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What are Treatment Preferences?
When you submit your case, the Technician creates your treatment setup using a set of default treatment preferences. You can customize your preferences for your setups in the Treatment Preferences section of My Account in the Doctor Portal.
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Treatment Preferences
Below are the treatment preferences ClearCorrect uses for treatment setups. Each preference lists the default preference used by the technician, at least one other preference option that can be selected by the user, and explanations for the preferences.
Movement Velocity
| Preference Name | Default Preference | Preference Option 2 |
| Movement Velocity |
Standard movement per tooth, per step – 0.3 mm translation, intrusion, and extrusion. 3 degrees rotation.
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Reduced movement per tooth, per step (will result in increase in # of aligners) - 0.2 mm translation, intrusion, and extrusion. 2 degrees rotation.
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Explanation |
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| The provider can change the movement velocity based upon the number of desired/required aligners and amount of tooth movement control. |
The standard movement is established and developed based on the design of our clear aligner along with the aligner material, trim line, and our software properties.
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The reduced movement per tooth option should be considered for extraction cases, molar up righting, space opening for dental implants, Full Class II and Class III correction (>2mm), as it can give more control over the desired movement. Note that with this option it will increase the total number of aligners in the treatment as well as treatment time/duration. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Wear Schedule
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 | Preference Option 4 |
| Wear Schedule | 2 Weeks | 1 Week | 10 Days | 3 Weeks |
| Explanation | ||||
| A 1-, 2-, or 3-week wear schedule is a decision that is determined by the Clinician and is made depending on the individual circumstances with each patient. | The default preference is based on our clinical protocols and aligner design. We suggest changing the aligners every 2-weeks. | A 1-week wear schedule should be considered with reduced tooth movement velocity and with patients that are still growing, such as with teen patients. | A 10-day wear schedule is indicated for cases when more efficiency is needed, in adult and teen patients. If the 10-day wear schedule is chosen, we recommend it is accompanied by a slower tooth movement velocity | A 3-week wear schedule could be desirable when you need more time to deliver the tooth movement based on the complexity of the case. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
IPR - Timing
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 | Preference Option 4 |
| IPR Timing | Start IPR whenever necessary (even from step 1) | Place IPR from step 1 onward | Place IPR from step 3 onward | No IPR |
| Explanation |
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| IPR is only placed on odd steps and when interproximal surfaces are in proper position. | No delay in IPR is an option when collisions can be addressed from the beginning of treatment. It can potentially help reducing the number of appointments when doing remote treatment. | IPR starting at step 1 when initial collisions can be addressed from the beginning of treatment. | IPR is delayed to step 3 to reduce the number of initial collisions and offer the patient a better initial experience and comfort, before you start changing the arch length and form with IPR. | No IPR will be performed throughout the treatment. recommended for simple cases that will be treated remotely. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
IPR - Maximum
| Preference Name | Default Preference | Preference Option 2 |
| IPR Maximum | 0.30 mm for anterior teeth, 0.60 mm for posterior | 0.60 mm for all teeth |
| Explanation |
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| The less the amount of IPR performed the more predictable control you will have over tooth movement. | The option of 0.30 mm as a maximum should be considered for patients with limited amount of mesial-distal enamel, or for clinicians that prefer a smaller amount of IPR. | Our experience is that 0.60 mm is a predictable amount to achieve treatment plan/goals within the default 2-week wear time. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Anterior Torque
| Preference Name | Default Preference | Preference Option 2 |
| Anterior Torque | Without contacts | With contacts |
