Now offering Reliance Orthodontics engager merchandise

We’re happy to announce a new addition to our online store! Reliance Orthodontics engager merchandise: Flow Tain flowable paste, L.C.R. composite paste, Assure Universal Bonding Resin and Assure PLUS All Surface Bonding Resin.

These items are recommended for use when placing engagers. You can pre-order these new items and save 10%. Enter promo code: RELIANCE when ordering. The pre-order 10% off discount is for the new Reliance Orthodontics merchandise only and is only available until May 26th.

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Here is the selection of new engager merchandise you can choose from:

Flow Tain

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Flow Tain is a flowable light cure composite used when filling engager voids. This material is very smooth when cured which will reduce wear and enhance patient comfort.  When cured, it has a low modulus of elasticity and is not as brittle as conventional composites. Even though Flow Tain is a flowable material, its time-dependent shear thinning properties prevent it from slumping for better control.

Using the 1.5g 19 gauge tips provided, this material is easily injected into lingual surfaces and across fiber splints.

We’re offering this great product for $15.00 with an additional 10% off with the promo code.

Flow Tain LV

Flow Tain LV is the same product as Flow Tain mentioned above, with a smaller 22 gauge tip.

We’re offering this great product for $15.00 with an additional 10% off with the promo code.

L.C.R.™ (Light Cure Retain) Composite paste

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L.C.R.™ is a flowable, light cure orthodontic paste-type composite, also used for filling engager voids. This 5gm syringe of highly filled light cure resin paste is great for when longevity and durability is required.

We’re offering this great product for $17.00 with an additional 10% off with the promo code.

Assure Universal Bonding Resin

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This bonding resin will increase adhesion to normal, atypical, dry or slightly contaminated enamel. This universal bonding agent bonds to metal restorations without additional primers. No drying or light curing required and it can be used with any light or chemical cure system. Assure Universal Bonding Resin is an Enhance Adhesion Booster and bonding resin in one step!

It will bond to the following surfaces without additional primers:

  • Fluorosed
  • Deciduous
  • Bleached or wet enamel
  • Dentin
  • Metal surfaces
  • Composite restorations

We’re offering this 2ml bottle for $33.00 with an additional 10% off with the promo code.

Assure PLUS All Surface Bonding Resin

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The difference between Assure and Assure PLUS is that if you're using Assure, you must use and apply a porcelain etch and porcelain conditioner first, before applying the Assure. There is no porcelain etch step if Assure PLUS is used.

Assure PLUS will increase adhesion to normal, atypical, dry or slightly contaminated enamel and zirconia and acrylic temps without additional primers. This universal bonding agent bonds to metal restorations and porcelain without hydrofluoric acid. It can be used with any light or chemical cure system.

Assure Plus All Surface Bonding Resin will bond to the following surfaces:

  • Fluorosed
  • Deciduous
  • Bleached or wet normal and atypical enamel
  • Dentin/Cementum
  • Gold, Amalgam, Stainless Steel
  • Composite restorations
  • Acrylic temporary/pontic teeth
  • Porcelain

We’re offering this 2ml bottle for $48.00 with an additional 10% off with the promo code.

These new engager items are being offered at these discounted prices for a limited time. Take advantage of these great pre-order prices as they will only be available until May 26th.

Click to pre-order!  

Estimated shipment - May 26th 

Providers talk engagers

In a recent survey, we asked some of our providers to share their tips & tricks for placing and removing engagers.

Nothing here should be taken as official advice or recommendation from ClearCorrect or its employees. It’s up to you to use your professional judgement on what is best for you and your patients.

As the clinician it is important for you to be aware of different approaches, so that you can customize treatment for each patient. By way of example, while it may be possible to place engagers all at once in one patient, it may be necessary to cut the engager template and place engagers separately for another patient. Another example is the availability of various composite resins. Some patients seem to have no problems with engagers made from flowable resins, and with others they can wear away and break down. In this situation, a filled resin or other more durable resin can be used. 

We wanted to pass on some of these responses in hope that you might find them useful in treating your patients.

