For aligners to do their job as intended, it's important to wear them in order. Unfortunately, because aligners look so similar, it's not always easy to tell when they've been shuffled out of sequence. This can happen at the office, in the patient's possesion, or (though we do our best to prevent it) it's occasionally possible for them to be mixed up during packaging.

That's why last summer, we started laser–marking aligners. Of course, your first reference is going to be the step number printed on the aligner bag, but the laser markings provide a way to double–check that you're dispensing the correct aligners to your patient. Your patient can use them, too, to keep track for themselves. Here's what you'll be looking for:

The first section of the code represents the patient's ClearCorrect case number. This number is referenced on ClearComm, on the treatment plan, and in most emails from ClearCorrect.

The next section represents the step number. The example above shows a Phase Zero aligner. Usually, this will be in the form of a letter and number. For instance, step 4A (representing the first step of Phase 4) would be followed by 4B, 4C, 4D, and then 5A.

And the final section represents whether the aligner is for the upper (U) or lower (L) arch.

You'll also find matching codes on the bottom of each dental model.

Occasionally you may receive an unmarked aligner (for instance, engager templates are currently unmarked). In that situation, you can double–check aligners by comparing them to the dental models. We have some upgrades planned which should enable us to laser–mark 100% of aligners and engager templates soon.

If your patient does end up wearing aligners out of sequence, don't panic. It's usually not an insurmountable problem. Assuming that the aligners fit well and there aren't any complications, you can identify which step best corresponds to the current position of the patient's teeth and continue from there.

If you have any suggestions for how we can make things easier for you, please don't hesitate to let us know. Until next time…

We talked earlier this year about using Hilliard thermopliers to finish out a case and complete a difficult movement. Today, we'd like to share another great use for thermopliers.

Sometimes, aligners just don't want to stay down, especially in the posterior. This is often caused by a lack of adequate retention points. Aligners work best with bulbous teeth. Some teeth are just so short or straight-edged that the aligners don't have anything to grab onto.

Fortunately, there's an easy fix that doesn't require remaking the aligner or requesting a revision to add engagers. Simply heat up the pliers and make a dimple between two teeth on the facial and lingual sides of the aligner. You'll want to place the dimples down by the gumline, so they can tuck in between the bases of the teeth.

It's a quick and simple trick, but it can make a world of difference.

Now you can choose whether to submit your cases with traditional PVS impressions or go all-digital with intraoral scans. We've been testing this feature with our PREP group for a while, and now we're ready to open it up to the public.

Naturally, we won't restrict you to any particular brand or model—we'll accept scans from any intraoral scanner, as long as they're in STL format. (STL is an open, industry-standard file format that can be exported by most popular scanners.)

We've already tested scans from a wide range of scanners, including the 3M™ True Definition Scanner, 3Shape's TRIOS®, and even Align Technology's iTero™. Please do your research before you buy a new scanner, though. Confirm whether you'll be able to export STL files with your reseller or manufacturer. Some models may require a service or software upgrade to enable STL export functionality.

You'll download your STL files from your scanner to your computer, and upload them just like your photos when you submit a case online. When you do, we can start working on your case immediately instead of waiting for your impressions to arrive. We expect all-digital cases to get turned around days faster, with more accuracy.

If you don't have a scanner yet, don't worry. You can just keep doing what you're doing. We're happy to accept impressions as well.

Exporting tips

We strongly recommend that you visually inspect your STL files before you submit them to us. Our favorite STL viewing application is netfabb Studio Basic, which is available free for Windows, Mac, and Linux. Other options include MiniMagics and FreeCAD.

Some scanners output several files, but the only ones we need are the upper and lower arches. The arches should be saved in separate files, with the arches oriented in occlusion.

We prefer "closed shell" models, but "open shell" models are acceptable too.

When you scan a patient with an iTero scanner, choose the iCast or iRecord format. The Invisalign format will not permit you to export STL files.

We can't provide support for your scanner software, but if you've got any other questions, as always, your account rep is here to help.

The rumor mill has been spinning overtime, so let's make a few things clear:

• Align has not won any of their suits against us.
• We are still making aligners.
• Nothing has changed.

First, a quick recap. As you probably know, our good buddies at Align have a long history of suing their competitors. This doesn't usually work out that well for them—Align has had patent claims invalidated and they've paid out tens of millions of dollars in settlements.

But old habits die hard, and they've stuck to this strategy against us. In March 2011, Align sued us in California and Texas, and in March 2012, they filed two complaints with the ITC. These cases take a long time to play out: nothing significant has happened in the California case, and the Texas case is on hold. The first ITC complaint was decided in our favor this January.

