Topics covered

• Consider the patient's conditions
• Discuss patient's goals
• Choose your treatment option
• Article references/sources

You can determine the complexity of a case by assessing the conditions, treatment goals and the treatment option to use for the case.

Download a printable guide here. 

Conditions

The presence of these conditions doesn’t prohibit treatment with clear aligners, but you must consider how their presence affects the patient’s candidacy as a good clear aligner patient and how it may compromise end results. If your patient presents with ten of these conditions and you plan to treat all of them, that would make for a far more complex case—and more of a challenge—than if you were to select only three conditions to treat.

Skeletal imbalance
Span of missing teeth
Tipped teeth
Rotated teeth
Crowded teeth
Open bite
Deep bite (Overbite)
Mis-shapen teeth
Irregularly shaped roots or crowns
Blocked out teeth
Unerupted teeth
Rx extractions
Crossbite
Muscle imbalance	An example could be; really tight lip muscles that restrict the forward movement of the teeth.
Periodontal issues
Large spaces
Existing implants
Existing restorations
TMD
Bruxism
Patients: Disabilities Metabolism Motivation Goals/Expectations

Goals

Discuss with your patient and determine their goals for treatment.

• Talk about the patient’s existing condition
• Find out what they would like addressed with clear aligner treatment
• Educate the patient on what will be required of them to achieve their desired results
• Discuss any health benefits

Choose your treatment option

ClearCorrect offers three options for treatment:

Flex

With Flex you get the exact amount of treatment you need—no more, no less—and only pay for what you use.

Note: These guidelines are just suggestions when deciding the complexity of a case and are not absolute. It‘s up to you as the treating clinician to perform the necessary patient examinations and determine if each patient is an ideal candidate for clear aligner treatment.

Consider choosing Flex:

• If correcting a small number of conditions
• Treatment requiring 6 or fewer sets of aligners
• Grade 1 - 2 of the Dental Health Component of IOTN index (Source 1) below)
• Only simple movements required
• For simple aesthetic corrections
• Single-arch treatments
• Minor orthodontic relapses
• Minor anterior movements
• Minor crowding or spaces
• Pre-braces adjustments
• Minor combination treatment

Simple movements

Slight rotation
Translational closure of small spaces
Minor arch development or expansion
Proclination or labial crown tipping
Minor intrusions

ONE

The ONE treatment option, gives you up to 24 sets of aligners and includes up to one year of treatment, one set of retainers, and one revision. 

Note: These guidelines are just suggestions when deciding the complexity of a case and are not absolute. It‘s up to you as the treating clinician to perform the necessary patient examinations and determine if each patient is an ideal candidate for clear aligner treatment.

Consider choosing ONE:

• Moderate to severe crowding and large spaces closure
• Overbite and overjet reduction
• Crossbite corrections
• Improving tipped and rotated teeth
• Reducing excessively proclined teeth 

*Currently only available in the US and Canada

Unlimited

With Unlimited you pay one flat rate for as many aligners and retainers as you need for five full years, including revisions and replacements.

Note: These guidelines are just suggestions when deciding the complexity of a case and are not absolute. It‘s up to you as the treating clinician to perform the necessary patient examinations and determine if each patient is an ideal candidate for clear aligner treatment.

Consider choosing Unlimited:

• If correcting a considerable number of conditions
• For treatment with a high probability of requiring 1 or more revisions
• Grade 3 - 5 of the Dental Health Component of IOTN index (Source 1) below)
• Class II and Class III bite relationships
• If correcting a skeletal condition
• If treating in multiple phases (Source 3) below)
• Combination treatments requiring auxiliaries (Source 2) below)
  • Elastics
  • Mechanical distalizers
  • Palatal expanders
• If you are a beginner or considering a case of high complexity
• Non-compliant patients
• Patients with potential treatment interruptions
• Patients requiring long-term retention
• If difficult movements are required

Difficult movements

Significant anterior rotations
Molar rotations
Multiple extractions
Distalization or mesialization of posterior teeth
Deep curve of spee
Major extrusions
Uprighting of posterior teeth
Anterior open bite corrections
Deepbite corrections
Short clinical crowns

Sources

1) “Index of Orthodontic Treatment Need (IOTN)” by Evans R. and Shaw W. C. A preliminary evaluation of an illustrated scale for rating dental attractiveness. European Journal of Orthodontics 1987; 9:314-318 https://academic.oup.com/ejo/article-abstract

2) “Creative Adjuncts for Clear Aligners, Part 1: Class II Treatment” S. Jay Bowman DMD, MSD, Frank Celenza DDS, John Sparaga DMD, Moschos A. Papadopoulos DDS, DMD, Kenji Ojima DDS, James Cheng-Yi Lin DDS www.jco-online.com/archive/2015/02/83/

3) “Eruption guidance in the mixed dentition: A case report” Weon Kim, Tae & Park, Jae. (2008). The Journal of clinical pediatric dentistry. 32. 331-9. 10.17796/jcpd.32.4.gt1504402674437p