Tech Tip: Short clinical crowns

Recently, we've been focusing our tech tips on troubleshooting tips to help you manage your cases when issues arise. One issue that may affect ill-fitting aligners is short clinical crowns. Because the clinical crown is so short, there are fewer retention points on which the aligners can apply pressure. When there aren't many retention points on the tooth, the aligner won't be able to fully seat over the tooth, or will "pop off".

A helpful way to prevent problems in treatment relating to short clinical crowns is to indicate any short clinical crowns and request engagers on the first or second premolars under the "Additional Instructions" section of your case submission form. Please specify to place those engagers during step 1A, and we will accommodate your request.

Letting us know about short clinical crowns when submitting a case prevents fitting problems. Check for short clinical crowns whenever you evaluate your patient (especially if Phase Zero doesn't fit). This way, you can request engagers right away and get your patient into successful treatment.

Tech Tip: Retainer materials

A couple months ago, we were asked a great question by one of our providers.

"What is the best material of choice for retainers after completion? We have .030, is that thick enough?"

When making your own retainers using the provided models of the last step of treatment, you may use any type of plastic that you prefer. When we manufacture your patient's final retainers, we use the exact same Zendura plastic (.030) that we use for each previous step of active aligners. If you prefer to use .040 plastic sheets, then those will definitely work as well. While we recommend Zendura as the best available material for your retainers or replacement aligners, any type of quality thermoforming plastic that you have available in your practice will also work.

For your convenience, we sell both Zendura and Biocryl sheets at providers-only rates. To order plastic sheets -- or a complete Trimming Kit for $90 -- call your account rep at (888) 331-3323.

Tech Tip: Troubleshooting aligner issues

Last week, we gave you troubleshooting tips to help you avoid submitting case revisions. This week, we continue with some easy methods you can use to fix issues with aligners without breaking a phase, delaying treatment, or submitting new impressions.

The best part? Most of these tips can be completed during the patient's visit, preventing additional chair time.

Ill-fitting aligners

When treatment gets off track and the aligners don't fit, it's often because the patient has not been adhering fully to the 22-hour a day wear schedule.

Try these quick fixes to common fitting issues:

  • Check your treatment plan for Compliance Checkpoints. Using dental floss, determine if there is contact between the indicated teeth. If there is no contact at a Compliance Checkpoint, it nearly always means that the patient has not been wearing their aligners.
  • Try backtracking. Wearing the aligner for an extra couple of weeks could help the teeth complete the movements scheduled for that step.
  • Check for contraindications to clear aligner therapy, including the use of prescribed bisphosphonates. Read our Case Parameters guide for more information about contraindications.

Sometimes the aligners fit, but leave a small gap between them and the teeth. This can occur when intruding and extruding teeth, or when a new patient tries on their first pair of aligners. We now carry a tried and true product to help you and your patient solve this issue.

Chewies

Chewies help patients improve the fit of their alingers and close gaps, both inside and outside of the doctor's office. By chewing on these reusable plastic rolls, patients help their aligners seat while relieving any tension or discomfort from a fresh set of aligners.

Chewies come pre-packaged in handout-friendly sets of two. We recommend distributing Chewies to your patients at each fitting appointment or including a large bag with the price of treatment.

To order a bag of twenty Chewies for $10, call your account rep at (888) 331-3323.

Tight Phase Zero

When Phase Zero aligners are tight, you don't necessarily need to send in new impressions. As long as the aligners seat correctly over the teeth, they are accurate.

The purpose of Phase Zero is to verify the accuracy of the impressions, retain the teeth in their current position until phase 1, and help the patient get used to wearing the aligners. Though the Phase Zero aligners are not actively moving teeth, they are "actively" retaining the teeth. The tightness and pressure your patient is feeling is probably due to the fact that an unfamiliar, rigid plastic device is being placed over their teeth for the first time.

If any incisal or occlusal gaps on the aligners are causing the poor fit, you may need to send in new impressions. We will generate a new treatment setup based on those new impressions, and, after setup approval, start right into phase 1. If you'd like a new set of Phase Zero aligners, you may purchase one for $95.

Lost or broken aligners

Patients lose or damage their aligners. It happens all the time. Aligners can be lost or damaged in a surprising variety of different ways: being left in a hot car, thrown away with lunch, eaten by the family dog. Our doctors -- and our account reps -- have heard it all.