Tips and tricks on engager materials/composite/flash

Doctors who preferred flowable composite said:

  • “I use only flowable composite to fill the engager templates. It is easier and fills the template without voids. I know you recommend a two fill system, but it doesn’t seem there is time to do that and still get a good fill. I have had good luck so far with my variation of your system.”
  • “When placing engagers, use a little drop of flowable to “wet” the inside of the well prior to injecting paste, then a dab of flowable to “wet” the interface of paste and tooth when going to mouth.”
  • “Flowable composite seems to work best versus packable products. Also, checking the bite after placing engagers can prevent some engagers from interfering with the bite and being dislodged. “
  • “A “thick” flowable resin like GC Universal Flo will work well, without need for two materials, thin flo and thick paste.”
  • “I use flowable composite first, then a filled resin when filling the template.”
  • “The combo of flowable composite placed on the etched, primed/bonding agent light cured teeth and heavier composite place in the lubed engager reservoir works predictably on seating and curing. The sandwich of light and heavy composite will leave some flash to remove.”

Doctors who preferred different composites & bonds said:

  • “Using a lower viscosity composite, but not flowable.”
  • “Blue phosphoric acid etch bonds better.”
  • “I use a packable composite and place the college plier’s tips in either embrasure, forcing the aligner into closer contact with the tooth.”
  • “Use cheek retractors, spot etch, bond and use Surefil flow, which has been my best result in placing engagers.”

On the topic of flash, doctors said:

  • “I find that if I leave a little flash they stay on better.”
  • “They key is high speed finishing off any flash or over extension of composite. Wearing an LED headlight with loops and air drying the tooth/engager composite junction shows excess flash the best. Always verify that the next corresponding aligners seat completely in the excess flash removal evaluation. I use yellow or red striped carbide finishing points (like a 7901 or 7102) to remove the flash. Remove some with a high speed and water spray, air dry, repeat until satisfied and remember less is more.”

Tips and tricks for attaching engagers

Doctors offered us a multitude of tips on technique, tools and even timing for placing engagers. Here’s what they had to say:

Doctor’s tips on engager placement techniques:

  • “Poke a small hole through the engager tray from the inside of the engager area to extrude excess air and composite material, then perform minor adjustment on the surface of the engager to smooth if necessary.”
  • “Make a pin-hole in incisal edge/cusp tip of template of each tooth getting an engager. Hydraulic pressure relief as seat filled template allows easier, more complete seating.”
  • “Using a very small bur the diameter of an adhesive tip (I use Flow Tain with disposable tip), drill a small hole in middle of engager on the template. Prep the tooth as recommended, place template on the teeth and then fill the engager bubble with adhesive through the hole. This ensures the correct amount every time.”
  • “For placing engagers, pre-load composite in wells, cover from light bonding procedures, then directly to mouth, less change for salivary contamination by pre-loading.”

Doctors tips for engager template removal:

  • “The composite tends to stick to the template tray unless you wipe with alcohol and then apply the Vaseline.”
  • “I cut up the engager template and only attach 2 at a time.”
  • I usually cut the template. I keep 3 teeth, the engager tooth and the 2 adjacent teeth on each side. That way it will be easier to remove the template once the engager is placed.”
  • “Trays definitely need modification prior to placing engagers. I separate the right & left sides, and remove the lingual portion of the tray just past the incisal edge. This way I can peel the tray off easily. I also place a light coat of Vaseline with a micro brush on the inside surface of the tray where the composite will go.”
  • “On the template for the engagers, I remove the aligner material on the gingival side just below each engager well, right up to the edge of it, either with a high speed hand piece or a hole punch. Removing the gingival area below the engager wells allows me to wipe away any excess composite material that extrudes out of the gingival side of the engager well. It also provides me a purchase point to be able to lift up the template off of each tooth that has an engager.”

Doctors tips on tools to use for engager placement:

  • “I do better with composite out of a fine needle syringe. It seems to be strong enough to hold up, but there is some excess flash that needs removing.”
  • “Attaching with Filtek Ultra resin worked so much better than anything else for me. Microetching first is a must.”
  • “Pumice and selective acid etching before regular bonding routine.”

Doctor’s tips on timing of engager placement:

  • “Attaching to rotated lower canines always presents a challenge because of the super-acute angles between the canine and the adjacent incisor. You should request to hold placement of those engagers until the last possible time during treatment.”
  • “Sometimes to ensure proper placement, I will have the patient wear the trays for one week and then come back and place the engagers.”

Tips and tricks for removing engagers

Based on our responses, doctors seem to favor burs and using a combination of burs, discs and polishers.

Doctors who preferred burs said:

  • “I find that the best FINAL tool is a small pointed low-fluted carbide bur.
  • “Use Braessler ET long multifluted burs to remove engagers and/or excess.”
  • “Use a diamond or carbine finishing bur, get close to the enamel, then use enhance polisher to remove residual resin. Does not harm the enamel.”
  • “I only use a finishing bur. It helps to dry the surface to see if any bond remains. If there’s bond/resin left, the surface will be dull.”
  • “Use a high speed composite finishing bur, dry, followed with a composite polisher.”
  • “I use older ET composite shaping burs as they are less likely to cut enamel.”
  • “12 fluted bur.”

