dental 3D scanner, software for rearranging your mouth, and attachment points that have to be epoxied onto (and later removed from) your teeth by a dentist.
They have to have at least 2 different materials as well. The temporary trays were much softer and I had almost ground through them in my sleep by the time I had to switch to the next one but the final set is much more robust.
A point I didn’t see sibling comments make is that the dentist often has to file between teeth for them to sit and align correctly. They did so several times in my case. I would not want to do that to myself!
It’s been tried, with some success. Pretty sure I’ve seen a post here on HN from someone that DIy’d it end to end.
But it’s also something that’s not responsible to shortcut. Shifting teeth around too fast can result in permanent root damage and even loss of teeth. There was a whole cottage industry in the US for a while focused on under cutting Invisalign with a reverse-engineered product, but they often moved on accelerated treatment timelines that caused a not-insignificant amount of harm to patients, and cut corners on intake (DIY at home mold kits) that also contributed to problems. Pretty sure all of the companies doing this are basically dead now.
Need expensive printers and you need CAD software that can correctly move the teeth. Also not all it can be done by software, sometimes you need to blank out certain teeth that dentist will make the call.
Yeah I have done similar evasive maneuvers a bunch of times. Also people run stop signs constantly, a competent defensively driving human may have just not started driving forward yet when they saw the other car driving towards the stop sign with some speed. I’m not sure of the exact timing in the story but I’ve waited at a stop sign when I saw another car driving towards the intersection many, many times, and a small percent of the time they don’t stop.
Which isn’t to say that the average driver wouldn’t have hit it, it’s just not obviously superhuman.
In this case, the other car didn't run the stop sign.
It waited at the stop sign like it was making a turn, then suddenly entered the intersection when the Waymo was 5-10 meters away, despite not having the right of way.
Maybe they were trying to commit suicide-by-Waymo?
Defer to an actual authority. Where is the official report on whether or not it was an interception? Even with a large explosion the fact that it landed in a wooded area implies it was intercepted. Those are targeted missiles, an acceptable result of an interception is to bring it down in an undeveloped area.
So I would think there should be some sort of authority with official capacity to state what happened, not just a random journalist that doesn't give concrete sources.
Iranians primarily use rockets, not missiles. It's perfectly possible, even likely, that said rocket just missed. If you read the article, the journalist did actually say he had a military source...
To be clear, it's not required to vote. It's required for a new registration to vote. Which is typically done when you get a new ID, which already requires having those documents, more even because you have to show proof of current residence.
In my state you can only get an ID mailed, and it has to be mailed to your primary residence. Except the mail doesn't go to many primary residences. The USPS straight up refuses to mine and gets real nasty if you ask them to, as they ask for made up paperwork requirements (certificate of occupancy) that isn't even issued for some houses in my county (this paper only needed if you want to follow certain increased scrutiny building options and plan on getting a mortgage, in my case there is no legal way for me to get one). Now if you're actually homeless you can use a shelter as a legal residence for your ID, but if you have a real legal residence USPS refuses to then you are shit out of luck.
A couple decades ago they used to print the ID then and there, IDs were far more accessible back then. For some god forsaken reason they stopped that most everywhere.
It's almost as if the insurance companies wrote those regulations. The same ones that required everyone to purchase their product and implemented government subsidies to pay them. Legitimately no way anything other than price increases and insurance profits could happen.
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