When teeth don't move as planned, you can request a case revision.  When you request a Revision your patient's treatment will be re-staged to target the original treatment goal, starting from the current position, unless you have requested otherwise. ONE cases include one revision with up to 24 sets of aligners. Revisions must be submitted within one year of the original case submission date to be included in the ONE package. For Flex cases, additional fees will apply. 

For information regarding case revisions, refer to the following:

• What to do before submitting a revision
• How to submit a case revision
• Identifying the revision on the treatment plan
• When not to send a revision

What to do before submitting a revision

If a patient comes in for an appointment in the middle of treatment and their next set of aligners doesn't fit, there are a number of reasons this can occur. We recommend you check out the following articles on this subject to prevent an unnecessary revision. 

• Aligners dont' fit - Incisal Gaps
• Aligners don't fit - Too Big or Too Small
• Aligners don't fit - Rocking
• Non-compliant patients
• Backtracking
• Tight Contacts
• Troubleshooting Rotations

If the case does need a revision, one can be submitted online very simply.

How to submit a case revision

Case revisions must be submitted online. Here's a step-by-step for submitting a revision along with some important tips.

1. Go to “Manage Orders” and click on the case that you want to revise.

2. When you select a case with a phase scheduled you’ll see a “Revise” button at the top right of the case page.

3. It will then take you to a new page titled “Request a revision”.

4. Select the step number for both the upper & lower arch that the patient is currently wearing & choose whether you’ll use an existing step, submit scans or impressions. 

• If the current aligners fit well and you just want to request a change (i.e., adding engagers or requesting overcorrection), select the option to use existing models.
• If you select the option to submit PVS impressions, you'll be presented with an option to ship it after you submit the revision request. Tip: When submitting new impressions or scans, take them before starting the online submission process.
• If you select any one of the scanner options, you can upload it along with the revision request, or submit the request first and upload the scans later.

Notes: Have the patient continue to wear the current step until the revision arrives. 

If you submitted your case as a dual-arch case, it cannot be changed to a single-arch case mid-treatment. Make sure you send scans or impressions for both arches when submitting a revision, even if you're only adjusting one arch. The aligners for the other arch will be passive (essentially a retainer) to keep everything in place and prevent relapse.

If you’re directly uploading scans from either a TRIOS or CEREC scanner, submit your revision in the Doctor’s Portal before uploading the scans through your scanner’s interface.

Tip: Remove all existing engagers before taking new impressions to improve accuracy.

5. Then provide detailed instructions to the technician, including:

• Existing condition of treatment
• What issues do you wish to overcome in the revision
• What is not tracking?
• In what angle/view do you see the issue?
• How do you want things to be – what do you want changed?
• What troubleshooting have you tried if any?

Specify any additional requests:

• If you would like overcorrection
• If you want a digital power chain
• Note any engagers that are not tracking (This can be a sign of bigger problems, more than just fitting issues)
• If you would like additional engagers

Tip: If you would like the same engager placement in your revision, you will need to specify in the revision instructions which teeth you would like the engagers to be placed and/or remain in the treatment.

The more information you provide the better. If your instructions are unclear, you will be contacted to confirm before we manufacture your revision.

Tip: If you're submitting a revision for “ill-fitting aligners”, for "engagers not fitting in the aligner" or for a specific tooth "not tracking", there isn’t a way for us to determine the patient’s current condition unless new impressions or scans are sent in. So for these types of revision submissions we always require new impressions/scans to get to the root cause.

6. Agree to our Terms & Conditions, then click “SUBMIT”.

Once you click “SUBMIT”, you will receive a revised treatment setup within a few days for your approval.

If you want to print a copy for your records, you can download one by clicking on the download icon in the documents tab on the case page.

Identifying the revision on the treatment plan

When you request a revision for a case, the treatment plan will reflect that you have received the revision with a small break as in this image.

All revisions are numbered based on the next odd aligner in sequence. For example, if the patient is wearing step 11, then the treatment and revision setup will now begin on step 13, regardless of how many aligners we’ve shipped in between. 

When not to send a revision

Following are circumstances when you should not send a revision:

• To request a replacement aligner
• To change the patient's wear schedule
• To request a hold be placed on the case

To request any of the above actions, contact one of our helpful Provider Services representatives and they can assist you.