Some doctors prefer a combination of tools:

  • “I use a band remover to remove engagers and then go to a fine diamond bur then carbide flame bur and polish the surface with something like a pogo.”
  • “I use a sandpaper disc and football Brasseler finishing bur to remove them.”
  • “I remove engagers with 1) medium diamond to very thin resin, then 2) carbide finishing bur to enamel resin layer, then 3) finishing/polishing discs, points and brush and last, 4) burnish fluoride.”
  • “To remove engagers, I use a diamond finishing bur to remove the bulk and then switch to a Softlex disc for the final removal.”
  • “I first use a scaler, then Soflex discs, dry to better visualize the borders of composite. I check with the side of an explorer to see if the composite abrades some metal or if is completely removed.”

And some doctors prefer other tools:

  • “Remove with a white stone and high speed hand piece.”
  • “Use a high speed dry (no water so you can see the difference between the composite and the tooth structure, then use composite polishers to finish.”
  • “I use a fine diamond for gross reduction and finish with Dentsply enhance.”
  • “Use G-Bond provided by ClearCorrect, red stripe (fine) bur to remove 90%, then usually I’m able to flake off with a scaler. Not fun but it works without damaging the enamel.”
  • “Dura white stone high speed ulta dent polishing brush.”
  • “I like to remove the final layer of composite with a Brownie point, at a reduced speed.”

Doctor’s tips on engager removal techniques:

  • “I like to polish after removing engagers to make sure all is smooth.”
  • “You can always shave down engager slightly if too difficult to remove aligner initially.”
  • “Have patience in removing. Using a porcelain polishing diamond wheel works very well. When the resin is very thin a scalpel can be used or a rubber resin polisher will help remove resin without removing enamel.”
  • “Use a fluoride treatment after removal.”

Tips and tricks for lubricating

Doctors offered us several different tips for lubricating the engager template before installing, helping with template removal.

  • “Lubricate the template with Vaseline.”
  • “Apply mineral oil to the aligner beforehand so engagers don’t come off in the tray.”
  • “Make sure template is thoroughly coated with a separator and pull template away facially not incisal after curing.”
  • “Your seating video is spot on. The key is to lube the engager housing with either a dab of Vaseline or separating liquid (Sure Sep by Belle de St. Claire lab products).”
  • “We coat the template with Pam cooking spray before bonding the engagers. It makes it easier to remove the template. With multiple engagers the bonding material would sometimes fracture during template removal before using the releasing agent.”
  • “I find that the template needs to be wiped with alcohol before using Vaseline. My guess is that there is some type of oxygen inhibiting layer that the composite sticks to.”
  • “I spray the inside of the aligner with a light mist of non-stick cooking spray and then air blow it out of the engager well, not allowing any to pool up but still leaving a thin amount of separating medium. The separating medium in the template helps prevent the composite from bonding to the template and also aids in disengaging the template from the teeth which minimizes the engagers popping off.”

General tips and tricks regarding engagers

From installation techniques and engager modification to patient preparation, here are some general tips offered from providers.

  • “The engagers are pretty sharp to the lip so I always polish them a bit.”
  • “ Have the patient wear the engager stent/tray for at least a week before placing the engager.”
  • “I do one quadrant at a time. Usually there’s an area on the tray that serves as the best point for removal. You may want to consider adding something similar to a removal button on PFMs.
  • “Important to place pressure on the template from buccal and lingual. This ensures the engager is not too thick.”
  • “Magnification is a must.”
  • “Keep area clean and dry. Etch the enamel very thoroughly. Fill template and push the material into each attachment to adapt it well.”
  • “I make sure to abrade the enamel slightly with air abrasion or diamond and then etch. I fill with composite slightly below level, then place a dot of flowable composite to fill the last bit so it is level before placing in the mouth.”
  • “I always round them just a little after I place them. They seem to work fine and it makes the trays easier to insert and remove. I know that could cause some trouble at some point, but so far it has not.”
  • “I do them one at a time so I can press the engager matrix hard against the tooth with the back of the tips of a cotton forceps.”
  • “You should overbuild the engager and reapply material if it does not look accurate.”
  • “Sometimes we like to modify the tray and enlarge the engager to act as a hook and use the engager with elastics/rubber bands to help super erupt a tooth.”
  • “We prefer longer treatment without engagers than shorter treatment with engagers. We also prefer to have engagers removed at the earliest possible step instead of waiting until treatment completion.”
  • “I try to always prepare people for engagers: “You’ll have a big, tooth-colored blob on these three teeth…etc. This way they don’t freak out: “You told me I could take them out but I can’t take this blob out!”

