Guide to Invisalign Refinements, MCC, iTero, Vivara

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Guide to Invisalign Refinements, MCC, iTero, Vivara

hi i’m dr amanda and i’m an orthodontist i’m also the ceo of straight smile solutions we help dentists all over the world understand orthodontics better we work with all systems braces appliances and brands of aligners and we support all systems and brands this video will share content that is the property of invisalign and align technology we’ve made this video upon request of 40 000 plus doctors subscribers and followers to help them achieve better outcomes with their invisalign cases we do not work for aligned technology all opinions expressed in this video are the opinions of straight smile solutions and not align technology thank you to align technology for continuing to support us educating and helping their doctors and letting us share this video around the world through youtube instagram facebook tick tock linkedin and all of our social media platforms together we unite to make more smiles if you have questions or concerns about this video please contact us directly at www dots enjoy the video hey it’s dr amanda with straight smile solutions straightsmilesolutions.com and today i want to talk to you about when you log into your invisalign account and you see that top right it’s called the supplemental order tabs you’ll see like additional aligners replacement attachment template warranty vivera start a new treatment all that kind of stuff so i kind of wanted i feel like they like don’t explain their portal very well and it’s one of those things you’ll learn over time but initially it can be very overwhelming so i wanted to take the time to explain it my words maybe not their words but hopefully it helps you to know what to do and what each of these tabs are for okay so and cool thing is this is kind of a fun fact if you take your mouse and you hover it over each of these bars it actually brings a little pop-up so this is their pop-up that kind of tells you what it is that’s very helpful so let’s start with additional aligners so additional liners is what you click on when you started a case and something went off track what does off track mean you have to go into my street smile solutions check out tracking videos or email us or contact us at streetsmansolutions.com and be glad to send you lots of information on tracking tracking is the number one key to success with invisalign treatment if you don’t get it and if your patient doesn’t get it your cases won’t work out and they don’t do a great job explaining that so if you went off track and if your patient didn’t save all their older liners like i always tell you to do i have them save them in like a little tackle box label it bring it to every appointment this is standard stuff bring it because if they went off track you go back and find the one that fits it’s really easy and that’s going to save you a lot of time now if they went like crazy off track just on a tooth but maybe the other stuff started tracking then you might have to do either a mid-course correction or a refinement aka a revision that’s the terminology that clearcorrect uses all pretty much the same thing mid-course correction means that you’re doing it in the middle of treatment let’s say you got 20 aligners you made it to nine you went off track that’s a mid-course correction let’s say you got had 20 aligners and you made it to 20 and then you noticed you didn’t quite get what you wanted or you were off track at the end that would be a refinement whatever same thing basically it’s the same button click the additional aligners button to me that’s a weird button they should just call it mid-course correction revision refinement but whatever all right and then they’ll we’ll have a different um there’s i have other videos that will teach you what that what to do once you click on that so i just wanted to tell you about these tabs and click on my other videos for more information on that all right so number two would be replacement so replacement is if something is broken or lost okay like patient says hey i lost number seven upper and lower or i ran over it with a car okay they’re gonna charge you for that um depending on what plan you have is how much you pay it’s not that much if you have a comprehensive plan i think your teen it’s a little bit cheaper than if you have like a limited um or express but um i don’t know 30 40 50 60 i don’t know it’s something like that 10 i don’t know it changes all the time you used to get free ones with the teen ones i don’t think you do anymore um okay so but you don’t always need to get a replacement so usually my answer to that is okay um can you put in the next one so you lost seven how far did you get with seven before you lost it oh i wore it a week okay well can you put an eight does it fit is it tracking completely can you get it down with chewie’s yeah okay fine then we don’t need seven but if they lost seven on the first day most likely they’re gonna need to stay in six until seven comes in and wear it and then of course patient pays for that so you guys that’s another thing you’re gonna wanna do is when you come up with your contract and i have some basic contracts but not everything’s looped in because you’re going to need to figure out how you want to do things you know