This week, Administrative Law Judge (ALJ) Rogers issued his initial determination for the second ITC complaint. His opinion was that ClearCorrect did not violate Align's product claims, but Align's method claims were violated. Naturally, we disagree with that opinion. Regardless, here's what you need to know:

1. This is not the final ruling on the case. The ALJ's initial determination will be reviewed by the ITC before they make their final decision, scheduled for September 2013. Then that decision is likely to be appealed in the U.S. Court of Appeals for the Federal Circuit. The ultimate conclusion is probably still years away.
2. In the previous complaint, the ITC reversed this same judge's initial determination and ruled in our favor.
3. We don't have to do anything differently right now. There's no effect on our day-to-day operations until the ITC makes their final decision.
4. This initial determination has been incorrectly reported as "a ruling to block U.S. imports of a competing product by ClearCorrect." We make our aligners right here in Houston, Texas, so it's impossible for the ITC to block us from "importing" them. The only "imports" at stake in this case are digital files transmitted by diagnostic technicians in Pakistan. (We've argued that data transmissions shouldn't even be considered imports.)
5. Align's legal VP recently claimed to investors that if the ITC ruling went their way, "ClearCorrect will be excluded from the domestic market." That's simply not true. Even if the ITC rules completely in Align's favor, we can continue manufacturing and selling aligners in the U.S. The only thing the ruling will determine is how and where we can stage the treatment plans.

In short, don't panic. We're sticking around. We've just invested in scaling up our production capacity by 30%, and we've got a really cool announcement to share with you tomorrow. Until next time…

Update: Align put out a second press release shortly after this was posted, but nothing has changed. The "cease and desist orders" they refer to are just the ALJ's recommendations from his initial determination. As explained above, the ITC is not expected to make a decision until September. If the ITC does issue cease & desist orders, they will apply only to imported data—our ability to design, manufacture, and sell aligners in the U.S. is not at risk.

We've talked before about how important it is to express your intentions clearly when you request a case revision. (See this previous tech tip for details.) Taking a few moments to double-check your revision form can save a lot of wasted time down the line.

Here's one issue that's tripped up a few doctors: they check the box requesting overcorrection of a tooth, but then provide conflicting instructions elsewhere on the form.

When you request overcorrection, this indicates to our technicians that you'd like to continue moving teeth in the same direction as originally planned -- just with a little extra pressure. If we got a form with conflicting instructions like this one, we'll have to guess which instruction to follow, and we won't always guess right.

If you don't want overcorrection, don't check a box in the tooth chart. Just list the teeth by number in your written instructions.

It's been over a year since we introduced Phase Zero™—an initial set of passive aligners that gets patients acclimated to clear aligner therapy as quickly and gently as possible.

Now we're proud to announce the latest revolution in orthodontic technology:
Phase Negative One.

Traditionally, the amount of correction that can be achieved with clear aligners has always been limited by the initial malocclusion of the patient's teeth. It happens all the time—patients come into your office begging to wear dental appliances like their friends and colleagues, but you have to turn them away because of their perfect Class I bite relationships and flawless, straight teeth.

That's where Phase Negative One comes in. It's a set of clear misaligners that distorts teeth into a more aesthetically-displeasing configuration before treatment begins. Now everyone can enjoy clear aligner therapy—even those who were unfortunate enough to be born with naturally perfect smiles.

Phase Negative One can be customized to create almost any type of issue you and your patient want to solve: from overjet and diastema to whifflebite and houndstooth.

Best of all, Phase Negative One reduces turnaround time to less than zero. The more inaccurate it is, the better it works, so you can have the misaligners ready in your office even before your patient's first appointment, without taking impressions at all.

Phase Negative One is available as a -$95 downgrade to any treatment option starting today, April 1.

Warning: Results may vary. Available by prescription only. Use of Phase Negative One may violate local, state, and federal regulations, Hippocratic Oath, and principles of basic common sense. Offer not valid on major continents or outlying islands.

Happy New Year! We hope you had a great holiday break.

The new year is an opportunity for patients to reinvent themselves with a new smile, and it's a great time for doctors to try something new as well. With that in mind, let's take a look at…

What's new in 2013

We said they were coming, and now they're here: ClearCorrect’s new treatment options.

To refresh your memory, the new treatment options are:

• Limited 6
• Limited 12
• Unlimited

Case evaluations are also available if you need a little help getting started, as are standalone retainers.

From here on out, all new cases will be processed as one of these case types: Limited 6 is a super-affordable option for minor anterior adjustments and ortho relapses. Limited 12 is great for cases with a couple of millimeters of crowding or spacing to correct. And Unlimited is the most flexible, no-worries option you can get: as many aligners as you need until the case is closed.