Thanks to all of the providers who answered our survey!

Check out our Help Center for more helpful information on treating your patients with clear aligners and don't miss our upcoming advanced training webinar Case submission, prescription & treatment setups or our advanced training series of webinars on various topics related to clear aligner treatment.

Until next time…

ClearCorrect editorial: Clear aligner therapy discreetly improves crowding and constricting archforms

Dr. Mark Bentele discusses treating a case with ClearCorrect for orthodontic relapse. Read full article on page 22:

ClearCorrect at the 2016 Florida Dental Convention

If you or someone you know has been wanting to take some training on clear aligner treatment with ClearCorrect, you can check out our training schedule here. Or you can call us at 888-331-3323 and ask to speak with one of our representatives if you have any questions.  

If you’ll be in the southeastern US this summer, ClearCorrect founder Dr. Willis Pumphrey is presenting a course at the 2016 Florida Dental Association Convention on June 18.

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We’d love to see you there!

Tech Tip: FAQ about Engagers

We sent out a survey recently asking doctors for their questions about engagers.

In this week’s tip, we’ve consulted with our Chief Technology Officer, Dr. James Mah, to get answers to your questions.

DrMah.jpegDr. Mah comments on engagers

Engagers are an active area of research and development at ClearCorrect and elsewhere.

Many conceptual designs for engagers have been discussed in literature and professional forums, but when they are reduced to practice and the shape is thermoformed in the engager template, problems of adaptation and air gaps reduce the capability of many of these designs.

Without conclusive information and until the mentioned adaptation problems are resolved, ClearCorrect is happy to stick to simple horizontal and vertical engagers, which work well.

Engagers and the treatment setup

When we send you a treatment setup, we are presenting our best attempt to represent the course of treatment that you want to pursue for your patient—the recommendations shown are not absolute. It’s up to you to make any necessary changes to create a custom plan for treating each individual patient.

Engager preferences and timing can be discussed and adjusted according to what you want for your patient. Just let us know about your particular preferences when you submit your case or when approving the treatment setup.

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Engagers, templates & case revisions

On the treatment setup, if the engager is blue, it means it’s a new engager placement. If the engager is gray, it means it’s a previously placed engager.

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If you are submitting a case revision based on a prior step (not new impressions or scans), we’ll assume that the existing engagers are still on the teeth. You won’t receive a new engager template unless new engagers are needed.

General questions about engagers

Do you need engagers, or can the case be done without them? Are they necessary to use if prescribed?

Much depends on case by case variables such as tooth morphology and the type of tooth movement. To simplify these decisions, ClearCorrect has provided guidelines on which teeth and types of tooth movements that we would recommend engagers.

These guidelines are general and are for you only to use and apply to individual patients. Variables such as clinical crown height (shorter or longer), tooth morphology (shape), root morphology and positions need to be considered.

It is the doctor that prescribes the engagers. The technician only provides a recommendation. If engagers are recommended, there is a valid reason to use them.

That being said, it is possible to treat some patients without engagers. ClearCorrect has designed the aligners to be more retentive to often eliminate the need for engagers. In addition, overcorrection of specific tooth movements also helps to reduce the need for engagers.

If an engager is lost DURING treatment, should I use the tray currently in use as the engager template?

Yes, the current aligner will generally have the best fit. In addition, since it has been worn, the composite should easily release from the engager void.

Can you make the engagers bigger with a square or triangle shape to give more control?

ClearCorrect has ongoing research to continually improve engagers. The evidence does not support the need for larger engagers. Additionally, this would introduce other problems related to placement on smaller clinical crowns, occlusal interferences and esthetics.

What should I do if the teeth are very crowded? I find that it is difficult to adapt the engager template and place engagers when this is the case.

Treatment of severe malocclusion often requires expansion/IPR and some improvement of tooth positions to allow for ease of engager placement. Doctors can prescribe engagers for later in treatment when submitting the case or when approving the treatment setup.

Engagers wear down over time and end up needing to be replaced. Is there anything I can do to avoid this?

This can depend on the type of material being used for the engager. In general, a filled resin will be more wear resistant than one that is unfilled.

Is there a way for you to incorporate more than one engager on a tooth to aid in rotation or extrusion? At times, I think this would be helpful.