what are you going to charge them i mean personally you should charge them at least to cover your lab fee plus maybe a little bit more for the time um unless you’re throwing them in the mail but um okay number three attachment template this is what you click on if you broke some attachments and let’s say you are on a liner seven of 20 and you can’t go back to the original attachment template at zero because that’s not gonna fit right now if you save your old attachment template and it’s just one tooth you can just cut that tooth out of the old attachment template that’s a little fun pack if it’s multiples that probably not going to work that well so then you have to order attachment template i’m pretty sure there’s a small fee for that have your patients stay in the old aligner until you can get the new attachments on do not progress okay because you’re gonna have to say what a liner you want it made off so that’s where you have to have really good communication with the patient or that’s not gonna work all right last one warranty oh not last one number four warranty so warranty is what you click when you get either like let’s say there’s like a sharp piece that patients just can’t tolerate or it’s like a fabrication issue there’s a weird lip or it’s like distorted you have this more of this issue when you’re doing impressions than when you do scans um if you just get it first thing i would recommend doing when you get your box in before you deliver is inspect everything you know inspect the attachment template you don’t have to i don’t want you to open up with all the packages but at least open up number one and make sure you don’t see anything weird i mean it’s very rare that there’s a defect because they have pretty good qc but you will have fit issues if you’re using impressions versus scan they’re gonna be exponentially higher and this is where you’re gonna have to use that warranty button um or if there’s just like a consistently sharp thing the patient can’t but like polish down with their nail file or something um again probably rated to impressions if you’re gonna do a lot of invisalign you need to get a scanner and of course invisalign only takes itero which is the expensive the most expensive scanner with monthly fees so lovely um okay so that’s what the warranty is you need to say where where it is what it happened um usually this is free to have these remade but they’re gonna probably want pictures documentation so you can’t like have it be in two pieces because the patient ran over it and say it’s a warranty problem they’re gonna bust you on that okay vivera retainers that’s self-explanatory those are retainers that are made at the end of treatment you can either i have a separate video on vivarius so just search for that um but they come in packs of one or packs of four um they are the best possible retainers it is better to rescan for your vivarius and to make them off the old aligner there’s also another option which i didn’t know about which is invisalign retainers which i guess is a cheaper not made of invisalign proprietary material retainers i think they’re about 50 bucks each these are meant to be temporary retainers so um like let’s say patient i don’t know patients getting married and she’s asked to have all her attachments off and get some temporary retainers for the wedding and then she’ll go back and get her attachments on again that’s where you would want to use something like that or you had to do some restorative work mid treatment and you just needed a temporary retainer um made off a certain tray just to hold them if you don’t have an in-house way of making retainers this is almost like having access to a retainer lab but it’s cheaper than vivera because it’s meant to be short-term um if you have an in-house lab you shouldn’t be using this that makes no sense um but just so you know it’s there it’s cheaper uh what else yes invisalign retainers here 50 per arch with treatment 65 per arch with new impressions um it’s a temporary retention option consisting of one or one set of retainers oh 50 per arch okay um during the course of orthodontic treatment it can be ordered from any invisalign treatment stage or with a new impression okay so it’s more expensive if you send in a new impression or scan okay and then lastly the start new treatment you’d want to hit start new treatment if i guess if the treatment was already closed out and you were starting a new treatment i don’t know how that works with the expiration date if it if it i think if if you’re if it hasn’t expired yet oh yeah maybe if even if you hit vivera if it hadn’t expired you could still start new treatment and then you may not have a live lab fee as long as you were still within your five years for comprehensive um so if it was outside the five years i think it’ll be closed you have to start a brand new case but you could double check with them anyways that’s pretty much what those tabs are hey this is dr amanda with straight smile solutions street smile solutions.com and today we’re going to talk to you about how to submit for a revision refinement or mid-course correction with invisalign and it’s pretty self-explanatory i had a previous video that showed the supplemental order tab in the top right you can go look at the video i posted before this and look at it but you’re going to go to the top right click on additional aligners additional aligners is basically your mid-course correction revision refinement mid-course correction means that you’re stopping in the middle of treatment you

know and starting over again maybe something didn’t track maybe patient had to get a new filling maybe patient wasn’t being compliant whatever if you have a comprehensive case there should be no cost to this if you have a more limited case you might get one of these included um or you might get none so you might have to pay for it so that’s the benefit of doing comprehensive okay um so that’s that and then from there you’re gonna go ahead and push the button and get started it’s pretty much the same thing as submitting a new case so do look at new case submission i have a video that was probably posted i don’t know a year ago so it means further back but just you can go into my um either email me info straightsmilesolutions.com go to my website streetsmilesolutions.com and message me and i’ll send it to you or you can search around within my videos um search and design and it should come up um how to submit a case but so i’m not going to go over all that just going over anything that’s a little bit