This is why we include plastic models with every phase of treatment, so that you can make a replacement aligner right in your office. We even have a simple step-by-step guide to making your own aligners available on ClearComm.

We will happily manufacture a replacement aligner for you, if you don't want to make one for yourself. Just understand that it will take time to ship them to you, and it will break one of your available phases, making that phase available solely for replacements.

Need supplies? Our Trimming Kit contains all the items you will need to create multiple replacement aligners in your own office. 

To order a Trimming Kit for $90, call your account rep at (888) 331-3323.

Tech Tip: Difficult tooth movements

Not all tooth movements are created equal. As our case parameters guide explains, tooth movements can be easy, moderate, or difficult depending on the direction and distance of movement. When a tooth needs to perform a difficult movement (such as intrusion or extrusion), an aligner may not apply enough force by itself.

Here are some methods you can use to complete those difficult tooth movements without resorting to case revisions.

Backtracking

When treatment gets off track and the next set of aligners doesn't fit, the teeth may just need more time to make those difficult movements. This is especially true if the patient hasn't stuck to the recommended wear schedule of at least 22 hours per day. All the case revisions in the world won't help if the patient doesn't wear the aligners regularly.

Use the models from the last step that fit to create a fresh pair of aligners in your office. A fresh pair of aligners will have more resilience and tension than a three-week-old aligner. Advise your patient to wear those aligners for another week, or until the aligners feel loose. If they stick to the schedule, it's likely that the next set of aligners will fit when they're done.

You can use a standard thermoforming plastic like Biocryl or Essix, or (if you have the right equipment) a premium material like Zendura. If you're all out, just give your account rep a call at (888) 331-3323 to place an order.

If you're sure the patient is being compliant and you've tried backtracking and breaking tight contacts, but the next set of aligners still doesn't fit, then the teeth just might be plain old stubborn. Then it's probably time to order a case revision.

Dealing with broken engager templates

Engagers give the aligner extra leverage to complete difficult movements. We include an engager template whenever it's time to install engagers.

If the engager template breaks, we'll be happy to replace it. Of course, it will take at least a few days to manufacture and ship. (And again, if you're out of phases, you might need to buy a step.) Fortunately, there is a quick & easy alternative that keeps your patients in active treatment:

Let's say that your patient is currently wearing step 3B, and comes to your practice for his 3C fitting appointment. As you prepare to place the engager, the template breaks.

Instead of waiting for a replacement template, just let your patient wear the step 3C aligners without engagers. Have your patient come back for an interim appointment three weeks later. There, you can use the worn-out 3C aligners as engager templates for the next step.

(A guide to placing engagers is available in the Documents section of ClearComm.)

Extruding teeth with auxiliaries

When a tooth does not erupt as desired, you can apply some extra force with auxiliaries by following our step-by-step guide. The treatment plan will never instruct you to place auxiliaries -- this is an advanced technique that you can use yourself whenever you see fit.

(This guide is also available in the Documents section of ClearComm.)

If you have any other suggestions or tips that you'd like to share, please leave a comment and let us know!

Tech Tip: A word from our reps...with visuals!

Nobody knows ClearCorrect better than our awesome account reps. We've shared some of their tips before. This week, we've got a whole new batch of answers to the questions they get asked most.

Where do I get the _____ form?

All the forms you will ever need are located in ClearComm, our online case management site. Simply visit dr.clearcorrect.com, and type in your username and password. Then, click the big green Forms link on the right-hand side, and choose the correct form from the list.

I lost my ClearComm username/password. Help?!

It happens to the best of us. If you ever forget your ClearComm username or password, click on the link called "Forgot Username or Password", located at the bottom of the log-in screen.

A temporary password will be emailed to the email address we have on file. After you log in to your account, you can change your password back again.

When is my case going to ship?

All estimated ship dates from our lab to your office will be shown on the Shipments tab on the right-hand side of ClearComm. A ship date is listed right next to each item.

You will receive an email with a tracking number each time we ship a case out to you. Depending on your location, delivery time could take 5-7 business days.

Where is my treatment setup?