While this may seem to help with rotations, it causes other problems in removal of the aligners. Researchers have tested this hypothesis and found that the teeth became excessively loose and when the aligner was being removed and inserted – it produced excessive force on the teeth.

Questions about composite material or flash

What is the best material (both composite and bond) to use for engagers? Microfill? Flowable? Hybrid?

In general, a flowable composite is used, but much depends on doctor preference and wear factors. A patient with heavy occlusion will likely require a filled or hybrid material that is more resistant to wear.

What are the best methods to place them without overfilling? I’d like to know the precise way to place the composite into the template while avoiding an over or under abundance.

See our article on how to place engagers. Clinicians generally develop an eye for the appropriate amount of material to place in the engager void.

Some clinicians prefer to puncture the engager void on the labial side with an explorer to create a vent and allow release of excess material before light curing.

How do you deal with flash? Should I remove the excess composite that flows on the facial surface?

Excess flash is generally removed with a multi-fluted carbide burr. Yes, the excess should be removed as it may lift the aligner slightly and this may affect the fit and tracking of the aligner.

What do I do about having too much or too little flash or bubbles at enamel resin interface? Is there a way to get it just right?

These are both signs of problems with filling the engager void with too little or too much resin. See our article on how to place engagers for recommendation on how to install.

Questions about attaching engagers

I have difficulty with the engagers staying on the tooth when using the template. They tend to pop off, are a pain when attaching for the first time and not always successful. Do you have any suggestions?

There could be a variety of technical issues such as under/over etching, excessive primer, and inadequate material in the engager void. You can check for any of these issues and address accordingly.

How do you ensure that the position of the engager using the template matches the engager in the aligner?

The best way to do this is to make sure that the template is fully seated.

It can be difficult to remove the template especially when placing multiple engagers and when bonding each side of the arch separately. What should I do about this?

Application of Vaseline usually helps to release the engager from the template.

When attaching an engager to a decalcified tooth, the composite does not stay on the tooth. Do you have any suggestions?

This is a complication of bonding to decalcified surfaces. It will not be possible to bond to severe decalcification. Glass ionomer materials may help.

I have trouble attaching engagers when teeth are lingual. Is there a trick to doing this?

Treatment of severe malocclusion often requires expansion/IPR and some improvement of tooth positions before placing engagers, to allow for ease of placement. Doctors can prescribe engagers later in treatment, when submitting the case or when approving thetreatment setup. You want to stage the treatment setup to start correcting the teeth from their lingual positions and place engagers later.

Questions about removing engagers

What is the best/easiest way to remove engagers? I have completely drilled off and attempted to remove with hand instruments.

A multi-fluted carbide burr is generally best.

It’s hard to see when you have removed the majority of the engager. Do you have any suggestions for making sure the entire engager is removed?

This is the same problem in restorative dentistry when an existing composite restoration is removed. Use of a metal instrument will show which areas have composite resin remaining. Some clinicians use a common pencil to help identify resin fragments.

How do you ensure you don’t remove any enamel when removing buttons?

A bond/bracket removing plier is recommended.

Questions about engager shape and size

On two max canine, is it possible for one engager to be thicker than the other?

This is most likely caused by differing amounts of composite resin placed in the engager voids.

The shape is too rounded. What about engagers with sharper corners?

ClearCorrect has ongoing research to continually improve engagers.

Some of the designed engagers prevent removing aligners. Is it possible to have a different design or to apply them later?

Treatment of severe malocclusion often requires expansion/IPR and some improvement of tooth positions before placing engagers, to allow for ease of placement. Doctors can prescribe engagers later in treatment, when submitting the case or when approving the treatment setup.

Questions on engagers and tracking/fitting issues

Sometimes they don’t fit. The previous aligner will fit perfect but the next one, or new one, won’t. What should I do about this?

Review the last fitting aligner. There may be tracking issues that have gone unnoticed until the next aligner. If tracking issues are present, have the patient stay with their current aligner, or you can request a revision.

Sometimes the engagers do not line up properly with the aligner even immediately after placing them. It seems like a problem with the fit of the template. Would it be best to maybe place engagers first before trying to move any teeth at all, like before step 1?

There may have been tracking issues prior to placing the engagers. It is possible to have the patient wear the next aligner without the engagers and return at the next visit and use the aligner as the engager template instead of the provided template.

Could the shape of the engager be enhanced to encourage continued seating of an engager when teeth aren’t tracking (extruding)?

This would be difficult to do. Teeth are being moved in fractions of a millimeter or 1-2 degrees of rotation. Another approach could be the use of a thermoforming plier to place divots or pressure points (aka dimples) at specific sites of the aligner.