| Standard cases: apply approximately 10 degrees of positive torque. | ||
| Class III cases: retrocline lower anteriors with IPR, overcorrect upper anterior positive torque. | ||
| Explanation |
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| Anterior torque is the rotation of an anterior tooth on its long axis, especially the movement of the apical portions of the teeth by use of orthodontic appliances.¹ | We apply anterior torque as needed or according to the clinician’s instructions for standard cases. | An open text field is available so you can provide specific notes or instructions, if you choose. The default preference will be applied unless specified otherwise in the preference notes. |
| For Class III cases the lower anterior fit will be retroclined with IPR when indicated and upper anterior positive torque is applied as needed or according to clinician instructions. | ||
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Posterior Torque
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 | Preference Option 4 |
| Posterior Torque | Minimal change only to improve occlusion | Upright upper posterior teeth and apply slight negative torque on lower posteriors | Upright lower posterior teeth and apply slight positive torque on upper posteriors | Posterior Torque |
| Explanation |
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| Posterior torque is the rotation of a posterior tooth on its long axis, especially the movement of the apical portions of the teeth by use of orthodontic appliances.¹ | The default preference is to keep/preserve the current/natural occlusion and intercuspation. Minimal change, only to improve the occlusal contacts, if needed. | Used depending on the type of malocclusion, where it may be necessary to change posterior teeth position to achieve a better occlusion; Crossbite correction & extraction cases are examples. This option adds negative torque on lower posteriors as well as uprighting of upper posterior teeth. | Same concept as preference option 2 however, this option adds positive torque on upper posteriors as well as uprighting of lower posterior teeth. | Posterior torque is the rotation of a posterior tooth on its long axis, especially the movement of the apical portions of the teeth by use of orthodontic appliances.¹ |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Expansion
| Preference Name | Default Preference | Preference Option 2 |
| Expansion | Expansion of canines to 1st molars combined with anterior protrusion. No expansion in 2nd & 3rd molars. Maximum 2 mm per quadrant. | Expansion of canines to premolars and hold other teeth as anchors. Maximum 3mm per quadrant. |
| Explanation |
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| The better/more anchorage the more expansion that can be achieved. Premolars biologically allow for more expansion than molars.² | Our default is to correct transversal discrepancies with expansion of anterior and posterior segments, limited to the 1st molar, with a maximum of 2 mm per quadrant. There is no movement of the 2nd and 3rd molars as they are used for anchorage. | For cases where you want maximum anchorage, consider expansion of canines to premolars with a maximum of 3 mm per quadrant. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Class II Corrections
| Preference Name | Default Preference | Preference Option 2 |
| Class II Corrections | Upper molar distalization with sequential movement |
No class II correction (no molar changes). |
| Explanation | ||
| If the mesial-buccal cusp of the upper first molar is anterior to this groove it’s considered a Class II molar relationship.³ | The standard is preferable/suggested to increase anchorage and tooth movement control. | When no anterior-posterior changes are expected during treatment. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Smile Arc
| Preference Name | Default Preference | Preference Option 2 |
| Smile Arc | Follow lip guidance based on frontal smiling picture | Align and level following ideal occlusion, no lip guidance |
| Explanation |
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| The Smile Arc (how the biting edges of the upper teeth ‘flow’ along the curvature of the lower lip line) can be used as guidance to help establish an ideal for how the teeth should look when the patient smiles.⁴ | We use the frontal smiling photo provided in the case submission to establish the smile arc for the case. | When the image quality is poor or there is no frontal smiling photo the smile arc will be determined without lip guidance. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Occlusion
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 |
| Occlusion | Three contacts in the posterior with no anterior contacts | Three contacts in the posterior with light anterior contacts | Heavy contacts in the posterior with no anterior contacts |