The fine print

The full details of the policies and pricing for these cases are spelled out in our updated terms & conditions. I know it's probably hard to imagine anything more boring, but you really should take a few minutes to look them over. They apply to all cases, not just new cases submitted in 2013.

We've clarified a few policies regarding how long cases can remain open. For instance, cases will be automatically closed after 180 days of inactivity—if it's been almost six months since you got your patient's last phase, time may be running out to request a final retainer or a revision.

Also, case revisions must be submitted within 3 years of the original submission. If you have any patients who started treatment back in 2009 and then drifted off without wrapping things up, it's too late to start the case back up and request refinements now. (We will still ship any already-planned and paid-for phases for older cases, even if they're 3 years old.)

If your patient hasn't been wearing aligners for a while and falls into one of these categories, your best option for doing a little touchup treatment is going to be to submit a brand-new Limited 6 case. (See, we told you they're good for ortho relapses.)

You might also notice a minor change we've made to our payment processing. We used to wait to charge lab fees until we had received all required records (photos, impressions, etc.). We're now charging the lab fee as soon as cases are submitted. We've updated our sample timeline to reflect this change.

Thank you again for being ClearCorrect providers. We can't say it enough. Together, we'll make this our best year yet. Until next time…

In last week's announcement of our new treatment options for 2013, we mentioned that we're also starting a new volume discount program.

This week, we've got the details on that, plus some answers to your questions from last week, and a reminder about a workshop discount that's going away at the end of the year.

Take five, Five for Five

You may be familiar with our previous volume discount program, called Five for Five. As you submitted cases, you could accumulate credit to be used the next quarter, depending on how many cases you submitted in the quarter.

If you weren't familiar with it, don't get too attached, 'cause it's going away.

Instant gratification

Our new volume discount program delivers instant discounts on Unlimited cases throughout the quarter.

The discounts kick in with a bang after you submit 10 Unlimited cases—the 11th Unlimited case submitted each quarter is free.

After that, the discounts really start to add up. You'll be able to take $100 off your 12th–25th Unlimited cases, $200 off your 26th–35th, and then $300 off Unlimited cases for the rest of the quarter. You'll get your discounts right away, instead of waiting months for an account credit or rebate check.

We know that a lot of you aren't going to treat enough patients to qualify for these discounts. That's why we've made our regular lab fees so affordable; so clear aligners can be accessible to as many people as possible.

However, we wanted to make sure that we were also offering the best available price to doctors who do run high-traffic practices. The discounts are bigger now, and they're available as soon as you earn them.

It's important to note that only Unlimited cases count towards the discount, and only Unlimited cases qualify to be discounted. The incredibly low lab fees for Limited 6 and Limited 12 cases are already available to everyone, regardless of volume.

Q & A

Now to answer some of your questions about the new treatment options:

Q: Can I still submit a Limited or Full case after January 1, 2013?

A: No. The Limited and Full case types are being discontinued on January 1, 2013. Any case submission form that we receive after January 1 will be processed as Limited 12 if it says "Limited" and as Unlimited if it says "Full".

Q: Will I still be able to buy extra phases for my existing Limited & Full cases?

A: Yes, you can still buy extra phases for legacy cases only. Or you can upgrade those cases to Unlimited by paying the difference in their standard lab fees. Any additional fees you've paid over the life of the case (for instance, for shipping, replacements, or extra phases) won't be credited towards the upgrade cost.

Q: I bought a voucher for a Full case. Is it still valid?

A: Yes. If you submit a case with a valid Full voucher after January 1, 2013, we'll process it as an Unlimited case at no additional charge. Cases already started as Full will remain Full unless you choose to upgrade them. (Don't forget to use those vouchers—they expire one year after purchase.)

Q: I've earned Five for Five credit in the fourth quarter of 2012. Can I still use that?

A: Yes. Any Five for Five credit you earn this quarter can be applied next quarter. However, starting January 1, 2013, the Five for Five program will be replaced with the new volume discount program, so you won't earn any additional Five for Five credit after that point.

Q: Which treatment option should I choose when I submit cases in 2013?

A: In general, anything you currently submit as Full will be Unlimited, and most Limited cases will be Limited 12. Limited 6 is ideal for minor anterior movements that can be completed within 6 steps. We'll offer more information to help you choose between case types next year.

Note to consumers: Our lab fees are confidential. Which is a shame, because they’re really worth bragging about. If you’re a dentist or orthodontist, give us a call at (888) 331-3323 to get the full scoop. If you’re already a provider, details are available on our wiki.

We’re excited to introduce our all-new treatment options, available starting January 1, 2013.