different but the main things you’re going to want to mention is this is this is the confusing one here the like reason for submission and you have to be careful with what you pick here because if you pick patient not compliant they might charge you um so i would either pick needs finishing improvements or teeth are not tracking would be my suggestion um if you pick needs needs new restoration dental work or patient not compliant i think there might be a fee not sure i just never picked those um and you know teeth are not tracking or needs finishing improvements because it’s just a more generalized term we don’t know why it’s not working out maybe it’s you maybe it’s me who knows let’s just click that that’s what i pick okay then they’re gonna ask what a liner are you currently wearing so let’s say a patient had like here they had 40 aligners are they in 40 did they finish if so that’s a refinement are they in 20 are they halfway there if so it’s a mid-course correction say what a liner they’re in remember if you’re starting this the patient should not be progressing they need to hold in that aligner until the new stuff comes in okay that’s the main thing if they didn’t finish so and if they can’t hold in that aligner then make them a retainer and have them hold in that but say which aligner it was off of so because this is really really important and you write that aligner here from there this is the confusing part okay again they’re going to ask you where you want attachments where you don’t want attachments where do you not want ipr what teeth don’t you move all the same stuff that we had when we submitted a new case you should have to pull up their x-ray this is a little confusing i always pick the top one here what do you want us to do with existing attachments this is the recommended one where they you can take the impression with the attachments on i don’t take attachments off before i unless i have one that’s like broken or worn down i just leave them on take the scan and then if they think i need slightly different attachments they’re going to virtually tell you which ones to remove and which ones to replace so it’s a lot less work than taking them all off and re-scanning but if it’s a hot mess um and you just think that you need to do a complete do-over then just take them off but yeah i usually pick the top one here this is like not at all explained well by the way invisalign if you hear this um lastly are you treating both arches upper lower um are you sending new impressions or scan you should always be sending new impressions or scan do not do this without sending new ones because they gonna it’s gonna turn out bad so you should say yes yes and how do you want your treatment plan set up this is important um there is i wouldn’t pick this one continue towards achieving the same tooth position because no you might want to change things so if you want something drastically different click other otherwise i would say make finishing improvements to the tooth position so that way you’re not getting the exact same treatment plan or other you know if you want something totally different if you’re taking in a different direction you can click that but ultimately you’re gonna get a clean check and you’re gonna be able to play with it again and that’s the main thing and that’s pretty much it that’s how you submit one um as always if you’re gonna do a more limited an express or a light you’re going to start unless you have a really good tracking program in-house compliance program you’re going to start getting hit with some major fees doing this so i don’t recommend any newbie invisalign providers do any express or light cases you should consider doing a white label if you’re going to do that at least you’re paying a third of the treatment plan do everything comprehensive or at the very least moderate for the easy cases and i would always submit everything is comprehensive work it up to ideal if it ends up being less than 20 then that’s where you can consider bumping it down to a moderate that’s my that’s my trick so hopefully that was helpful hey this is dr amanda with straight smash solutions and today i’m going to talk to you about something that i see quite often which is an error that happens in invisalign when you don’t take good pictures or scans or impressions and this is why it’s super important to submit perfect records so that they can do a perfect setup if you don’t do if you do a sloppy job submitting your

records you’re gonna get a sloppy setup and then your case is not gonna turn out and you’re gonna wonder why so let’s start at the very beginning how to double check your work now i have a pretty good eye when i see treatment plans and i know when things don’t match up but to a less trained individual um you’re not going to see it so let me give you a hack to do this right so log into your case okay and you want to go ahead and double check to make sure the articulation or the way the byte is set up correctly because if it doesn’t match your patient clinically you’re going to get a bad setup okay and that’s not their job that’s on you so in any case what you want to do is go to the occlusion button up here okay show occlusal contacts now i’m at the beginning of the case you know checking at the end of the case is a whole another thing and we can do that in a separate video okay i just isolate the maxilla here okay and you can see the green dots these are the dots that they’re saying are in contact okay if you use if you used articulating paper you should replicate this the way the patient is at the start so if you aren’t sure okay you need to double check have your patient come in use articulating paper and see if this matches if it doesn’t match you either sent in incorrect photos where the patient’s not biting correctly or you send in an incorrect scan or impression that means you need to double check and redo your records okay so that they can re-articulate it so just