hey it's Dr Amanda with straight smile Solutions straight smile solutions.com and today we're going
to talk about updated mechanics to submit a clear correct clear aligner case for submission how to
get a really good quote unquote clinch Clint check is a branded term used by Invisalign or Align
Technology how to get a good aligner setup or they call them clear pilot setups with clearcorrect now
if you are a fan of my YouTube site which is an orthodontic site to help General and pediatric
dentists and for the most part it's geared towards doctors but patients listen to it too
to understand Concepts more but you'll see that I have a lot of content about clear
correct going back six years but it changes over time they have really really improved and I've
always been a big fan I mean I was really close to their team way back when back in
2014 2015 I knew them really well um they got bought out by Straumann it got a little funky
for a while it's getting better the culture still isn't what it used to be in my opinion
a lot of really good people were fired and left really talented people but in any case
you know I've been observing and I have a lot of doctors who are Die Hard correct fans and
I've been realizing that you can really optimize they give you the tools to optimize and get a
really good setup and get a really good outcome it can do almost everything that Invisalign can
do I say almost everything there's a few things that aren't quite as good but for the most part
if you know how to drive the boat you can get a good outcome with clearcorrect and it definitely
has some benefits depending on how you want to look at it so you can watch all my other videos
on Clear Creek versus Invisalign to learn all that today we're going to specifically go over
how to submit a case now I did take these Snips directly from their portal so as always strong
and clear correct if I put up any of your IP and uh you don't like it you can always ask me
to take it down you don't have to send me a Clear Creek has never sent me a cease and desist or a
nasty letter I'll let you guys know almost every other clear Liner Company has that's out there
um something from their legal team telling me to take something down do something clear correct has
not so um I consider them a friend if they don't harass me so in any case yes those are their Snips
but it's good stuff I'm not going to say anything bad if anything is just going to help their
doctors get better outcomes and anytime I make a favorable video um you guys are smart enough to
let me lead it up because it's going to help a lot of people and this is what people are asking for
because they find your website a little clunky to submit a case so um I just walked a doctor through
submitting a case yesterday I had been a little while and I was like oh it's changed it's actually
pretty cool so let's go over this all right so a couple points I want to go over for the most
part if you've done Invisalign submitting a clear correct case should be us you know
should be a breeze and for those of you who are starting out as clear correct doctors not wanting
to do Invisalign because you don't have the itera or you have issues with the way Align Technology
runs their whole scanner policy and that's why a lot of you guys don't want to do it you're just
upset at Align Technology and I get that I think what they're doing is so stupid and I've even told
Joe Hogan not to his face but anyways I said you know what I realize you're also in the scanning
business but you I know in other countries these scanners work because you guys take them
in other countries and I know there's a lawsuit in the US but this is BS you're hurting doctors
and what a line technology did four or five years ago when they just slammed it down and stopped
you know accepting other scans it was really a boost to clearcorrect I was like oh you guys
are actually you guys should take this and run with this and they have so good for them okay so
um and anyways like I was gonna say the best way for you to learn how to do good clear correct is
to watch all my Invisalign videos because a lot of the concepts are exactly the same the colors The
Branding might be different but the concepts are the same now of course Invisalign is a slightly
different material it has a slightly different trim line so I do things slightly differently but
for the most part if you understand the concepts that are in the Invisalign Channel which right now
is totally free I do not have the paid course for Invisalign so you can go into my YouTube channel
scroll down to the Invisalign playlist and just watch it all I've tried to sort certain Concepts
and put them in clearcorrect and own off label Channel but you know I'm still building that okay
so point one this is something different that they don't have with Invisalign they don't have
a recommend versus limit well I guess they do because when you when you submit for Invisalign
they ask you to choose what package you want there is no recommend so they say do you want an Express
do you want a light do you want to go do you want an assist do you want to moderate do you want a
phase one Invisalign first you want to Invisalign second do you want it's confusing right well not
for me but for you guys so here there's only two options it's recommend or limit never never never