| Explanation |
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| The ideal goal for occlusion is to have a cusp-fossa relationship when the teeth are brought into contact. | Our standard is to provide a balance of occlusal contact throughout the arch. | For cases where you want to maximize posterior intercuspation, no anterior contacts is suggested. | This is an option when you want to overcorrect posterior occlusal contact or intercuspation, heavy contacts is suggested. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Curve of Spee
| Preference Name | Default Preference | Preference Option 2 |
| Curve of Spee | Idealize Curve of Spee by combination of tipping, intrusion, and extrusion | Improve occlusion, but do not correct Curve of Spee unless requested on prescription |
| Explanation |
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| Curve of Spee is the curvature of the mandibular occlusal plane beginning at the canine and following the buccal cusps of the posterior teeth, continuing to the terminal molar. Correction of the Curve of Spee is up to the Clinician & the treatment goals for the case.⁵ | Our suggested default is to only make small changes to preserve the natural Curve of Spee, improving the occlusion only as necessary. | This option is indicated for cases where full Curve of Spee correction is not desirable. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Virtual C-Chain
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 |
| Virtual C-Chain | Preform only when requested on prescription. Default placement on last 2 steps. | Perform Virtual C-Chain on all cases to tighten spaces. | Perform on all Virtual C-Chain cases, remove attachments before C-Chain steps. |
| Explanation |
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| A Virtual C-Chain is where any existing spaces (at a specific step of treatment) are closed. Virtual C-Chains are usually planned and used at the end of treatment. | Virtual C-Chain is indicated for cases where you want to close all spaces and do not want any remaining space in the arch. As a default we place it on the last two steps so that any remaining spaces at the end of treatment can be closed. | This is an option for clinicians who prefer to have a virtual c-chain applied to all cases to close spaces at the end of treatment. | For clinicians that prefer to have the last steps of treatment without the use of attachments and to close all remaining spaces. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
First Molars
| Preference Name | Default Preference | Preference Option 2 |
| First Molars | Improve if needed to establish better occlusion | Do not move 1st molars |
| Explanation |
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| First Molars play a pivotal role in the maintenance of the arch form and proper occlusal schemes. Establishing a preference for the approach you would like to take for first molars in your treatment setups is important for treatment planning purposes. | The standard is to only improve if needed to establish better occlusion. | This option is for cases where you don’t want any movement of the 1st molars. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Second & Third Molars
| Preference Name | Default Preference | Preference Option 2 |
| Second & Third Molars | Improve if needed to establish better occlusion. | Do not move 2nd & 3rd molars. |
| Explanation | ||
| Molars (depending on the amount and required movements needed) can be difficult to move with clear aligners alone. It’s important to have a clear plan in your treatment preferences for how you want to approach 2nd and 3rd molars in your treatment setups. | If you want to move the 2nd and 3rd molars in the treatment, the default preference will include moving the 2nd and 3rd molars as needed to establish better occlusion. | This option is for cases where you don’t want any movement of the 2nd and 3rd molars, usually if they’re already in an ideal occlusion. Sometimes with implants or restorations, it’s undesirable to move the 2nd and 3rd molars and this is an available option for those types of cases. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Overjet & Overbite
| Preference Name | Default Preference | Preference Option 2 |
| Overjet & Overbite | Set to ideal overjet (2 +/- 0.5 mm) with no anterior contacts | Set overjet to 2 – 3 mm but with slight overbite and no anterior contacts |
| Explanation |
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Overjet is an increased projection of the upper teeth in front of the lower teeth, usually measured parallel to the occlusal plane.⁶ Overbite is an increased vertical overlapping of the mandibular anterior teeth by the maxillary anterior teeth, usually measured perpendicular to the occlusal plane.⁶ |