as another hack here let me scroll this to the end and we can do it at the end same thing goes with the ending you want to see really good balanced contacts at the end for the most part one of my preferences is to ask for three points of light contacts that are balanced on molars and two points of leg contacts that are balanced on premolars and one point of light contacts that are balanced on canines i don’t like to see articulation or occlusion on the anterior teeth so this case is not done obviously and by the way again you need to capture the terminal molars so that means if the patient has second molars you need to capture them if the patient has third molars you need to capture all of them as well not maybe you can get half to two-thirds and get away with it but it depends on what you’re trying to do if you’re trying to fix bites or close spaces you need to capture the whole thing okay so by the way this case is not done clearly there’s a couple errors that are going on here but i just want to show you what to look for and how to do it okay so in any case there’s my hack you can also do it on the bottom double check on the bottom too okay so it needs to replicate clinically as to what it should look like and let’s look at the ending all right that’s a little bit better all right any case so please do this on all your cases double check and if you want to make it even easier take pictures when you take your actual records for invisalign use the articulating paper you know and check it then so and make sure it matches up all right thanks so much have a fantastic day if you have any questions don’t forget to submit your questions to straightsmilesolutions.com hey it’s dr amanda with straight smile solutions straightsmilesolutions.com and i wanted to talk to you a little about a little hack or a little tip that i like to use with my invisalign cases this will save this tiny little step will save you tons of heartache later and tons of time and the patience will be happier so i recommend this at all times and even if you have an eye tarot you still want to do this tiny little step and this tiny little step will cost you six dollars per year that’s how cheap it is because that’s what a container of articulating paper costs me so i recommend even uh it’s not a huge deal if you have an itero or a good scanner it’s probably not quite as critical at the start but it’s definitely critical at any mid course correction revision or refinement when you take the clinical photos to use articulating paper before you take the photos okay mark the contacts then take your updated progress photos okay and then verify it when they do the setup as you can see on the right side make sure you’re pushing the occlusion button at the top and if you don’t know where that is please call me and i will tell you where it is and you’ll get a little the little green dots you want to make sure little green dots match with what you saw clinically it’s that simple because so often with mid-course corrections revisions and refinements we’re in kind of a transitory bike where you might not have a full stable bite so they’re doing their best technicians based on the photos that you gave them and they scan which sometimes isn’t always that accurate and they’re just doing their best so you can’t trust that what they gave you is right unless you verify it and this is really the only way to verify it and same hack i would say for clearcorrect however they don’t have the articulation feature and knowledge of most of the other ones you would have to ask them to verify it you know just visually eyeball it but i

like this way you can just see the little dots and be like oh that’s exactly what i saw and then you feel good if you fail to do this in true honesty i see a lot of invisalign cases per day like a lot a lot like dozens sometimes even more per day um i wish this line would give me a little credit for that um for how much i see you know but um i would say one-third to one-half this is my personal stats that i see one and this is people with scanners okay people with eye tarot this is really kind of unforgivable as far as i’m concerned but and i see the notes honestly on the technicians leave a lot of time to say we’re really not sure you need to read the notes on the right side that they put in a little text because so often we i think they write a lot they write too much they need to like bullet it because it’s like it’s honestly like verbal i’m not gonna say what it is it’s like regurgitation it’s like you know they just have too much words and people ignore it you know because they just think it’s it’s a lot of times it’s not customized it seems like it’s just stocked stock words you know so people ignore it but there’s some really critical information in that right side you need to look at it and most often honestly the technicians will say hey we don’t know if this bite is right can you please check it and the doctors don’t check it right and then you’re going to get some whack-a-mole set up that that turn you’re going to get a whack-a-mole outcome is what’s going to happen it’s going to take you another six months to fix it just because you didn’t take this extra you know 30 seconds of your life to spend six dollars a year to verify the bike anyways long rant but i’m telling you this is the easiest way to get better invisalign outcomes and like i said you can do it with any aligner company but they don’t necessarily have the articulation feature so you’re going to have to ask the technicians to verify whether it’s done or not i don’t know so um that’s pretty much it hopefully that makes sense if you need more step-by-step help as always you can go to straightsmilesolutions.com we’re glad to help you with the case our fees are on the services page you can take a look if you are a dsn member you get a free case but you have to message us through workspace or workplace in order to redeem that so that way we can verify that