The teeth sometimes have trouble tracking and end up not engaging after a while and the case ends up needing a revision. This is frustrating. What can I do about this?

Refinements/revisions are common with clear aligner treatment. There are numerous scientific articles on the efficiency and accuracy of tooth movements with aligners. The need for revisions increases with the complexity of the malocclusion.

Sometimes rotated teeth don’t track in the engagers, why is this and what can I do?

Much depends on the tooth, root length and root morphology. Be careful not to advance too quickly through the aligners. If necessary, you can extend the patient’s wear schedule to get the needed movements.

I rarely have engager cases that track adequately. What could be the reason for this?

Engagers are usually recommended for more difficult movements, so it's not surprising that those movements may be more prone to tracking issues. Patient non-compliance or advancing through the aligners too rapidly can cause cases to go off-track. Use of Chewies can help to reduce tracking issues.

 

We hope you found this information helpful! There's lots more where this came from—check out our Help Center, which is filled with useful information for treating your patients with clear aligners.

Also, don't miss our advanced training series of webinars on various topics related to clear aligner treatment.

Until next time…

ClearCorrect: Essential to My Digital Workflow

Dr. Meena Barsoum recently talked with Dental Product Shopper (DPS) about his experience using ClearCorrect--a more streamlined approach to clear aligner treatment processes. "The big driver for me personally is the ability to submit digital scans. Not only am I able to submit a more accurate impression for the ClearCorrect prescription, but the process is just that much easier for my patients and me," says Dr. Barsoum.

After consulting with his patient about clear aligner therapy, he is able to take a full mouth digital scan, and then submit the scan to the ClearCorrect online doctor portal within minutes. This quick turnaround time is huge for his practice and patients. He is able to quickly show the patient what their smile will look like at the end of treatment and walk them through all of the treatment steps. 

ClearCorrect's customized treatment setup plan (example below) allows doctors to review the digital representation of the complete course of treatment. The treatment setup contains 3D models for each step of the treatment, representing the tooth movements that the doctor prescribes. Once the doctor and patient approve the treatment setup, the models will be printed and used to manufacture clear aligners which are then delivered 2 to 3 weeks later.

 

"Making ClearCorrect a part of my practice has been very simple with convenient access to free online training covering advanced and basic aligner treatment topics. In addition, the online portal for submitting cases, making changes, and requesting retainers is easy to use. Also I have a dedicated account manager, and this available communication and support is a big benefit of working with ClearCorrect," continued Dr. Barsoum. 

Read the Dental Product Shopper full article here. 

Now offering ContacEZ IPR Strips & Snap-On Disc Guards

It's our pleasure to announce a new addition to our online store: ContacEZ IPR Strips and Snap-on Disc Guard. 

Pre-order these new items and save 10%. Enter promo code: PRESALE when ordering. Pre-order prices are for the ContacEZ IPR Strips and Snap-On Disc Guard only and are available until May 3rd.

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We're happy to offer both of ContacEZ's IPR strip systems in three convenient packages.

IPR Strip System Package

These strips help to make IPR safe and more accurate without creating sharp corners. The strips curve and flex along the natural contours of the teeth to prevent soft tissue irritation, helping to avoid cutting excessive enamel and maximize patient comfort.

We're offering this package for $190.00 with an additional 10% off with our presale promo code. It contains a total of 32 strips, 8 of each (Yellow Starter 0.06mm, Red Opener 0.12mm, Dark Blue Widener 0.15, Green Extra-Widener 0.20mm).

  • Single-handed design offers optimal tactile control
  • Will not cut lips or gums and eliminates gagging
  • Flexible strip will contour the curvature of the tooth without creating subgingival ledges or sharp corners
  • Reduce binding and prevent residual crowding
  • Easy access to tight anterior or posterior areas
  • Autoclavable up to 280 degrees (steam heat only, not dry heat), and multi-usable

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IPR Optional Strips Package

The strips in this package allow for in-depth personalization to suit the variety of different cases and clinicians' preferences involved in interproximal reduction. These strips contour the curvature of the tooth to safely and efficiently reduce interproximal enamel without creating sharp corners.

These optional strips offer a larger starter strip (0.10mm Clear strip), a single-sided 0.12mm widener (Cyan strip) and two thicker options for widening (0.25mm Purple widener and 0.30mm Brown widener).

We're offering this package for $190.00 with an additional 10% off with our presale promo code. It contains a total of 32 strips, 8 of each (Clear Single-Sided Opener, Cyan Single-Sided Widener, Purple Super-Widener, Brown Mega-Widener).

