At the end of treatment it's important to assess whether you and your patient are satisfied with the results.
Sometimes, your perception of a nicely finished case is different from the patient’s. When you give the patient an opportunity to express their satisfaction of the treatment result before announcing that treatment is finished, your patient will feel like you care about how the they feel about their result. It also gives you the opportunity to correct any remaining undesirable issues.
Here are our recommended best practices for finishing cases.
Identify potential issues prior to the last aligner
Before delivering the last aligner to your patient, evaluate for the presence of any of the following conditions and determine if they need resolution before you tell your patient “You’re finished!”:
- Residual spaces: Small, interproximal spaces may still exist due to a variety of reasons, e.g. patient has not worn their aligners sufficiently to close the spaces, excessive IPR had been done, or space existed in the approved setup.
- Incomplete rotations: If a tooth has not finished its rotation correction, the patient will undoubtedly be aware of it and not consider their treatment finished.
- Teeth are not aligning as expected: Alignment is not as expected – if teeth are not aligned as seen in the setup, it is important to determine the cause as soon as noticed; most often, the discrepancy is due to the lack of required space, i.e. insufficient arch expansion or IPR (see images).
- Irregular or uneven incisal edges: A tooth may need enamoplasty or need to be intruded or extruded to level its incisal edge with adjacent teeth.
- Marginal ridges: The misalignment of the marginal ridges of adjacent teeth may indicate a tooth should be tipped to improve its axial alignment.
- Occlusion not fully interdigitated or idealized
- Posterior openbite: While the etiology of these openbites may be uncertain, an appropriate resolution should be offered to the patient before the delivery of their retainer.
- Black triangles: These unsightly interproximal spaces can be visually unsettling to the patient and should be managed proactively in an appropriate manner.
When you're ready to order the retainer
Once both you and your patient are satisfied with the treatment outcomes, it's time to order the retainer. Following is the process for ordering the first set of retainers at the end of clear aligner treatment. Retainers can also be purchased at any point post treatment.
For a new patient (not treated with ClearCorrect) there is a different process. Please see this article for those instructions.
- Retainers can be ordered based on PVS impressions, intraoral scans or a previous step. Decide which option you want for your patient and have them ready.
- Locate your patient in ClearComm. They may be under "In progress" or "Closed".
- Click on a case to go to the case page.
- Click the REQUEST RETAINER button.
- Let us know if you're submitting impressions, intraoral scans or if they will be based on a previous step.
- Indicate how many retainers you want to order.
- Apply any discounts & select your preferred shipping method.
- Select your payment method and click "Submit".
- For legacy cases that have never been closed:
- the first set of retainers is included (plus shipping), if it is based on an existing step.
- Additional fees apply for retainers based on impressions or scans.
- Additional retainers may be added to the order at a discounted rate.
- New Unlimited cases include up to two sets of retainers every six months.
- All other retainers are available at standard Flex prices.
- You will be taken to the case page for the new patient. Use the green UPLOAD button to upload scans, or the green SHIP button to print a shipping label for impressions.
Retainer appointment & retention protocols
- When scheduling your patient's retainer appointment, make sure that you allow enough time for the shipment to arrive at your practice.
- Educate you patient during the retainer appointment about the way that it works in preventing the relapse of teeth. You may also want to educate them in the importance of complying to your suggested wear schedule.
- Determine the retention protocol for the patient. The type of retention protocol you select can depend on the type of treatment, any post treatment corrections and even patient preference.
- A typical retention protocol used by an experienced orthodontist:
- Last aligner for 2 months
- Clear aligner retainer for 2-6 months full-time wear
- Continue removable retainers bed-time wear
- 6 month follow-up retainer check appointments until done