never never pick limit okay no don't pick that click recommend and then when it comes back you're
actually going to double the internet I actually clear correct this 2.5 times the aligners there
are their movements are very aggressive 2.5 so if they recommend tender liners and you like to set
up the way it moves you agree with how it moves then you just made that 25 honors okay that is
what makes clear correct predictable never this never works out limit never works out and never
take the number that they recommend you always multiply it by 2.5 okay also the other thing you
want to toggle their default where schedule is going to be two weeks that's dumb they're gonna
make your movements way more aggressive and way less predictable always click one week they have I
think a one week ten days two weeks three weeks is insane I mean it's like direct to Consumer stuff
the bigger the movements the bigger the steps in between aligners the more likely it's going
to go off track the higher the forces the worse it is for the teeth the more pain the patient
has the more more likely more more likely it's going to unsee and untrack okay always one one
week now I'm not sure if you click one week you might not have to do multiply it by 2.5 I all my
doctors always just take the default which is two weeks which is why I multiply by 2.5 so I'd have
to see what some setups look like with the one link to see if it really makes a difference I
might only multiply by two that's what I do with Invisalign which is a one Nick so I just thought
I'd give that disclaimer oh this is pretty small okay so these are things that you need to toggle
okay so I believe I don't know if the default is leave or improve but there's a maintain or improve
um I usually have everything is improved unless I know I don't want to do something
okay so this is midline over jet overbite Arch form canine relationship molar relationship
posterior crossbite um I usually keep maintaining on posterior crossbar because you really shouldn't
be messing with posterior cross bites in adults and in kids if you have a posterior crossbite
you should have done an expander so that should always be maintained there's a few exceptions like
a single tooth posterior crossbite like on number five or something okay yeah I'm gonna fix that but
this see a lot of my videos on fixing posterior Cross Bikes and aligners and are probably will
say Invisalign and you'll learn more about that okay now this is how do you want to do it and
if you watch my video on how what are the five different ways we can get space in crowded teeth
with aligners let's quickly go over what the five different ways are right you guys usually can spot
off two or three you don't always know all five first one is expand right expand arches watch my
videos on Arch expansion can and should you expand arches and adults well depends you got to look at
the bone you gotta look at the angulation of the teeth you got to look at the perio you look at
the age of the patient are are there signs that we're pushing it to the limits is the recession
so in terms of expansion don't know and you know what you certainly don't let the aligner company
decide if you can expand their default on every single patient that has cloudy is going to be
expand arches so you need to put your doctor hat on and if you don't know this is where you need to
consult with an orthodontist and or a periodontist and that's where I like to for expand and
proclient I like to y'all don't know what you're doing you go to your little friendly periodontist
and say can I expand can I Proclaim because most often they will say if they think there's a thin
biotype or something like that or a risk they'll say no do not expand do not Proclaim that just
took the risk and responsibility off of you put it on the periodontist so now there's no liability if
something happens of course you have to do what they say and build that into the treatment plan
remember every single crowding treatment plan from Clear craft will come back with tons of expansion
and tons of proclination they just blow it out and blow it Forward why because that's their default
mechanics they are not orthodontists they are not General dentists they are not the treatment
planners they just do what you say if you say recommend they go with their default plan which
is expand and Proclaim which in most adults unless you are like 20 it's probably not a great idea so
you have to decide if it's a good idea okay so that's expand and Proclaim you got to say no
or yes or if needed okay so on a lot of adults I'm going to say no and in terms of the Proclaim
again you got if you don't have a SEF or a cvct slice I don't know I don't know without this if
you work with me a lot of times I'm going to say well where's my SEF you know like I don't
know this is a major crowning case you know I can kind of look at the e-line I can kind
of look at the angulation of the teeth but that's kinda that's that is subjective not objective and
I don't know the answer to that so without that sagittal slice x-ray of a cbct so I can see the
angulations without that lateral cephalometric x-ray where I can run numbers on it and you guys
have an entire playlist on it it's not that hard I'm glad to help you out with it I don't know so