you’re actually the sn hey it’s dr amanda from straight smile solutions straightsmilesolutions.com and today we’re going to talk about yay you’re done with your invisalign case what do we do next at the end like yay we got there great outcome so let’s talk a little bit about that so i would not rush like patient finish let’s say it was a 25 case tray tray case and you got to the end of 25 and patient just finished 25 yesterday and they’re like hey can i get my retainer so you might want to hang out for a few weeks especially if there were some extrusions and stuff just to let things stabilize a little bit you know in the land of braces we do this all the time for like a month or two so kind of tie it all together and let it sit it’s kind of like letting things stabilize um because when you pop those um attachments off you might get a little shifting you know without the attachments on so best to let it settle for a little bit but that’s just my tip you could also build a couple passive aligners into your treatment plants which basically is like okay we finished at 25 so 26 is basically just 25 again but they used to get to change the aligners to get fresh ones so patients don’t really know it’s passive aligners so that way it’s built in there just a little tip um but if you’re doing unlimited or comprehensive you know it’s free so why not and you can do that with any aligner company but anyway so let’s say we’re done we hung out for a little bit we’re pretty sure things are stable how do we order retainers and of course retainers is oh my goodness i have so many blogs on retainers and retainer options and retainer aftercare programs and retainer description programs and what to do but remember retainers are for a lifetime okay so and i have like if you want me to send you this because i have you know like i said almost a thousand pieces of content email me at info streetsmilesolutions.com info streetsmilesolutions.com or message me on my website straightsmilesolutions.com or through one of every other social media and i can send you exactly what you’re looking for but i have some step-by-step instructions exactly what to say do everything like that what your options are but real quick remember retainers are for life the actual frequency of retainer wear is customized for the patient you can’t have a one-size-fits-all approach um always better to wear it more than less etc etc um one clear retainer will not last you for a lifetime you’re going to need numerous you need to be straight forward with your patient in terms of what’s included with their plan ideally you want to do that on the front end and not the back end and let them know at the beginning patients will get really really really upset if you did not give them what they expected and if they’re coming in

expecting upper and lower bonded retainers and you’re giving them one set of clear retainers that only last a few months they’re going to be pissed off and you’re going to get a really bad review so you should be having this retainer discussion like before you start pretty much every few months you may not know exactly what the right retainer is for them and that’s okay to say that hey i pick a customized approach there’s lots of different retainers did you come in with a certain type of expectation i would love to hear about it and i can tell you my philosophy of what i think might work for you um and when i work with clients one-on-one with streets mass solutions we talk about that and we talk about each patient and kind of where we think the retainer should be and what might be good for this patient but anyways by their retainers are great retainers um they’re customizable there’s a lot of cool things that they have um they’re nice they’re pretty strong you will still need several by theirs over a lifetime you might even need more than that they come in packs of one or packs of four so eight total for uppers and lowers um let me walk you through what to do let’s say you want to order vivarius and you don’t want to go you can order very similar retainers it may not have the same scalloping or some of the same features um might be a different price point it may not come in a pack of four but you could order very similar clear retainers from any local lab as well whether there is i mean they should be like oh four oh um and stuff like that but um when you make them in-house just in your own suck-down machine it’s probably not going to be as good as a vibra because unless you have a really really high quality like biostar pressure-y suck-down thing i’m going to have some videos about that versus just your regular vacuum foreigner it’s former it’s not going to be as good you’re going to get more relapse so i wouldn’t recommend that they’re forever retainers just be something you made in your back lab unless you have a really good lab so just saying there is a difference and i and i’ve seen a lot of relapses happen with in-house clear retainers that are just made in somebody’s lap okay so personally if they relapse in the first couple months and you just made an in-house retainer you’re liable you need to redo their braces or their invisalign and of course if you did you know a comprehensive case you can retreat at no cost but you know hassle for you right so um so let’s talk about that so you let it settle for a little bit that’s great and now you go in and you’re going to order your vibra so you need to make a decision so you go to the right side to the right of the patient portal and you click by vera retainers right this is really small so i apologize but you guys get the idea and then um they’re gonna ask you do you want one or do you want the pack of four and i think the pack of four is four uppers and four lowers eight total is 275 one is oh i can’t even see that 95 something like that so um one upper and one lower or something like that um do you want to treat both arches upper or lower and then you’re going to go ahead and