ClearCorrect Editorial: Dr. James Mah, CTO for ClearCorrect

Dr. James Mah, CTO for ClearCorrect, recently wrote an editorial for Dental Economics

Clear Aligner Therapy and Practice Management: Tips and Things to Avoid 
View full article here

ClearCorrect patient review: Mercedes Flores

Dr. Andres Ramirez and his patient Mercedes Flores recently sat down with us to discuss Mercedes' treatment and overall ClearCorrect experience.

Congrats to Our Attorney Mike Myers -- American Lawyers' Litigator of the Week

Mike MyersShout out to our Attorney Mike Myers, who was named American Lawyers’ Litigator of the Week!

The recent ruling in favor of ClearCorrect against Align Technology is a big win and officially ends three of four litigations asserted by Align.  Moreover, we fully expect to successfully resolve the final case.

Congratulations, Mike!

ClearCorrect Eliminates Three Align Technology Lawsuits

USPTO Rejects Patent Claims of Fourth and Final Lawsuit

ROUND ROCK, TX-- November 12, 2015

ClearCorrect, LLC, a leading U.S. manufacturer of clear aligners, has been successful once again in litigation brought against the Company by Align Technology, Inc. The United States Court of Appeals for the Federal Circuit cleared the Company of any liability in the International Trade Commission (ITC) investigation relating to certain Align patents, ending the ITC action initiated by Align in 2012. This resolves the third unwarranted and unsuccessful lawsuit Align has brought against ClearCorrect since 2011.

The November 10th Appeals Court decision is the latest in a series of favorable decisions for ClearCorrect in both the ITC and the United States Patent and Trademark Office (USPTO). “This decision solidifies the fact that the ITC is without jurisdiction to regulate electronic transmissions of data and all of the ITC’s rulings in the case are therefore null and void,” said Michael D. Myers, ClearCorrect’s attorney in the case and a partner with the Houston, Texas law firm McClanahan Myers Espey, LLP.

"While the ITC has no authority or jurisdiction to judge the validity of these patents, the USPTO certainly does, and it has found substantial questions exist in all of the Align patents that it has reviewed thus far despite Align’s oral arguments and written responses to the contrary. The input of this expert agency reinforces the strength of ClearCorrect’s insistence that we do not infringe any valid patent rights.” explains Scott A. McKeown, a partner with the Washington, DC law firm Oblon, McClelland, Maier & Neustadt who is leading ClearCorrect’s efforts at the USPTO. Align’s final case against ClearCorrect is a patent infringement case in a Texas federal court that has been dormant since 2012 pending the resolution of the ITC actions. That remaining case, however, faces substantial hurdles in light of the ongoing cancellation proceedings of the USPTO, which have significantly progressed:

  • 6 of 9 patents asserted in the Texas suit are currently subject to USPTO cancellation
  • The USPTO has agreed with ClearCorrect’s invalidity positions on over 75 claims across the first 6 patents
  • The final 3 patents which ClearCorrect will be pursuing are largely overlapping in subject matter with the current challenges Align originally filed two lawsuits against the Company in 2011, followed a year later by two ITC actions.

One of the 2011 lawsuits was settled last month when Align voluntarily dropped its claims in exchange for ClearCorrect’s dismissal of its counterclaims. Align also settled the remaining ITC action through an agreement with ClearCorrect that was contingent on the appeal decision. With the appeal ruling in its favor this week, ClearCorrect has effectively resolved three of Align’s four litigations and expects to successfully resolve the final case.

Setups based on old impressions or scans

When you evaluate a treatment setup, you have four options:

  1. Approve the setup and start the case
  2. Decline the setup and ask for changes
  3. Decline the setup and submit new impressions or scans
  4. Decline the setup and cancel the case

If it's been a while since you took the impressions or scans, you’ll need to evaluate whether they’re still accurate. Only approve a setup if you’re confident it accurately represents the current position of the patient’s teeth. Otherwise, you’re likely to have fitting problems, starting with step 1.

Here's what our Chief Technology Officer, Dr. James Mah, has to say on the subject:

Dr. James MahIt is best practice to promptly revise and approve the setup as the patient's dentition may change over time. The amount of change and the time frame depends on the individual patient. The dentition is not immune to the effects of wear and aging and is more dynamic than most people appreciate.

Practically, patients may be classified in the stable group where any changes are undetectable or subtle enough that there is no effective difference over many months. These dentitions typically have all teeth present in an adult, healthy periodontium, no habits, neuromuscular problems or parafunction and no unusual amounts of dental wear/attrition. A good rule of thumb for these patients is to take new impressions/scans after three months have elapsed to avoid the possibility that changes have occurred.

On the other hand, patients may have unstable dentitions where the teeth may change sufficiently to impair fit of the aligner. A common situation is following extraction of a tooth. Adjacent teeth often shift and the opposing tooth may super-erupt. For this reason, extraction treatments with aligners almost always have the extractions performed only after the aligners are available. In situations involving extractions, there is great variation and in some patients changes over a short period of time such as 2 weeks is enough to cause the aligners to not fit.

Another group that experiences tooth shifting are patients with ongoing periodontal disease. Active periodontal disease is often associated with unintended tooth movement. It is best to manage the periodontal disease and re-evaluate to determine whether orthodontic treatment is even a possibility.

Patients that clench and grind or other situations where there may be loss of tooth structure such as bulimia may also end up with poor fitting aligners depending on the severity of the problem and the amount of resultant enamel and dentin loss.

