This article covers the following topics:
- Getting the patient to sign the Informed consent & agreement and important initial patient education
- Prescribing the case and the pre-submission worksheet
- Getting intraoral scans or PVS Impressions
- How to take one-step impressions
- Taking the required photos and tips on taking photos
- X-rays (optional)
Your first steps in starting a case with ClearCorrect will be collecting patient records. You will collect the records in your first appointment with the patient.
Informed consent & agreement
We recommend as the first action for you to review the Informed consent & agreement with your patient and sign it together. The document is provided to prepare patients for the various issues that can arise during treatment as well as potential risks associated with clear aligner therapy. The Informed consent & agreement is a legal agreement between you and your patient establishing that your patient consents to receive treatment and understands the risks involved. Though we don't require a copy of this form for our records, we strongly recommend that you keep it with your patient's records for future reference.
Educating your patient is key to obtaining positive results in clear aligner therapy. It is important to take time to educate your patient in this first appointment.
Some doctors have created additional agreements to serve as confirmation that you have educated your patient on specific important aspects of their treatment. While using any additional forms or agreements is entirely at your discretion, we encourage it. Below are a couple examples of forms used in some dental practices:
- A "Holding Form" for when a patient's treatment goes on hold.
- For when treatment is complete a "Patient Satisfaction Form" confirming that the patient is satisfied with their treatment.
Easily one of the most important records you'll send us is your prescription. It tells us what you want us to do. You treat your patient, not ClearCorrect. What happens with the case is entirely up to you, so it's important that you guide us with a thorough and detailed prescription.
We've tried to make it as easy as possible for you to send us the information we need. Simply complete the prescription form on ClearComm when you submit your case.
Some doctors prefer to use our pre-submission worksheet when sitting chair side with the patient. With the pre-submission worksheet you can collect needed information for your case submission while you're with the patient. While we don't accept pre-submission worksheets for submitting cases (all cases must be submitted online), it can be a useful tool for doctors to collect information in the first appointment.
Intraoral Scans or PVS Impressions
The aligners we make are custom appliances. We make them to specifically fit your patient based on a series of models made from the intraoral scans or PVS impressions you're required to send us when submitting your case.
Intraoral scans work best, but PVS impressions have been an industry standard for years and continue to work well.
Note: We only accept any silicone-based impression material, including PVS, VPS, and polyether materials.
If submitting scans for a case, we require scans of both the upper and lower arches, even if you're only treating one arch. Why do you need both impressions for single arched cases?
We also require that the scans be positioned in occlusion. You'll know they're positioned correctly if when opened in a 3D viewer they appear articulated like the patient's bite, as in the image below.
If you don't have an intraoral scanner or just prefer taking good old-fashioned PVS impressions, we'll still accept them. As with scans, we require both upper and lower impressions, even if you're only treating one arch.
Bite registrations are optional. There may still be a few scenarios where the bite registration is beneficial (for instance, when the patient has a posterior open bite or mandibular asymmetry), but in most cases the bite registration is no longer required to submit your case.
You can use nearly any type of tray you like for your impressions except for metal or mesh trays. We don't return your impressions, so it's best to use disposable trays anyway. Make sure your trays are properly sized to fit all the teeth, cover the surrounding gums 4mm beyond the zenith of the gingival margin, and extend beyond the distal of the terminal tooth.
PVS or VPS materials work best. Polyether (Impregum) will work as long as the detail for the gum lines are there. In our experience, Sultan Genie™ VPS and Premium Dental VPS impression materials are easy to work with and deliver consistent results. If you prefer a different polyvinyl or polyether impression material, feel free to continue using that.
Alginate is not acceptable because it dries out and distorts. Stone models are not accepted either. For more information on this, check out our impression materials article here.
The final set of records we require is photos. Photos help us understand your prescription and interpret your instructions. If you don’t have the photos on hand when you submit your case, you may be able to upload them later on the case page, but don’t wait too long—the case won’t move forward until we have all required records.
We need photos of eight specific angles:
Your photos will need to be uploaded as digital files when you submit your case in ClearComm. The most important thing is to include clear, well-lit photos from all eight angles.
Below are the eight different photo angles required for your submission. These photos will help us produce the best aligners possible:
- Full face (not smiling)
- Full face (smiling)
- Profile (not smiling)
- Occluded buccal view of anterior
- Occluded buccal view of right lateral
- Occluded buccal view of left lateral
- Occlusal view of upper
- Occlusal view of lower
For a fillable photo template click here.
We recommend that you provide x-rays, but we won’t hold up your case if you decide not to include them. Even though you'll tell us in your prescription about the sorts of things we'd look for in x-rays--things like ankylosed or fused teeth, restorations, implants, etc.--that old adage "a picture's worth a thousand words" really does hold true, especially with x-rays. It just makes it that much easier for us to understand what you're trying to accomplish with the treatment.
We're happy to accept either a panoramic x-ray or a full-mouth series.