Here are the first 6 items in the Global clinical preference page. I have added
some comments.

  • I prefer NO IPR for the first ClinCheck created after record submission.
    This is for the initial ClinCheck and for refinement ClinChecks. I prefer to
    develop the arches, using the 3D Controls before adding IPR. Arch
    expansion will often reduce or eliminate the need for IPR. I prefer to use
    the 3D Controls when adding IPR.
  • I prefer to delay attachment placement until stage 3. Then the patients
    can get used to the aligners before adding attachments. Also, it helps
    with scheduling as my assistant can deliver stage 1.
  • No delay in extraction because I prefer the extraction be done 1-2 weeks
    before delivering stage 1. No actual extractions are done though until
    the treatment plan is finalized and the extraction was done virtually.
  • Here are my selections in the next 6 items in the Global clinical preference page. I have added some comments. • I allow expansion across the cuspid, premolar, and molar teeth however I limit the degree to <= 2mm. We need to be careful about adding a lot of expansion because amounts greater than 2mm can result in buccal crown tip (proclination) and hanging lingual cusps. The reason is that crowns move easier the root apices.

Special instructions:

  1. Move the lower and upper anterior teeth forward for 4 stages to create some
    temporary spacing to help with rotation. START ROTATIONS AT STAGE 5. Use hinge type
    movements for the rotations. After the rotations are complete, close all space. I realize
    by doing this you are adding 4 more stages to the treatment plan. You can start other
    movements like intrusion anytime.
  2. Use buccal crown tip movements to perform posterior expansion.
  3. Add over-correction c-chain aligners for all cases except when an aligner limit
    prohibits adding them.
  4. Collision tolerance set to zero please so there is no interproximal binding when
    moving teeth. I want very light interproximal contacts (open contacts) around teeth
    that are being rotated.
  5. I prefer attachments at stage 3 except for cases with 14 or less aligners. If there are
    14 or fewer aligners place attachments at stage 1.
  6. Place attachments for all refinements (additional aligners) at stage 1 unless I specify
    differently in the refinement prescription.

Instructions:

1.Please correct anterior rotations with hinge type movement. Create an axis for rotation (hinge) on the mesial or distal of the tooth. It is OK to move the hinge buccal to create spacing but perform ALL the rotation using the hinge as axis of rotation. Create light interproximal contacts and do NOT start rotations until this temporary space exists. Maintain this space until rotations are completed. Once alignment has been achieved move the tooth buccal or lingual as needed. Close all space.

2. Collision tolerance set to zero please so there is no interproximal binding when moving teeth. I want vely light interproximal contacts (open contacts) around teeth that are totated.

3. No IPR in the first Approver even if the resulting overjet is not clinically ideal. I will add IPR if needed after the first Approver.

4. Upright all posterior teeth. Correct ant lingual inclinations of posterior teeth.

5. I prefer attachments at stage 3 except for cases with 20 or less aligners. if there are 20 or fewer aligners place attachments at stage 1.