Unfortunately, in these situations of instability, there are no general rules to follow as each patient is different with different etiologies and severity. Certainly, much is up to the discretion of the doctor but change of some degree is anticipated. For this reason, these treatments have additional complexity and the patient should be informed of the issue. If treatment is elected, the best practice of promptly revising and approving the setup is recommended, rather than allowing the teeth to potentially shift for months before approving.

We hope you found this information helpful.

Until next time...

Tech Tip: Popping TMJ

What should I do if my patient’s TMJ pops when she uses Chewies?

It's possible that the Chewies could be creating a fulcrum point in the patient's occlusal plane, resulting in joint stress and positional changes.

A conservative joint management approach is recommended:

  1. Discontinue Chewies and ask the patient to help seat the trays by pushing up/down with fingers instead.
  2. Ensure the clinical TMJ exam is complete including joint films (CBCT) and a radiologist report. (You need to rule out degenerative joint disease and pathology.)
  3. Continue to clinically monitor the patient's TMJ signs and symptoms at every visit. If pain or limitation of jaw movement is noted, consider pausing treatment and remaining in the previous step until symptoms resolve with conservative therapy (Motrin, no gum chewing, soft diet, limit wide openings, etc.).
  4. Consider a one-year TMJ radiographic examination—if there are no changes from baseline, consider a 3-5 year radiographic follow-up.

Hopefully the patient's joint popping or pain will diminish. If they do, continue on with the patient's aligner treatment. (Steps #2-4 above could also apply to aligner patients who suffer from TMD.)

Don't forget about our Help Center and support representatives—they're chock-full of useful information, and we love hearing from you.

Until next time…

New Advanced Webinar


Dr. Ken Fischer presents an informative webinar on advanced topics in clear aligner treatment. From useful troubleshooting techniques to marketing tips, this webinar covers a wide variety of advanced scenarios that can arise in treating patients with clear aligners. The webinar is a PACE approved program offering 2 hours of CE credit upon completion.

Contact one of our sales representatives at (888) 331-3323 to register, or click below to register online.


Friday, January 8th 2016, 7:00 p.m. - 9:00 p.m. CST.

Saturday, January 9th 2016, 1:00 p.m. - 3:00 p.m. CST.


Webinar login details will be emailed upon registration.

Webinar Objectives:

  • To improve proficiency in creating the optimum treatment setup
  • Identifying factors involved with monitoring treatment progress with clear aligners
  • Learn techniques needed to keep clear aligner treatment on-track
  • Present advice on how to market ClearCorrect clear aligners

Webinar Syllabus:

  • Optimizing the Treatment Setup
  • Monitoring Aligner Treatment
  • When Aligners Do Not Fit
  • Finishing Cases
  • Marketing Clear Aligner Treatment

Video: Retention

Orthodontic treatment doesn't end when the teeth are straight—most patients will require retainers. This new video on retention discusses the options that are available, including Hawley retainers, fixed retainers, and clear retainers from ClearCorrect.

Until next time...

Tech Tip: Trim Lines

We've been getting some questions about trimming recently, so we're revisiting some of our older tech tips on the subject.

As you know, aligners need strong retention in order to move the teeth as desired.

In a 2012 study, doctors from the University of Nevada compared the retentive strength of three trimming techniques:

  • A) a scalloped margin,
  • B) a straight cut at the gingival zenith, and
  • C) a straight cut at 2 mm above the gingival zenith.


The difference between the techniques was remarkable. For clear aligners without engagers, the straight cut 2 mm from the margins was about twice as retentive as the scalloped cut. For clear aligners with engagers, the straight cut 2 mm from the margins was over four times as retentive as the scalloped cut!


Trimming the aligners differently had more of an impact than adding or removing engagers.

Based on these findings, we started trimming our aligners with a smoother contour and a larger overlap with the margins in 2013.

Because there is less risk of the aligners impinging on the unattached marginal gingiva, our aligners are more comfortable with this technique. The edge of the aligner is concealed further under patients’ lips during everyday use, so they're also a bit more discreet.

Here are answers to a couple of common questions:

Can I make custom trimming requests?

At this time, we are not able to accept custom trimming requests. We trim all aligners using the same standard protocol. If you want to customize your aligners, you can do so fairly easily in your office with a buffing wheel (like the ones available in our online store).

What should I look for if my patient complains of sore gums?

ClearCorrect aligners go through a multi-stage polishing process, so actual rough or sharp edges should be quite rare. It is fairly common, however, to experience some discomfort for the first few days wearing an aligner. This often indicates that the soft tissue is getting used to having foreign material present in the mouth. Changes to the mucosa eventually fade away when the patient stops wearing aligners.

If the gums are being impinged, one possibility is that the gingiva were not captured accurately in the impression. We prefer 4-5 millimeters of gum to be included. Incomplete impressions will affect our production models.

You may also want to look for frenum pulls.


These can be difficult to detect because the aligner may feel comfortable at first, but as the patient speaks and moves around, the frenum becomes irritated and ulcerated. Unfortunately this dynamic movement is not captured in the impression. Clear photographs can help to identify these. Gingival frenum pulls are rare, but when they occur, they are typically found in the maxillary premolar and midline areas. If this proves to be a problem, you may want to trim the aligner shorter in the affected areas.

We hope you found this information helpful. Don't forget—you can always visit our Help Center, which has loads of useful articles, and of course, feel free to contact any of our knowledgeable support representatives.

Until next time…

ClearCorrect editorial: Dr. Peter Gardell

ClearCorrect provider Dr. Peter Gardell recently wrote an editorial for dentaltown on the use of CEREC Ortho for digital impressions:

Orthdontic Roadblocks: How to Get Patients to Say Yes to Treatment