that covers expanded Proclaim which is going to be their default there are other three different
movements are not going to happen unless you ask for them now anytime I take a case that's ortho in
my mind I already know how I'm gonna move teeth and if I'm not sure I'm gonna get that Seth I'm
going to get that lateral cbct slice and that way I know I'm gonna get that pan out don't be
operating with just bite wings or an fmx you don't know if there's good ridges so you can distalize
how can you do ortho blindly this is where it's going to bite you guys in the butt because if
there's a complication if there's a problem if that patient complains to the Dental Board if that
patient complains to the insurance company and trust me it happens even with orthodontists quite
frequently everyone's out there to get a quick Buck if they can't and there's a lot of dirty
lawyers out there and a lot of dirty dentists out there that will throw other dentists under
the bus if you didn't literally make this plan in your brain you hear how I'm going through this
narrative I'm going through each of these check boxes and I'm telling you the way I'm thinking for
every single case is going to be different there's things you have to look at you have no business
doing clear liners because you're going to get bitten in the butt one of these days and you know
what you're going to be coming to me and saying what should I have done well you did everything
wrong and you know what clear crack not going to tell you any of this invisalign's not going to
tell you any of this that's why us orthodontists are sitting here laughing at what you guys are
doing because you're like you guys are doing your in the way that they teach you is so wrong which
is part of the reason why I make these videos because hey I have a general dentist husband who
does Ortho and I was just disgusted and horrified of the stuff he learns in the lectures that are
targeted towards GPS the stuff he learns in the CE classes that are targeting towards GPS not
only is it wrong it's sloppy and it's it's bad bad bad bad bad Orthodontics yeah you guys and
US orthodontists sit there and laugh because we go hey they're just gonna Jack it up and
the patients are going to come back to us and it saves the profession we don't care but I do care
okay because I care about these patients all right so we talked about expand we talked about Proclaim
um what are the other ways you've got IPR sure I like IPR nothing wrong with that but I also hate
IPR because IPR takes me a long time IPR takes a lot of share time patients hate IPR okay they
think they like the idea of it but then they hate it when they actually have to do a lot of
it and at 45 minutes to an hour of my chair time is a complete waste of money I'm wasting money on
this case right if a patient is demanding a ton of IPR I'm probably not going to take that case
good is not worth my time especially if it's an insurance case and anyways anytime you have that
much IPR in a case it is never ever ever accurate until there's like a laser system that precisely
does Micro amounts of IPR that's a game changer someone can invent them until that happens I hate
IPR and I actually don't want it and I'll leave it on only if needed sometimes you do need it and
if you're not sure why like there's a Bolton discrepancy you need to go to all my bulletin
videos or IPR videos all right the last one that you guys probably don't know about is distalized
that's my favorite favorite way to make space and I think I have yes marked here because of course
you don't can't have impacted teeth and you can't have erupted third molars if you want to dislike
third molars need to be gone gone but in a lot of cases with crowding it's a fantastic and very
accurate way to make space without damaging teeth very very easy but it's time consuming which is
why of course you need to only be doing one week but you need to be doing recommend and these these
cases are going to go 60 to 80 aligners that's a year and a half nothing wrong with that normal
for braces cases take a year and a half so those of you who are trying to speed things up and do
anterior only treatment you're doing weird weird things with your cases okay so and getting to that
treatment approach approach her full correction versus aesthetic you don't pick this no no no
no no no no no no no they say they suggested for class two cases that's insane you guys are nuts
it just means a ton of IPR not only is it going to look weird but if we're all doing aesthetic or
social six and we're not moving back teeth at all still all weird things will happen the arch phone
is strange things aren't interdigitated right it never turns out well and again you can't be
building d80 80 the 80 90 you got to be limited if you do that okay which changes your reimbursement
and if you build the wrong thing and you marked this it's gonna come back to bite you in the
butt later guaranteed it well okay so be really careful always full Arch correction okay unless
the patient has there's a few one-offs where I'll do a social six um patient class one maybe
has a tiny Gap and there's clearance for me to close the space I can close the space on the top
only with the front teeth only without having to move the bottom teeth and I won't have any
interferences great yes I will do aesthetic or on a case maybe that has a little lower crowding but
