What technologies does the clinic use in clear aligner treatment?
The clinic uses the Invisalign system. In this system, the teeth are recorded digitally with the iTero intraoral scanner, the treatment plan is prepared in three dimensions (3D) in the ClinCheck software, and the aligners are custom-made from a material called SmartTrack. At check-up appointments, a new scan can be taken when needed to assess how the teeth are progressing against the plan. These tools make planning and communication easier, but they do not change the treatment decision, the exam or the orthodontist's follow-up. Below, we explain in plain language what each one does and what its limits are.
What is iTero digital scanning, and how is it done?
iTero is a device known as an intraoral scanner. A pen-like wand is moved slowly over the teeth; using light, the device captures a large number of images of the tooth and gum surfaces and stitches them together on a computer screen to build a 3D model of your mouth. In addition to the upper and lower teeth, the way the teeth bite together is also recorded. No X-rays are used during the scan.
How long the scan takes depends on the number of teeth, the structure of the mouth and any areas that are hard to capture. If an area is missed, only that region can be rescanned. You can also watch the model take shape on the screen during the scan; this makes it easier for your orthodontist to show you the current state of your teeth.
A digital scan alone is not enough for a diagnosis. The exam, intraoral and facial photos and any X-rays the orthodontist considers necessary are integral parts of planning. You can also read about the general logic of the digital workflow in our article on digital dentistry.
How does a digital scan differ from a traditional impression?
| Topic | Digital scan | Traditional impression |
|---|---|---|
| Method | The scanner wand is moved over the teeth | A tray filled with impression material is held in the mouth for a while |
| Record | A 3D model on the computer | A plaster model poured from the impression |
| Missed area | Only that area can be rescanned | The impression is usually retaken from scratch |
| For the patient | May be more comfortable for people with a strong gag reflex | The impression material can make some people feel like gagging |
| Transfer to planning | The record is sent digitally to the planning software | The model has to be converted to digital separately |
Both methods can be used for orthodontic planning when done correctly. Scanning is especially practical when a new record is needed and when transferring the record to the planning software.
What is a ClinCheck 3D treatment plan?
ClinCheck is the software in which Invisalign treatment is planned. The scan, photos and X-rays are loaded into this software, and it shows in 3D how the teeth will move step by step from their starting position to their target position. The plan includes:
- The direction and order in which each tooth will move
- Which teeth will get attachments (small, tooth-colored bumps bonded to the teeth) and in what shape; for details, see our article what are attachments
- If needed, the location and amount of light enamel reduction (IPR) to create space between the teeth
- The planned number of aligners and the stages of treatment
The software helps create the first draft; it is the orthodontist who reviews the plan, corrects it, changes it from scratch if necessary and gives final approval. The orthodontist makes their decision by assessing, together with the exam and X-rays, information that cannot be seen on screen alone, such as the condition of the tooth roots and bone, gum health and the relationship between the jaws.
Does the ClinCheck simulation show the outcome of treatment?
The simulation shows the planned tooth movements, not a set outcome. How teeth respond to the plan varies from person to person. Factors such as whether the aligners are worn 20–22 hours a day, bone structure and the shape of the tooth roots affect the actual movement. That is why, for some patients, an additional set of aligners may be planned at the end of treatment for fine-tuning; we explain this in our article on Invisalign refinement.
The real value of the simulation is that you can look at the same screen as your orthodontist and talk about which teeth will move and how, where the attachments will go and what stages treatment will go through. Asking your questions about the plan at this appointment helps keep your expectations realistic.
What is the SmartTrack material?
SmartTrack is the name of the thermoplastic material Invisalign aligners are made from. Following the digital plan, the aligners are custom-made separately for each step. The material is thin and transparent, wraps around the surfaces of the teeth and is designed to apply a continuous, gentle force to the teeth while the aligner is in the mouth.
The material is part of the treatment, but it does not determine the outcome on its own. For the material to do its job, the aligner needs to be worn 20–22 hours a day, changed at the right interval and kept from being warped by hot water or heat. For aligner care, see our page on how to clean clear aligners.
How is digital monitoring done at check-ups?
At check-up appointments, the orthodontist examines how the aligners fit, the condition of the attachments, gum health and how the teeth are progressing against the plan. When considered necessary, a new iTero scan can be taken to record the current position of the teeth. If an additional set of aligners is needed, the new planning is done the same digital way, with a new scan and in ClinCheck.
How often you have check-ups is determined by your treatment. Keeping your schedule organized between check-ups helps you tell your orthodontist clearly which aligner you are on and about any hiccups in between; our aligner change schedule page can guide you.
What does digital planning offer you as a patient?
The benefits of the digital workflow for the patient can be summed up, without exaggeration, as follows:
- Understanding by seeing: Seeing the current state of your teeth and the planned movements on screen makes the treatment easier to understand than a verbal explanation.
- A chance to ask questions: Using the plan, you can ask when each tooth will move, where the attachments will go and whether enamel reduction between the teeth is needed.
- Comparing records: The starting record and later scans give the orthodontist an additional perspective when assessing progress.
- Easy re-recording: In situations such as an additional set of aligners, a new record can be taken without impression material.
These benefits do not in themselves determine the length or outcome of treatment. How treatment goes depends on the features of the case, the accuracy of the plan, regular check-ups and daily aligner wear, all together.
What are digital records used for after treatment ends?
When active treatment is complete, a retention appliance (retainer) is used to keep the teeth in their new position. The scan taken at the end of treatment can be used to make the clear retainer. If the retainer is lost or worn out, the orthodontist may ask for a new record to be taken before making a new one, because the teeth can show small changes over time. You can find details of the retention phase on our page on retainers after clear aligners.
What are the limits of digital technology?
- The scan and 3D plan do not replace an exam or, when needed, X-rays.
- The software is a tool; the orthodontist makes the treatment decision and approves the plan.
- The simulation is a goal; because of each person's individual biological response, it is not a certainty.
- Whether clear aligners are suitable is determined at the exam; not every case can be treated with aligners.
- One of the factors that most affects how treatment goes is how many hours a day the aligners are worn.
You can find who may be suitable for clear aligners on our page who clear aligners are for, and how the Invisalign system works in general on our Invisalign page.
What to expect at your first exam
At the first appointment, the orthodontist examines your teeth, bite and gum health and listens to your concerns and expectations. If considered necessary, X-rays are requested and intraoral and facial photos are taken. The digital scan is taken at the stage the orthodontist considers appropriate. Once planning is complete, the ClinCheck plan is reviewed together with you, your questions are answered and the decision to start treatment is made together. It is perfectly normal to want time to think after seeing the plan; you are not expected to decide in a hurry. If it turns out that clear aligners are not suitable for you, your orthodontist will also explain the other orthodontic options. The orthodontic consultation question list may come in handy as you prepare for your exam.