Your treatment setup is located in - you guessed it - the Treatment setups section. On the Treatment setups page, you'll see a list of all your available treatment setups. When you click "View Setup", you'll be taken to a page like this:

Click on the PDF icon to view the treatment setup, then approve or disapprove it along with Phase Zero.

(If you have trouble viewing this setup, you may need to right-click the icon and save the PDF to your computer, then open it in Adobe Reader).

How do I order my patient's retainers?

Once your patient has finished treatment, you need to officially close the case before your retainers will be shipped. We do this to make sure that we don't make a retainer before your patient is ready for it - saving you and your patient time and money!

To close your case, complete and submit a case completion form to your account representative via email or fax. After we receive this form, we will manufacture and ship your retainers!

 

Of course, if you have any other questions, your account rep is always available to help. You may reach them at (888) 331-3323.

Tech Tip: Breaking tight contacts

We've had several calls during the past few weeks where doctors have noticed that the patient's teeth had not fully aligned on the last step, though the models show that the patient should have completed treatment.

Instead of requesting a case revision in this situation, we suggest using a diamond strip to break tight contacts. This will give the teeth a little more room to move in order to complete treatment.

If the teeth are not tracking and both the mesial and distal surfaces are tight, you can loosen things up by performing 0.1mm of IPR with diamond strips.

When we originally stage a case, we prefer to create space by distalizing teeth, and recommend IPR only when necessary. When your'e near the end of treatment, however, a little IPR can go a long way. It's a simple and effective way to open up space quickly without a lengthy case revision.

You can purchase diamond strips (or a full IPR kit) from the ClearCorrect Online Store.

Tech Tip: Taking impressions with undercuts

If you've ever tried to pull your feet swiftly out of a giant puddle of mud, you've experienced the frustration associated with making impressions of teeth with undercuts.

We asked our chief technical officer, Paul Dinh, to give us some tips on taking quality impressions from patients with undercuts.

The impression material gets locked in the patient's mouth because the material fills in between the teeth. When the impression hardens, there isn't enough flex to remove the impression. 

To save you from having to physically cut out the impression material from the patient's mouth, Paul gave us two great solutions:

  • Fill the area between the undercut teeth with a material that will not bond to the impression (like wax). The impression will be able to glide right out from between the teeth, while still making a quality impression that we can use to make your patient's treatment setup.
  • Try a two-step impression. Once the first step is done, get a knife and remove the gums 2 mm past the gingival in the medium body material. Then, when the light body gets added onto the medium body, the second step light body material will be the only material that will be covering the gums with the undercuts. The light body will flex easily to allow removal of the impression.

You can view our step-by-step video on taking two-step impressions here.

Thanks again to our chief technical officer. If you have any tips or experiences you'd like to share, please let us know!

About that "Mini Promo Kit" mailer

Do-It-Yourself Mini Promo Kit mailer

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.

Closeup of miniature posters & brochure

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.

Have any marketing tips?

While we're on the subject of promotions, we need your advice.

Some of the most frequently-asked questions we get from our providers are questions about how to effectively promote their practice as ClearCorrect providers. We've highlighted a few of our providers' suggestions in the past on our blog, but we are now on the lookout for new creative ways to share with both our new and seasoned providers.

Have you ran a promotion for ClearCorrect that worked great for your practice? Did you utilize any of our promotional items in a creative way? Was there anything that absolutely didn't work?

If you have any marketing tips or tricks, photos of your creativity at work, or just want to brag about your marketing successes, please reply to this post and let us know!

Ordering a Promo Starter Kit? Leave your marketing tip with your account rep while ordering and we'll throw in an extra pack of brochures. There's nothing like getting rewarded for your awesomeness.

Phase Out t-shirts

We had some t-shirts made a while back featuring great artwork by our graphic designer, Zach Kimmel. These were originally only available to ClearCorrect employees, but it seems like a shame to keep these to ourselves.

So now we're offering these t-shirts to our providers for a limited time. There's only a limited number of shirts available, so if you want a particular size, you should order quickly. We have two designs: a geometric heart/water design titled Give, and a hand-lettered illustration we're calling Words.

The shirts are 100% cotton and made by American Apparel. Both designs include a Phase Out logo on the back, and both are available in various sizes for men & women. (The women's shirts run about a size small.) Call or email your account rep to order shirts for $25 each, plus shipping & handling. A portion of the proceeds for each shirt will be donated to charity: water.