Common

ClinCheck ® Errors

An overview of common ClinCheck® errors

and how to correct them.

.5
.5 .5 .3

.3

.3

.2

.2 .2
.4
.4 .4

.4
Aligner Global Community | Common ClinCheck® Errors 1
Copyright © Aligner Consulting | All Rights Reserved
 TABLE
OF CONTENTS
About the Author 3

Chapter 01 4

Potential pitfalls of single arch cases 5

Education Is Essential 6

Chapter 02 7

Preventing posterior open bite 8

Chapter 03 10

Step by step clincheck® review 12

2 Aligner Global Community | Common ClinCheck® Errors

Copyright © Aligner Consulting | All Rights Reserved
ABOUT THE
ALIGNER GLOBAL
COMMUNITY
Aligner Consulting, as education and training
partners for Align Technology in EMEA, have
trained thousands of dentists all over Europe in
Clear Aligner Therapy. This is now being augmented
with the launch of The Aligner Global Community
(AGC). AGC, Powered by Aligner Consulting, is a
dedicated industry peer-to-peer community for
Dentists, by Dentists. The aim of the platform is
to connect dental professionals from all over the
world to a central hub of information, training and
other valuable content and support. We are the
‘go-to’ platform for all areas of communication and
interaction within the dental community globally.

ALIGNER
OUR AUTHOR: DR. SANDY
Director of Clinical Education at Aligner Consulting
| BDS, PGDip ClinEd

Dr Sandy is a General Dental Practitioner, she joined

GLOBAL
the UK Clinical team with Align Technology in 2017
providing clinical support and training to Invisalign
providers. This involved having expert knowledge
of the ClinCheck® software in order to provide case
specific advice on optimising individual treatment
plans for predictable results.

In 2019 Dr Sandy joined Aligner Consulting where

she continues to provide Clinical Education in
aligner therapy. Alongside this she manages the
Aligner Consulting speaker team across Europe.

Find Dr. Sandy on the Aligner Global Community

and follow @thedrsandy on Instagram.
Aligner Global Community | Common ClinCheck® Errors 3
Copyright © Aligner Consulting | All Rights Reserved
 CHAPTER

01
“ Welcome to this series on
common ClinCheck® errors and
how to avoid them. In this chapter,
we will be looking at factors to
consider if a patient has asked to
have a single arch treatment.

I have often given advice on

cases that are already at the
ClinCheck ® stage and have been
set up as single arch treatments.
Usually the case ends up being
switched to a dual arch case to
avoid certain issues that become
apparent when reviewing the
ClinCheck® plan. In this chapter
I have highlighted some points
to consider the next time you get
“
this query from a patient!

4 Aligner Global Community | Common ClinCheck® Errors

Copyright © Aligner Consulting | All Rights Reserved
POTENTIAL PITFALLS
OF SINGLE ARCH CASES
From a patient’s perspective they may dislike the appearance of their
teeth and prioritise one arch more than the other. Often this is the
upper arch and so they may request treatment of the upper teeth only.

This is understandable, patients are unlikely to be aware of how this

may limit the result you are able to achieve for them. Therefore, it is our
responsibility to assess whether a single arch treatment is feasible, or if
it will end up creating a limited or unfavourable result. This should then
be communicated to the patient in a way that they understand.

SOME FACTORS TO CONSIDER

Treatment Planning Considerations

Final Overjet and Overbite

If only treating one arch, will you be able to finish the
case with sufficient overjet and overbite?

Arch Coordination
Will the arches be well coordinated at the end of
treatment? To ensure this, will you have to limit certain
movements such as expansion?

Function
Are you able to plan the final position to ensure good
function if only treating one arch?

Aesthetics
Patients often become more aesthetically aware during
treatment. If part way through they decide they would like
to treat the opposing arch too this can be tricky to plan.
It usually means finishing the treatment you have started
before being able to start treatment in the other arch.

Aligner Global Community | Common ClinCheck® Errors 5

Copyright © Aligner Consulting | All Rights Reserved
 EDUCATION IS
ESSENTIAL
EDUCATE YOUR PATIENT FROM THE OUTSET

Explain that single arch treatments can be

successful, but only in very specific cases.
Have this discussion early on with the patient
so they are well informed from the start.

SET UP MULTIPLE CLINCHECKS®

Set up a single arch ClinCheck® plan and a
dual arch ClinCheck® plan. Make a list of
the pros and cons of each option and then
present these to the patient. This will help
them visualise and understand what you are
explaining much better. They are then more
likely to go with your recommendation and
are making an informed decision.

“ REMEMBER, AS YOU GAIN

EXPERIENCE YOU WILL QUICKLY
BE ABLE TO RECOGNISE SUITABLE “
CASES AND THOSE THAT ARE NOT.

6 Aligner Global Community | Common ClinCheck® Errors

Copyright © Aligner Consulting | All Rights Reserved
CHAPTER

02
what might happen if you plan a case
without adequate final OJ?