The default to set to ideal overjet (2 +/- 0.5 mm) is considered the standard amount for normal occlusion, with light contacts on the lower incisors up to the lingual surface of the upper incisors. | A more prominent overjet and overbite is an available option to be chosen according to the clinician’s preference. This option is also indicated for cases where you want heavy contacts in the posterior occlusion and open bite correction. Suggested for finishing touches at the end of treatment to improve posterior occlusion. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Mild-Moderate Crowding
| Preference Name | Default Preference | Preference Option 2 |
| Mild – Moderate Crowding | Expand canines & premolar regions, place IPR as needed, and apply anterior protrusion. | Expand canines, premolar regions, and first molars. Place IPR as needed, but no anterior protrusion. |
| Explanation |
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Crowding is a condition where the teeth are too close together & have abnormal positions such as overlapping, displacement in various directions, or torsion.⁶ Up to 3mm of crowding is considered mild and beyond 6mm is considered severe.⁷ |
Our default is to increase arch length with transversal corrections, changing the arch form/shape. With expansion on posterior teeth and proclination of the anterior segment. IPR will be applied as needed. 1st molars are not moved with this preference. | This is indicated for cases where you want expansion on the 1st and 2nd molars as well, and no anterior changes will be made. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
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Moderate-Severe Crowding (Class II)
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 |
| Moderate – Severe Crowding (Class II) | Expand canines & premolar regions, & first molars distalization of 1-2mm, no 3rd molars. Place IPR as needed, & place anterior round tripping as needed. | Expand canines & premolar regions, and first molars distalization of 1-2 mm, no 3rd molars. Place IPR as needed, but no anterior round tripping. | Expand canines & premolar regions, and first molars distalization of 1-2mm, no 3rd molars. Place anterior round tripping as needed, but no IPR. |
| Explanation |
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Crowding is a condition where the teeth are too close together & have abnormal positions such as overlapping, displacement in various directions, or torsion.⁶ Beyond 6mm of crowding is considered severe.⁷ |
For treatment of severely crowded cases 1st molar distalization is applied in addition to the expansion of the posterior teeth. Consider extracting the 3rd molars for more efficient treatment time. | Same as default preference except that no round tripping of the anterior teeth will be applied. In some cases, round tripping (moving the tooth, buccally or lingually, to create spaces and avoid collisions) is not necessary, an option for cases that can be resolved without it. | Same as default but for cases when IPR is not recommended or not possible. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Engager Protocols
| Preference Name | Default Preference | Preference Option 2 |
| Engager Protocols | Use of engagers for rotations, intrusions, and extrusions | No engagers at all |
| Explanation |
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| Some malocclusions need more anchorage, so we provide alternative options for placing engagers on the teeth for better control when needed. | Engagers are indicated for less predictable tooth movement for rotation, intrusions, extrusions and translations. | No engagers will be added during treatment. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Engager Timing
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 |
| Engager Timing | Delay and place at step 3 and keep until end of each arch’s treatment | Place at step 1 and keep all engagers until end of treatment | Place only when requested on prescription |
| Explanation |
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| The step where engagers will begin being placed in the treatment. | As a default the engagers will be placed on the 3rd step of treatment to allow for better patient experience and acclimation to the clear aligners at the beginning of treatment. | Where patient appointments need to be optimized, such as long-distance treatment or if preferred by the clinician. Engagers can be placed on the first step, kept throughout treatment and removed at the end of treatment. |
This is an option where the clinician can customize and choose exactly where and when they want engagers placed in the treatment. No engagers will be placed unless specifically indicated by the clinician.