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ContacEZ IPR Strips - Combined Package

This package combines the IPR Strip System and the IPR Optional Strips packages for $245.00 with an additional 10% off with our presale promo code. The combined IPR strip system contains 8 of each of the IPR Strip System strips (yellow, red, dark blue and green) and 2 of each of the Optional Strips (clear, cyan, purple and brown) a total of 40 strips per box.

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Don't want any of the packages? No problem! Each of the IPR Strips are also being sold in our online store individually in a refill package of 8 or box of 32. 

Snap-On Disc Guard

Using these guards during interproximal reduction with discs helps to protect your patient's tongue, lips, cheeks and gums from IPR discs. We're offering 1 package which contains 20 disc guards for $40.00 with an additional 10% off with our presale promo code.

  • Quickly snaps on and off
  • Provides safety and peace of mind
  • Economical and cost-effective
  • Transparent plastic
  • Clearly see the spinning disc
  • Single-patient use, disposable
  • Can be used with discs, rubber wheel, and brush wheel

Snap-on-disc-guard-1.png

We are offering these packages and each of the individual IPR strips along with the snap-on disc guard at these discounted prices for a limited time. Take advantage of these great pre-order prices as they will only be available until May 3rd.

  Click to pre-order!

Estimated shipment - May 3rd 

ClearCorrect Scores Another Victory With the Federal Circuit

Align Technology Fails Again to Overturn ClearCorrect Victory in Widely-Watched ITC Case

ROUND ROCK, TX--(Marketwired - March 31, 2016) - ClearCorrect, LLC, a leading U.S. manufacturer of clear aligners, is pleased to announce that the United States Court of Appeals for the Federal Circuit today denied the petitions for rehearing en banc that were filed by the International Trade Commission (ITC) and Align Technology, Inc. in case number 2014-1527. This is another U.S. court decision in favor of ClearCorrect, supporting the company's position that its clear aligner product complies with legal standards and does not infringe Align's patents.

The ITC or Align Technology may ask the United States Supreme Court to review the case, but such a review is unlikely to occur under the present circumstances. Last November, the U.S. Appeals Court ruled in favor of ClearCorrect, ruling that the ITC was without jurisdiction to regulate electronic transmission of data and today's reaffirmation of that decision is a victory not only for ClearCorrect, but the entire orthodontic industry.

"Denial of these petitions solidifies our victory in both actions we faced in the ITC," said Jarrett Pumphrey, ClearCorrect's CEO. "Based on the Federal Circuit's ruling last November, we expected today's outcome and are pleased that we will have no liability from either of these cases," he added.

"Today's result, coupled with last year's settlement of a civil action with Align where both parties agreed to dismiss their claims, means that three-quarters of the litigation Align initiated against ClearCorrect has now been resolved," said Michael D. Myers, ClearCorrect's attorney in the case and a partner with the Houston, Texas law firm McClanahan Myers Espey, LLP.

Align's final remaining lawsuit against ClearCorrect is a patent infringement case in a Texas federal court that had been stayed pending the resolution of the ITC actions. In anticipation of this case, ClearCorrect initiated reexaminations with the United States Patent and Trademark Office (USPTO) of 6 of the 9 Align patents asserted in the suit. The USPTO has the jurisdiction and authority to judge the validity of patents. Those key patents are now at risk of being cancelled, as thus far, the USPTO has indicated agreement with ClearCorrect's position that all 75 claims of the patents in question are invalid.

"Unless and until all the claims against the company are dropped or resolved, ClearCorrect must continue to defend itself. And those defensive efforts are progressing quite well," Myers said.

ClearCorrect case study: Dr. James Alexander

Orthodontic Practice US recently published a ClearCorrect case study: Dr. James Alexander discusses a way to avoid traditional PVS impression.

Utilizing CEREC scans with ClearCorrect for alignment

Providers talk IPR

In a recent survey, we asked ClearCorrect providers to share their tips & tricks for performing IPR. As you'll see, we got a wide variety of responses, some of them contradictory. Everybody has their own preferred techniques.

Today, we're passing on some of the responses we got. Nothing here should be taken as official advice or recommendations from ClearCorrect or its employees—use your professional judgement to evaluate what's best for you and your patients.

Tools for performing IPR

Based on our responses, the most popular tools for performing IPR are diamond strips, followed by burs and diamond discs.

