Topics covered:

• What are Treatment Preferences?
• Treatment Preferences
  • Movement Velocity
  • Wear Schedule
  • IPR - Timing
  • IPR - Maximum
  • Anterior Torque
  • Posterior Torque
  • Expansion
  • Class II Corrections
  • Smile Arc
  • Occlusion
  • Curve of Spee
  • Virtual C-Chain
  • First Molars
  • Second & Third Molars
  • Overjet & Overbite
  • Mild - Moderate Crowding
  • Moderate - Severe Crowding (Class II)
  • Engager Protocols
  • Engager Timing
  • Engager Size
  • Engager Beveling
• Setting Up Treatment Preferences
• Sources & References

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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. 

 

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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.

 

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Movement Velocity

Preference Name	Default Preference	Preference Option 2
Movement Velocity The provider can change the movement velocity based upon the number of desired/required aligners and amount of tooth movement control.	Standard movement per tooth, per step – 0.3 mm translation, intrusion, and extrusion. 3 degrees rotation.	Reduced movement per tooth, per step (will result in an increase in the # of aligners) - 0.2 mm translation, intrusion, and extrusion. 2 degrees rotation.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Wear Schedule

Preference Name	Default Preference	Preference Option 2	Preference Option 3
Wear Schedule 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.	2 weeks	1 week	3 weeks

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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IPR - Timing

Preference Name	Default Preference	Preference Option 2
IPR Timing IPR is only placed on odd steps and when interproximal surfaces are in proper position.	Delay IPR to step 3	No delay for IPR

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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IPR - Maximum

Preference Name	Default Preference	Preference Option 2
IPR Maximum The less the amount of IPR performed the more predictable control you will have over tooth movement.	0.60 mm for all teeth	0.30 mm for anterior teeth, 0.60 mm for posterior teeth

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Anterior Torque

Preference Name	Default Preference	Preference Option 2
Anterior Torque 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	Standard cases: apply approximately 10 degrees of positive torque Class III cases: retrocline lower anteriors with IPR, overcorrect upper anterior positive torque	[Free text field] Additional notes

Ref: 1) Dorland's Medical Dictionary for Health Consumers, 2007.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Posterior Torque

Preference Name	Default Preference	Preference Option 2	Preference Option 3
Posterior Torque 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	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.

Ref: 1) Dorland's Medical Dictionary for Health Consumers, 2007.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Expansion

Preference Name	Default Preference	Preference Option 2
Expansion The better/more anchorage the more expansion that can be achieved. Premolars biologically allow for more expansion than molars.²	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.

Ref: 2) Mosby's Medical Dictionary, 8th Edition

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Class II Corrections

Preference Name	Default Preference	Preference Option 2
Class II Corrections If the mesial-buccal cusp of the upper first molar is anterior to this groove, by the width of a premolar of more, it’s considered a Class II molar relationship.³	Upper molar distalization with sequential movement	If correction is planned with elastics or surgery, move molars to Class I occlusion before the start of the setup using Arch Correction Simulation.

Ref: 3) E. H. Angle, 1907.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Smile Arc

Preference Name	Default Preference	Preference Option 2
Smile Arc 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	Follow lip guidance based on frontal smiling picture	Align and level following ideal occlusion, no lip guidance

Ref: 4) D.M. Sarver, 2001.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Occlusion

Preference Name	Default Preference	Preference Option 2	Preference    Option 3
Occlusion The ideal goal for occlusion is to have a cusp-fossa relationship when the teeth are brought into contact.	Cusp to fossa occlusion with light, even contacts throughout the arch	Light contacts in the posterior with no anterior contacts	Heavy contacts in the posterior with no anterior contacts

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Curve of Spee

Preference Name	Default Preference	Preference Option 2
Curve of Spee 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	Idealize Curve of Spee by combination of tipping, intrusion, and extrusion	Improve occlusion, but do not correct Curve of Spee unless requested on prescription

