Aim: To examine the efficiency and effectiveness of the SureSmile process using the standards of the American Board of Orthodontists Objective Grading System (ABO OGS). Methods: Three diplomates of the American Board of Orthodontics provided study casts of 62 patients whose orthodontic treatment was consecutively completed. Patients treated using the SureSmile process and a conventional approach were anonymized and randomized prior to independent scoring by two ABO OGS–calibrated examiners. Results: Intra- and interexaminer reliability was consistent in all components with no differences between examiners (r = 0.96, P < .001). The ABO OGS score for the SureSmile patients (mean 26.3) was 4.4 points lower (P < .001) than for those treated conventionally (mean 30.7). Furthermore, treatment with the SureSmile process was shorter (14.7 months vs 20.0 months). Conclusion: The SureSmile process results in a lower mean ABO OGS score and a reduced treatment time than conventional approaches. The approach has great potential to both decrease treatment time and improve quality. World J Orthod 2010;11:16–22.