Doctors who prefer strips said:

  • “Floss first then diamond strip.”
  • “I usually underprepare the IPR so that the reduction gauge is difficult to fit between the teeth. If needed, more can be done later, often with a finishing strip, so that a closed contact can be reliably achieved.”
  • “I generally do IPR with manual strips every six weeks until contacts are not tight. I don't think this is better I am just more comfortable with this.”
  • “Pre-wedging prior to IPR and starting with strips prior to discs.”
    “IPR first with hand strips. Also, I find it easier to IPR when teeth are aligned first in the contact areas.”
  • “Start with the thin stainless steel strips and switch to the thicker carborandum strips as contacts become less tight.”
  • “I like to use a long finishing diamond to do IPR because I think it gives me more ability to maintain ideal proximal tooth contours.”

Doctors who prefer burs said:

  • “I find it’s easier to do IPR with burs as opposed to discs and strips. The smallest bur that I have found for 0.3mm is the mosquito interproximal from Neo Diamond. #1416f”
  • “I prefer a mosquito diamond to discs for IPR. I feel like I can shape it better.”
  • “I use ContacEZ high speed mosquito bur 1.6mm x 5mm length.”
  • “Mosquito burs are much easier to use and safer than discs, especially posteriorly.”
  • “I use a Brasseler mosquito bur from the cervical incisal to prevent lodging and make sure contact is completely broken.”
  • “I have stopped using the discs and use the mosquito bur to open the contact at the correct angle then I also use it to provide the correct proximal contours. Then I use the strips to finish to final IPR spacing and polish.”
  • “A high speed air turbine and bur seems to be the quickest and most controlled method.”

Doctors who prefer discs said:

  • “Start with low speed and stay in clear vision and control of the procedure. I use loupes 3x or microscope to do it.”
  • “It’s important to reduce straight (not angulated) and to carry the separation through the contact areas.”
  • “I use a slow speed straight hand piece with a VisionFlex disc. Fast and smooth and has many uses. You must be very careful.”
  • “Have different sized discs.”
  • “Just remember to use a guard on the wheel.”
  • “Use reciprocating files when extremely crowded and then rotary diamonds.”
  • “Use Brasseler perforated diamond disc - tissue guarded mandrel is an absolute must use.”

And some doctors prefer other tools:

  • “Always use diamond floss.”
  • “Use a combination of diamond discs on the slow speed hand piece with a soft tissue guard. Measure the amount of reduction done. Finish the IPR with hand strips. Check with an explorer to make sure that there is not a ledge left. Before starting any case involving IPR, inform the patient that it is needed.”
  • “I use a Komet, USA IPR kit with a reciprocating hand piece and safe tips. Then I finish with diamond strips to smooth and finish and contour. The gauges to confirm amount removed are integral as well.”
  • “I routinely perform IPR with a high speed hand piece and tapered carbide bur in conjunction with fixed appliance treatment. IPR occurs after separation of the contact points, and is performed on molars, bicuspids, and cupids as needed.”
  • “Use a high speed with a needle fine diamond. Check with the spacer key. Then round off the edges with the Diamond to restore anatomy. Done.”
  • “Get the electric wiggle saw. I do not know the name. Safe and effective.”
  • “On an extremely tight contact, I will place a separator for a few minutes prior to IPR. When I remove it and perform IPR, the patient is more comfortable and the strips do not break as often.”
  • “I use an oscillating hand piece made by Komet. It's easy to use and relatively comfortable for patients.

General thoughts on IPR

Some doctors prefer to perform IPR after aligning teeth, some from posterior to anterior and some prefer to perform IPR after arch expansion to allow access. Here are a few general tips from providers:

  • “Measure, re-measure, recheck before IPR, and also during the process.”
  • “Under IPR rather than over IPR.”
  • “The trick is to have the ClearCorrect technicians expand the arches to create more access to the area that is supposed to get IPR. I do use a mosquito nose diamond from SS White. It’s called a piranha diamond very fine, ISO FG# 392-016.”
  • “Do the posterior first, then anterior later.”
  • “Use a steady hand to be sure you don't open up too much space. I've used local anesthesia before on very sensitive patients.”
  • “Always use a gel topical anesthesia on the soft tissue, acts as a lubricant as well as anesthetic. And separate the teeth with a soft flexible wedge. It eases access and protects the soft tissue.”
  • “I like to use topical fluoride after IPR, trying to re-mineralize the cut enamel.”

Thanks to all of the providers who answered our survey. We hope you found something useful here.

Check out our Help Center for more helpful information on treating your patients with clear aligners and don't miss our upcoming advanced training webinar on IPR or our advanced training series of webinars on various topics related to clear aligner treatment.

Until next time…