Ref: 5) Farlex Partner Medical Dictionary © Farlex 2012.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Virtual C-Chain

Preference Name	Default Preference	Preference Option 2	Preference Option 3
Virtual C-Chain 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.	Place only when requested on prescription. Default placement on last 2 steps.	Perform Virtual C-Chain on all cases to tighten spaces.	When performing a Virtual C-Chain, remove attachments before C-Chain steps

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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First Molars

Preference Name	Default Preference	Preference Option 2
First Molars 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.	Improve if needed to establish better occlusion	Do not move 1st molars

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Second & Third Molars

Preference Name	Default Preference	Preference Option 2
Second & Third Molars 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.	Improve if needed to establish better occlusion.	Do not move 2nd & 3rd molars.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Overjet & Overbite

Preference Name	Default Preference	Preference Option 2
Overjet & Overbite 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	Set to ideal overjet (1.5 – 2 mm) with light contacts	Set overjet to (2 – 3 mm) but with slight overbite and no anterior contacts

Ref: 6) Mosby's Medical Dictionary, 9th Edition. © 2009.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Mild-Moderate Crowding

Preference Name	Default Preference	Preference Option 2
Mild - Moderate Crowding 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	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.

Ref: 6) Mosby's Medical Dictionary, 9th Edition. © 2009; 7) T. Weir, 2017.

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) 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	Expand canines & premolar regions, & first molars distalization of up to 1-2mm no 3rd molars. Place IPR as needed, & place anterior round tripping as needed.	Expand canines & premolar regions, and first molars distalization of up to 1-2 mm, no 3rd molars. Place IPR as needed, but no anterior round tripping.	Expand canines & premolar regions, and first molars distalization of up to 1-2mm no 3rd molars. Place anterior round tripping as needed, but no IPR.

Ref: 6) Mosby's Medical Dictionary, 9th Edition. © 2009; 7) T. Weir, 2017.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Engager Protocols

Preference Name	Default Preference		Preference Option 2	Preference Option 3
Engager Protocols Some malocclusions need more anchorage, so we provide alternative options for placing engagers on the teeth for  better control when needed.	Deep Bite	Rectangular engagers on 1 and 2 premolars and no engagers on anterior teeth	Engagers on anterior teeth and no engagers on posterior teeth	No engagers at all
	Open Bite	Rectangular engagers on anterior teeth and no engagers on posterior	Engagers on premolars, canines and incisors	No engagers at all

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Engager Timing

Preference Name	Default Preference	Preference Option 2	Preference Option 3
Engager Timing The step where engagers will begin being placed in the treatment.	Delay and place at step 3 and keep until end of each arch’s treatment	Place only when requested on prescription	Place at step 1 and keep all engagers until end of treatment

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Engager Size

Preference Name	Default Preference	Preference Option 2	Preference Option 3
Engager Size ClearCorrect offers different engager sizes for better fit according to the anatomy of the tooth and to improve anchorage.	3 mm	2 mm	4 mm

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.   

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Engager Beveling

Preference Name	Default Preference	Preference Option 2
Engager Beveling Beveling is applied to redirect force and tooth movement. Depending on where the beveling is placed you can redirect the alignment of force for tooth movement.	Position beveled edge towards incisal.	[Free text field] Additional notes.

The treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details. 

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Setting up Treatment Preferences

To setup your treatment preferences, log into the Doctor Portal and go to My Account

On the side menu, click on "Preferences."

In the Preferences section of My Account you will be presented with basic information about the Treatment Preferences feature before the available preferences. There are 4 sections to the Treatment Preferences feature:

• Clinical Preferences
• Crowding Preferences​
• Aligner Customization​
• Additional Treatment Preferences Notes

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 pink font. Any other available preference options will appear below the default preference.

Some preferences offer a text box where you can provide additional notes, if desired.

If you have any other information or notes regarding your treatment preferences, you can include them here in the Additional Treatment Preferences Notes section.

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.

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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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