“
final
The most common cause of a posterior open bite
at the end of treatment is due to a lack of overjet in the
result. This can lead to hard contacts anteriorly

“
which prevent the posterior teeth from meeting, giving
the appearance of a posterior open bite. The good news
is that with careful planning this can be avoided in the
vast majority of cases. Let’s look at this in more detail.

Aligner Global Community | Common ClinCheck® Errors 7

Copyright © Aligner Consulting | All Rights Reserved
 PREVENTING
POSTERIOR
OPEN BITE
1 FOLLOW SAFE ASSESSMENT AND 4
SENTENCE PRESCRIPTION (4STP)

If you have certified in Invisalign® with Aligner

Consulting you are probably well versed in using
the SAFE assessment and 4STP. The 4 sentence
prescription was developed by Dr Andy Toy
and Dr Raman Aulakh, it’s an excellent way of
communicating your clinical treatment goals
to the technician working on your ClinCheck®
treatment plan.

The final point in the 4STP is to specify the

final overjet and overbite or set a lower anterior
reference point. If you request a final overjet
of between 2-4mm this should ensure your
ClinCheck® plan comes back with an adequate
overjet built in. For most cases without an
underlying skeletal discrepancy, this range of an
overjet value should be achievable.

8 Aligner Global Community | Common ClinCheck® Errors

Copyright © Aligner Consulting | All Rights Reserved
2 CHECK YOUR CLINCHECK®
CAREFULLY

When the ClinCheck ® plan comes back

from the technician you can use a few
different tools to help check the final
overjet.

ClinCheck® Pro Users: you have access to

the overjet/overbite tool, the grid (each
square is 1mm) and the occlusal contacts
tool.

ClinCheck ® Web Users: you have access

to the grid and the occlusal contacts tool.

Chin Up View: orientate the model to the

‘chin up’ view and check the final overjet.

Using these tools and the chin up view will

help you assess whether the planned final
overjet is sufficient, or whether you need
to modify the ClinCheck® ® plan further
before approving it. Time spent here on
careful case assessment and planning will
pay off at the end of treatment!

Aligner Global Community | Common ClinCheck® Errors 9

Copyright © Aligner Consulting | All Rights Reserved
 CHAPTER
03
In most areas of Dentistry, we have
a structure and a process to follow
to help us diagnose, treatment plan
and carry out dental treatments.
The same should be true for digital
treatment planning. Do you have a
systematic way of reviewing your
ClinCheck® plans?

10 Aligner Global Community | Common ClinCheck® Errors

Copyright © Aligner Consulting | All Rights Reserved
“One of the
most common
errors is
“One of the most
common errors is

to simply
to simply check the
final position without

check the
following a set process.”
@thedrsandy

final position
without
following a set
process.” Aligner Global Community | Common ClinCheck® Errors 11
Copyright © Aligner Consulting | All Rights Reserved
 Step by step
ClinCheck review

Follow the 5 step ClinCheck® review outlined below and you can be confident
that you have been thorough in your approach.

1 | Check the initial bite 4 | Play the ClinCheck® through

Has the initial bite been set up Is there any round tripping present?
correctly? A quick way of checking If so, is this acceptable or would you
this is to assess the OJ, OB and like to minimise it? Do you need to
midlines against the photographs or add other features such as elastics,
scan you have submitted. bite ramps or extra attachments for
anchorage? These are case specific
and not always applicable. Are you
happy with the amount of IPR and
its location?
2 | Read the comments
Always read the comments from
the technician as they will give you
5 | Modify or approve
valuable information about your
case. If they need further information If you are happy with all aspects of
from you, new records, or clarification the plan you can click ‘Approve.’ If
about a comment you have placed, there are some changes you would
they will ask for this here. like to make, select ‘Modify’ place
further comments or use 3D controls.
Then await the new ClinCheck ® plan.
3 | Check the final position
If you implement this method of
Check this against your 4-sentence reviewing your ClinCheck® plans
prescription. Has the patient’s main every time, it will soon become
complaint been resolved? Are you second nature. It will drive
happy with the reference points you efficiency by reducing the number
selected, or do you need to modify of modifications - this mean you can
the plan? Is there sufficient OJ and get your patients into treatment
OB planned? more quickly!

12 Aligner Global Community | Common ClinCheck® Errors

Copyright © Aligner Consulting | All Rights Reserved
Remember, the quality of your ClinCheck ® plan depends
on your SAFE assessment and how well you communicate
your goals to the technician working on your case.

Aligner Global Community | Common ClinCheck® Errors 13

Copyright © Aligner Consulting | All Rights Reserved
 e | [email protected]
w | alignerconsulting.com
c | community.alignerconsulting.com

®
14 the
Invisalign®, Aligner Global
Invisalign logo,Community | Common
ClinCheck®, iTero®, ClinCheck
Invisalign Errors
Teen®, SmartForce®, SmartTrack®, and Vivera®, among others, are trademarks and/
Copyright
or service marks of Align © Aligner Consulting
Technology, Inc. or one of| All Rights Reserved
its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries.