dr amanda with straight smile solutions straightsmastsolutions.com and today
we're going to do another video on invisalign refinements a lot of you get so confused at the
refinement process just a friendly reminder a long long time ago we called them refinements
there was refinements if you finished all the trays and then you need to make a reboot
then there was also mid-course correction which was if you weren't done and you needed to make a
change now things are called something different and you guys get super confused i mean we still
call them refinements but actually invisalign has rebranded the process to additional aligners
instead so if you want to do a quote-unquote refinement or mid-course correction you actually
need to click the additional aligners tab which is in your patient's portal top right you'll see it
and then they're going to take you through a bunch of prompts there's also another option called
warranty fit if the quote unquote refinement or midcourse correction or additional aligners that
you need to establish happens in the first three aligners they call that warranty fit
you always have to submit a new impression or scan i mean there's a few one-offs if you haven't
if the first one didn't even fail you're still gonna have to submit it occasionally you can
call and just have them trim something off but for the most part you're gonna have to do it
um for warranty fit they sometimes ask for the aligners back so it's always better to
be at least at a liner floor than a liner one two three so i'm just letting you know because it can
complicate the process and you will need to say what a liner they are on now between you and me
you can say whatever line you're on at all so sometimes if i i mean i don't want the invisilite
people to get upset but sometimes if like i know it's not something we did wrong and i just don't
want to go through the extra hassle i'm going to say 4 even if it's 3 does that make sense
okay anyways so how can you make this additional aligner process more streamlined this is they have
certain defaults that it prompts you and the problem is i don't agree with their defaults
so this is number five number five is one of the ones i don't agree with so i want to go over it
it defaults to make finishing improvements to tooth positions ap relationship will be maintained
that means that if you're doing now for me i optimize all my refinements ideally i mean
sorry i optimized all my clin checks ideally from the beginning talk to the patient about
it we agree on it the patient signs off so i'm not going to make a change in my refinement i'm
going to keep working towards the same plan which i've already spent time doing and i've
already spent time optimizing so why would i want to go through this whole process all over again
when i've already done it so i just want to cut to the chase hey i already did a good
job just match it with this last plan with the new scan and just make it a little bit shorter
and so if my let's say this for example if my original plan was 60 aligners patient made it
halfway through okay um if i didn't have any compliance issues with the patient it was just
one of those random things where i went off track then okay i'm going to ask them to quote
you always want to mark this one continue towards achieving the final two positions
as in the last approved clint check treatment plan remember this is not defaulted you have to
tick that and that's the mistake most doctors make then they do all the work all over again
so mark that but then you want to tell them in the comment section couple other things you want to do
you want to tell them please work towards the last you know treatment plan i like to clarify
which which the last treatment plan was so if the last room home was five i'm gonna say please work
this plan towards stream upon number five but with the updated scan dated blah blah blah blah blah
but please make it a little bit shorter so i actually tell them exactly how many aligners
i want it to be based on how compliant i know the patient is because if you don't do that they're
just going to shortchange you you know and it's not gonna be a predictable treatment plan and
i don't want it to be as long as the other one because we've already made a lot of progress right
so you actually have to tell them how many liners you want it to be so in my mind i do
the math and i tell them i know that sounds a little confusing but remember invisalign's
goal as a company is always going to be to save on overhead and to cut prices as much
as possible so they're going to try to do as little work as possible on your clinch
to make it acceptable enough that you'll approve it so that they're not wasting money that's just
the way business works right but my goal is to try to get my patient a predictable treatment
plan that will track hopefully the first time if not the second time so i have to kind of it's a
balancing act right you got to kind of guide them they're not going to give you a longer plan unless
you ask for it if you ask for it they'll give it to you so always mark this if you've spent
the time optimizing it now if you haven't optimized your plan then you're gonna have
to you know do the plan this time um the reason why i never do this because this basically says
let's say you our patient has an overjet or let's say your patient has negative over jet
they're just basically not going to change the bike all they're going to do is straight finishing
i like give you a few liners to fine tune the front teeth basically if you mark this that's
not what i do that's not the dentistry i do so i do this so anyways i just wanted to show you how
that works other things you may or may not want to consider and we've gone over this i have a ton
of videos on refinements so if you want to watch them all you can go to your youtube channel put
in your youtube channel straight smile solutions at the top that'll take you to my youtube channel
um you can go down on the home page and look at the playlist i have one on invisalign i have over
250 videos just on invisalign and there's a ton of stuff on refinement so just watch all those videos
but other things to think about do you want to take attachments on or off well to me it really
depends on if the plan initially was optimized did the patient break any attachments if the plan was
optimized the patient did break attachments and it's all in all going well we just had a
tiny little hiccup then i'm just gonna leave the attachments on unless they're somehow worn down
and i'm gonna mark that button as i submit it now it makes it seem like you know they don't want you
to do that i think it's more work for them but i always tell them if needed they can add additional
attachments and i always say if extrusions are needed please add additional attachments
so i add that in addition if there are small open contacts that aren't flagged or picked up by the
scan i make sure to put in the comment section where those open contacts are and sometimes
they'll ask for virtual ipr so i'm going to ask them to do 0.1 millimeters of ipr in between
the following contacts that's where my open contacts are but i'm actually going to do the ipr
so that way they're just tightening it up a little bit so that's another little hack that's helpful
all right hopefully this was helpful if you ever need help with an invisalign case you want to
optimize clin checks learn how to do it give us a holler straightsmilesolutions.com thank you