we have overjet so I can straighten it without having to do too much movement or expansion or
anything like that great I'll do aesthetic but that's a rent one off it's maybe like one or two
percent of the cases I've done all right lastly you've got these things down here this is going to
tell you exactly how you also want you want to do it right and the nice thing about clear correct is
you can Mark you want Universal you want polymer blah blah so it's nice um obvious you want to Mark
the teeth you don't want to move like baby teeth implants and bridges make sure you mark that off
you don't Mark that off they're going to move them and you're going to have trouble okay it's
your job to mark them it's not their job to look at your X-ray avoid engagers only time I Mark that
is when I've got a veneer a gold crown or a really really nice porcelain crown that I don't want to
damage I'm going to go ahead and Mark that okay or some tooth that's like traumatized or damage that
I just gotta block the movement or a baby tooth so then you want to avoid the engagers keep in mind
if you avoid engages you're probably not going to get movement on that tooth so you can't say I
don't want engagers on the front teeth and expect them to move because they're not going to move
so um don't be doing it for cosmetic reasons if a patient is that picky that they don't want
to engage us for or attachments for aesthetic reasons pump them to know if someone down the
street because I'm not going to take them because I can't promise you that we won't need them nor am
I even gonna do a case that where you don't want them because it's just going to be unpredictable
and you're going to get frustrated I'm gonna get frustrated No One's Gonna Be Happy so bye bye go
to someone else go to smiledirectclub you can deal with them all right teeth to be extracted I have
seen of course Lauren Sizer extractions no problem you can also Mark if you're having wisdom teeth
taken out Mark that yeah so they don't include them in the plan they know that they're out
have I done or seen a four by extraction case in clearcorrect I think there's a few that I know
that are going on I haven't personally done any because I've always used Invisalign those work
out great um but you can definitely Mark the ones that that don't that need to go but I mean
they say that you can do for by extraction but not sure yet okay and this is leave these spaces open
if you have an implant or if you're leaving spaces for um like uh veneers you want one-third mesial
two-thirds distal blah blah blah you can go ahead and leave the spaces open and they usually have a
space where you can type things into so I always recommend being as clear as one of what you want
and how you want it yeah they have they have a comment section so that's what I'm going to say
I want this to be 50 to 70 aligners I want to use up to two millimeters of sequential
distillation per quadrant on the lower and up to four millimeters of sequential distillation
per quarter on the top do not expand arches do not Proclaim arches do not round trip make space
first and then align the teeth make sure you have full size attachments on teeth seven and ten this
is like a typical treatment plan for me that has crowning okay so I tell them exactly what I want
and how I want it and now they also have bite ramps which is great there's a place where you
can Mark if you want them make sure you ask for them I put them on almost every case clear correct
is notorious because of the thickness of their practice plastic for having posterior open mites
if you don't put bite turbos on it you're probably going to get a posterior open bite it's default on
almost every case for me with a few exceptions if you're not not sure why you should watch my videos
on anterior bite turbos with Invisalign and then extrapolate it into clear cred because now they
have it which is a game changer for their aligner company so again strawman if you're listening to
this this was a completely bullish post about using clearcraig how to submit cases I'm using
it more and more only thing I wish it would do is I wish it would save your damn password that
drives me nuts at least Invisalign has an option to Google save the password so it saves it and so
you can get in it's a big pain in the butt to have to type passwords I hate passwords so I think that
would be really cool if they had that if they had a little more flexibility I think they're
starting to have some more staff functionality and notification alerts but still pretty clunky you
know it's definitely not streamlined Invisalign of course I would love it if they had an option
of like clear crack virtual I know that they partner with DM because DM is partly funded by
um Dental monitoring is partly funded by strawman I think they invested in it but it just doesn't it
doesn't connect it doesn't sync so there's no way to be doing um virtual check-ins and having that
data coming right into your dashboard as far far as I know again anyone from strauma to clearcorps
if I'm saying anything wrong or if you want me to retape this educate me spend some time teaching me
it's been a while since I've talked to your team happy to update this video alright this is pretty
much it so check out clear correct it's definitely a much better product than it used to be