We tested countless variations before finalizing these options. Based on the feedback we’ve received from doctors, we think these new options will provide the greatest combination of affordability, flexibility, and predictability ever available for clear aligners.

Let’s get started, shall we?

Limited 6 — $███

We believe this will be the most affordable clear aligner treatment option available in the industry.

The Limited 6 is ideal for simple anterior adjustments. It includes up to 6 steps of clear aligners (single or dual arch). That’s more aligners than the competition, offered at a lower price. This price is not a limited-time promotion—it’s our everyday lab fee.

Like every ClearCorrect case, this comes with a treatment setup, and (unlike the other guys) Phase Zero and retainers are included at no extra cost. (We could have called this Limited 8, but we didn't want to rub it in.)

Limited 12 — $███

Cases you currently submit as Limited will be treated as a Limited 12, starting January 1.

It’s very similar to what you’re familiar with—you still get up to 12 steps of clear aligners, plus a setup, Phase Zero, and retainers. There's still no fee for revisions, so long as you stay under 12 total aligners. Up to 2 free replacement aligners are now included, and they won't count against the 12 steps allowed for your case.

Unlimited — $███

This is a biggie. If Limited 6 is the most affordable clear aligner option in the industry, this is the most flexible and predictable.

Starting January 1, any cases you currently submit as Full will be treated with the new Unlimited option. It's pretty simple to explain: you get as many aligners as you need, until the case is closed. That includes unlimited revisions for up to 3 years and replacements for any step at no extra cost. Seriously.

While you take a minute to let that soak in, I’ll just mention that the Unlimited lab fee can actually sink as low as $███ with our new volume discount program. (More on that another time.)

We'll also be offering case evaluations and standalone setups to lower the barrier to entry even further. And you can upgrade any case (including legacy Limited and Full cases) to a more comprehensive treatment option just by paying the difference in lab fees. We've added answers to most of your questions about these changes on the wiki, and we'll introduce updated terms & conditions soon with full details.

It’s the same great ClearCorrect product you're used to, now even more flexible and doctor-friendly.

What’s the catch?

As the sharper-eyed among you may have noticed, the Limited 12 and Unlimited lab fees are slightly higher than the current Limited and Full options. We haven’t raised our prices since we started 6 years ago, and we don't plan to do it again any time soon.

We believe in being open and transparent, so here's why we're making this change now:

1. A new medical device excise tax is going into effect on January 1, 2013. Rather than tack it on top of our advertised lab fee, it seemed better to revise our prices to accommodate it.
2. We heard your feedback: you love the flexibility of phase-based delivery, but you don’t like keeping track of unused phases, or paying for extra ones. We've eliminated that hassle by creating the new Unlimited option. Increasing the lab fee slightly makes that feasible.
3. The increases are partially offset by the introduction of Limited 6—our most affordable treatment option ever.
4. This keeps us in line with inflation, and will allow us to continue to expand and improve our product.

If you want to submit cases before this price increase goes into effect, we totally understand. Any cases submitted by December 31, 2012 will be handled just like they are today, and charged at the current rates. Next year, you’ll have the option to upgrade those cases to the new treatment options at any time just by paying the difference in the lab fee.

I’m sure you want to know more. First, check out the wiki. If you still have questions, post them in the comments, and we'll include our responses in the next tech tip.

Until next time!

We hope you're enjoying your Independence Day weekend! For this week's tech tip, we want to address something that's got our phones ringing off the hook...

You may have received this postcard in the mail last week, showcasing a "Do-It-Yourself Mini Promo Kit."

We've received a lot of calls about this mailer, and we wanted to clear the air. 

First of all, while it is technically possible to trim & fold tiny brochures, posters, and a banner by following the instructions on the mailer, the "mini promo kit" was intended as a joke. We apologize for any X-ACTO® knife injuries sustained while attempting to follow our instructions.

Secondly, based on the volume of calls we received asking to order a "promo kit", there definitely is a demand out there for a simple, easy-to-order bundle of promotional materials. Who are we to argue? In honor of the response to the mailer, we've created the new...

Let-Us-Do-It-For-You Actual-Size Promo Kit

(Um, no. Let's just call it the Promo Starter Kit. --Ed.)

$75 gets you:

• 1 vinyl banner, for indoor or outdoor use. (Banner size: 36" x 72")
• 1 small brochure holder
• 50 brochures
• 4 posters (chosen at random)

To order, call your account rep at (888) 331-3323 or send us an email.

Supplies are limited, so order quickly if you're interested!

Of course, you can also still order any of our promotional items individually, if you prefer. We just want to make it as easy as possible for you to market your practice.