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The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Engager Size
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 |
| Engager Size | 3 mm | 2 mm | 4 mm |
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Explanation |
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| We offer different engager sizes for better fit according to the anatomy of the tooth and to improve anchorage. | 3 mm is the default for best fit of most types of teeth and tooth movement control. | 2 mm should be considered for short clinical crowns and in combination with cutouts and buttons. | 4 mm engagers should be considered when more anchorage is desirable, and on posterior teeth, such as 1st and 2nd molars as well as occlusal surfaces. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Bite Ramps
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 | Preference Option 4 |
| Bite Ramps | None | Add bite ramps 2x2 when the lower incisors need to be intruded by more than 1.5 mm | Add bite ramps 3x3 when the lower incisors need to be intruded by more than 1.5 mm | Add upper bite ramp only on canines when the lower incisors need to be intruded by more than 1.5 mm |
| Explanation |
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Bite ramps will be placed lingually on the upper anterior teeth. ClearCorrect offers two sizes: •3 mm •5 mmSize and depth of the bite ramp will be based on the size of the tooth and the contact desired between the lower incisors and the bite ramp. |
Bite ramps will only be applied by doctor request. | 2x2 bite ramps are indicated for most deep bite cases with moderate overjet. | 3x3 bite ramps are indicated when the force distribution is desirable on the incisors and canines. | Upper bite ramps on canines are indicated for cases with large incisors overjet and for cases in which the upper incisors need to be proclined. |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Cutout Shape
| Preference Name | Default Preference | Preference Option 2 | Preference Option 3 | Preference Option 4 | |
| Cutout Shape | None | Class II |
Upper Arch: slits on canine Lower Arch: button on first molar |
Upper arch: slits on canines Lower arch: slits on first molars |
Upper arch: button on canines Lower arch: button on first molars |
| Class III |
Upper Arch: button on first molar Lower Arch: slits on canines |
Upper arch: slits on first molars Lower arch: slits on canines |
Upper arch: button on first molars Lower arch: button on canines |
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Explanation |
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| When using the button cutouts, the elastic is placed on a button directly bonded on the tooth as anchorage. When using the double slit, the elastic is placed directly on the aligner. | Cutouts will only be added by doctor request. | Buttons on first molars are indicated in clinical situations where a large force can be applied with elastics. These combination of button cutouts and slits works best for most of the Class II and Class III malocclusions | Slits on upper and lower teeth are indicated when the force needs to be transmitted to the teeth through the aligner. | Buttons on upper and lower arch are indicated when forces need to be applied directly to the teeth, canines and molars (recommended for Class II division 2 malocclusion). | |
The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.
Setting up Treatment Preferences
Steps:
There are four steps to set up your treatment preferences once you are signed into the Doctor Portal:
- Access the My Account menu
- Go to the Treatment Preferences section
- Make your selections
- Save your preferences
The ? Icon is a link to an article in the Help Center with further information on each preference.
Access the My Account menu:
Treatment Preferences can be accessed from the My Account menu in the Doctor Portal. Once signed into the Doctor Portal click on the dropdown menu in the top right corner of the screen. Click on My Account in the dropdown menu.
Setup Treatment Preferences section:
From the My Account menu, click on Preferences. There are 4 sections to the Treatment Preferences feature:
- Clinical Preferences
- Crowding Preferences
- Aligner Customization
- Additional Treatment Preferences Notes
Make your selections:
The default preference and current selection will show in the field in a dark bold text.
Click on the dropdown menu icon to view other preference options. The currently selected preference will show highlighted in grey and in a teal font. Any other available preference options will appear below the default preference.
Save Preferences:
When you are done making your selections for your treatment preferences, click on the Save button and your preferences will be applied to all Treatment Setups from that point forward.
Sources & References:
1) Dorland's Medical Dictionary for Health Consumers. (2007). Retrieved April 10 2019 from https://medical-dictionary.thefreedictionary.com/torque
2) Mosby's Medical Dictionary, 8th edition. “Expansion” retrieved April 10 2019 https://medical-dictionary.thefreedictionary.com/expansion
3) “Malocclusion of the Teeth. Seventh Edition“ by E. H. Angle, M.D., D.D.S. Published by S.S. White Dental Manufacturing Company, Philadelphia, 1907. Chapter 2, pages 28-59.
4) “The importance of incisor positioning in the esthetic smile: the smile arc” by D.M. Sarver. PMID: 11500650 DOI: 10.1067/mod.2001.114301
5) Farlex Partner Medical Dictionary © Farlex 2012. Curve of Spee. (n.d.) Farlex Partner Medical Dictionary. (2012). Retrieved January 5 2022, from https://medical-dictionary.thefreedictionary.com/curve+of+Spee
6) Mosby's Medical Dictionary, 9th edition. © 2009, Elsevier. “Overjet” and “Overbite” Retrieved April 9, 2019.
7) “Clear Aligners in Orthodontic Treatment” by T. Weir in Australian Dental Journal, 2017.
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