In a recent survey, we asked some of our providers about any questions they might have on the topic of case submission, prescription and treatment setups. Below are some of the questions and answers. We hope you find this information helpful!
FAQ about case submission, prescription & treatment setups
Is ClearCorrect now 2 weeks for each aligner? I’m still using the 3 week method.
We did change our default wear schedule from 3 weeks to 2 weeks in 2015. At the same time, we also added the ability for you to choose your patient's wear schedule when you submit your case. With this change, you're able to request a 3-week, 2-week, or even 1-week wear schedule and you can dispense as many aligners as you see fit at each appointment. (This only applies to new cases--any cases that started on a 3-week schedule should still be on that schedule.) We recommend that most patients wear each set of aligners for at least two weeks. See our full article on aligner wear schedules.
Wear schedules can be viewed in the treatment setup and in the fine print on the treatment plan.
If a bite is no longer needed, how do we bypass this in CEREC Connect?
At this time, a bite scan is a requirement and part of the workflow when scanning with CEREC Connect. While we've made bite registrations optional, most doctors still like to take a bite scan to have as a record to compare to the bite that we provide in our treatment setup.
I understand that this system is only for anterior teeth. Is that correct?
No, ClearCorrect is an advanced system of clear aligner therapy that uses the latest digital technologies, design and clinical approaches to treat various types of malocclusion, ranging from simple to advanced extraction and surgical cases depending on the knowledge and expertise of the doctor.
What are the most common issues that cause a Limited 12 aligner case to be elevated to an Unlimited case?
When the ClearCorrect technician reads the case submission form, they try to follow all of the doctor's instructions taking into account the requested case type. However, if they can't follow both the treatment plan and case type instructions, they will prioritize the treatment plan instructions over the case type which can lead to upgrading the case to an Unlimited. If it's noted on the case submission form that the case type is a higher priority over the treatment plan, along with a note of which correction is allowed to be compromised for the case type, then our technician will follow those instructions instead of their normal protocol.
I’m not sure about the amount of trays to plan for. Maybe a guideline to selecting the right case type?
In 2015 we made a change where by default and at no charge to you, our technicians recommend a case type appropriate for the treatment you prescribe, which eliminates the need for you to choose the case type for your patient. However, if you have a preference, you can indicate it when you submit the case.
Either way, the case type won’t be final until you approve a treatment setup and pay for the case.
If you want to choose your case type, we've prepared a simple chart to help you predict which treatment option might be best for your case:
Can I ask for specific sizes or shapes of attachments for the setup?
Not at this time. Engagers are an active area of research and development at ClearCorrect and elsewhere. Many variations of engager shapes have been proposed and discussed in literature and professional forums, but in practice, once 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 the simple horizontal and vertical engagers that we've been using for the last ten years, which have proven sufficient to help with movements requiring an engager.
Fortunately, because of the way we trim our trays, our aligners are 2-4 times stronger than our competitors. This can reduce the need for engagers in many cases.
It looks like some overcorrection was built into the treatment setup. Is this correct?
Overcorrection is only added to the case per the doctor's instructions. Overcorrection can be requested at the beginning of a case when filling out the submission form, when submitting a revision or when reviewing/approving the treatment setup.
No bite turbo or bite ramps were offered, is this something that will be coming or is it even necessary with the greater gingival coverage that ClearCorrect has in their aligners?
Doctors can request lingual engagers to prevent full closure of the teeth. This is an advanced treatment technique, and should be monitored carefully. Whether a bite turbo and/or bite ramp is necessary would be determined on a case by case basis.
In cases with anterior interproximal reduction, how can I have a virtual power chain added to the end of the treatment sequence so that I have all the required aligners, including for the power chain, without having to request a revision?
When submitting the case, just ask for overcorrection with a digital power chain on the last two steps in order to get a virtual power chain without having to request a revision.
How do you determine which teeth will start the movement? (Or, phrased differently); How do you stage treatment?
We use protocols that have been developed by our Chief Technology Officer, orthodontist Dr. James Mah; ClearCorrect founder Dr. Willis J. Pumphrey; and our VP Products, Paul Dinh, CDT. These protocols are applied on a case-by-case basis by our technicians to help get the outcomes you prescribe for your patients.
Is there a process that I can tweak the final treatment setup myself?
Not at this time, though we are aware that doctors are interested in this functionality. The current process for adjusting your treatment setup is described below.
How do I make adjustments to a treatment setup?
If the model looks inaccurate, you want to move the teeth differently, or you want to cancel the case, click DISAPPROVE when viewing the treatment setup and let us know what you want to do. Our technicians will do their best to make any changes you request and upload a new version of the treatment setup for your approval within a few days.
I have difficulty with viewing the setup. It isn’t real clear to see the final result. I kind of just go on faith that it is going to look good.
At the bottom left of the setup, you'll see a timeline representing every step of the case. The starting position of the teeth is shown at the left. Steps with checkup appointments are numbered on the timeline, and the final position of the teeth is represented on the right as a retainer.
To navigate between steps, you can drag the slider, click on a step, click the Previous and Next arrows, or click Play to animate the treatment from beginning to end. You can click Previous at the beginning or Next at the end of treatment to quickly toggle between views before and after treatment.
Shortcuts are available for the most common views: Upper occlusal, Lower occlusal, Right, Front, and Left. You can also rotate the model to view the teeth from any angle by clicking and dragging.
I sometimes need help in deciding on the treatment setup.
When approving a treatment setup, it's best to begin with the end in mind - consider the whole treatment and what are the goals for that particular patient. Also, when filling out the case submission form, the more information you give the better treatment setups you'll receive.
For more information, see our recommendations for how to evaluate the treatment setup in our Help Center article on this topic.
As a “bracket man” for years, I feel that the torque movements are hard to envision. Can some support evidence or outcomes be made available to give me more confidence?
We understand that being able to see some successful outcomes is helpful. We offer a number of different case studies covering a variety of scenarios from treatment of a Class II with crowding and a deep bite, to treating an anterior open bite with clear aligners. You can check out all of our case studies in our Help Center.
Provider tips & tricks
Some of our providers offered a few tips & tricks for submitting cases. 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.
- "I usually let ClearCorrect dictate the course of action. I have had an extraction case that I had never done before and the ClearCorrect technician walked me through it and said that she had seen my other work and was sure that I could do this as well. It made me feel good."
- "I look at my comprehensive diagnosis and go through in my head step-by-step what I need to correct the deficiencies."
- "I like to avoid placing attachments at the initial stages, so that the patient can become accustomed to the appliances before making it tougher to remove them."
- "I would recommend that all doctors finish with a digital power chain."
- "I would overcorrect all rotations and ask for power chain to close any original spacing. My experience tells me that less engagers allow better fitting and tracking of aligners."
- "I always leave 1mm of overjet between anteriors at completion to prevent a slight posterior open bite."
Thanks to all the providers who answered our survey!
Check out our Help Center for more helpful information on treating your patients with clear aligners.
Until next time...