say where you are you know do i want to make it off am i going to send a new scan you know i’m going to take the attachments off clean them up rescan that’s the recommended choice or do you want to order it off one of the previous aligners and if so you need to say which one it will usually fit better to go ahead and take the attachments off and rescan some people what they’ll do at the end of treatment is they will order just one off the end of liner and then you know let their gums get healthier get a cleaning all that then rescan and make the pack of four as a bundle but that’s an option so there’s a lot of things it would be better but you i mean i don’t know many people that give the pack of four uppers and the lowers as stock that’s like an option um it’s a nice thing you know to do i mean they’re going to need more than a couple in a lifetime so again you got to clarify that with your patient what are they getting what are the options nobody likes an upsell at the end so you need to be having and there’s a lot of cool retainer subscription programs that are out there retainers for life um retainers forever retainer of forever align club proline maybe has one there’s so many different things that are out there that you can third-party ones that you can join or your patient may choose to join so i mean if you don’t come up with a plan they’re gonna it’s only a matter of time before venture capitalists jump on this because it’s a huge opportunity so i suggest you come up with your own in-house plan for now right another question is are you going to put a fixed lingual retainer on if so it’s recommended that you put it on first and then rescan and they’re saying that they may or may not have to cut a window around that you know so because i mean anytime you’re taking an aligner on and off over a fixed thing it can torque it so they’re saying they’re not responsible so that’s a question so again i have tons of content on fixed retainers you should definitely go to my youtube um put in bonded retainer or permanent retainer or whatever um if not email me message me on any of my socials and i’ll

send you the content but um i highly recommend you don’t just use a braided wire and slap it on that never works out good so you should have it customized done by the lab done passively passively because i’ve seen some terrible stuff happen with that uh what else pontix they’re going to ask if you want a pontic if you want it obviously you’re going to have to fill it but i have tons of videos on filling politics as well this is a new thing i didn’t even know they had that they’re going to ask you if you want bike ramps and i love love love that they have that so now i’m actually more on the vivera bandwagon than i ever was after i saw that um it must be new because i hadn’t seen that in a while so why would you do that i would only i mean obviously we’re not actively moving teeth so we’re not leveling the crevice b but a lot of times when you have plastic over the back teeth you can if you have a clencher or a grinder you can get a posterior open bite so for those type of patients and if you’ve if you’ve seen that happening during your treatment or if you’ve experienced posterior open bite during a treatment or if you had bite ribs during your treatment you might want to consider putting them on your retention um as well and for me like as a clencher it really is nice to be able to have that type of ramp just to wear at night time it takes a lot of pressure like a lot less headaches and stuff like that it’s a free service so you can go ahead and put that on if you want to but keep in mind you’re going to be front loading those top teeth if you do that this front teeth so if you have endo or trauma teeth you would not want to do that or perio or something like that you’d want to have a full stable so just things to think about but yeah i mean that’s pretty much it and then you go ahead and submit and you pay um and they ship it so that’s your vivera retainer so i think they’re pretty good value um but there is stain a lot more than some other retainers do you know whether it’s the zendora a or the essex i’ve done a lot of staining challenges so just keep that in mind that they do stain so patients shouldn’t be eating or drinking with them in you know again frequency where frequency might be three months full time six months full time something like that please read my other blogs about phasing down your retainer when to go tonight stuff like that if you don’t do this right you’re going to get relapse so it’s really critical that you do it the right way and not every patient is the same so have a chat with me if you have any questions this is dr amanda from straight smile solutions and i had a couple great questions come in today that i wanted to answer um first one was about it’s actually a pretty common question it’s about vivera retainers which is a branded retainer which is made by invisalign which is aka publicly traded company align technology that is their brand of retainers you can buy them in packs of one or packs of four you do need to buy them through your dentist any dentist that is invisalign certified can prescribe by their retainers in order to get those retainers you’ll need to either have a scan or an impression done by your dentist if you’ve gone through invisalign treatment you’re last and you’re happy with the outcome and your dentist is happy with the outcome that last retainer sorry that last stage and the very last aligner can be that file that um 3d image can be transferred to be made into a vivair retainer so for clarification you really shouldn’t use your last aligner as a retainer because it’s way thinner than an actual retainer should be to hold the teeth so you’re moving your teeth you’re moving your teeth the properties of the plastic that moves the teeth during invisalign treatment or regular aligner treatment is much thinner and much more elastomeric elastic ish in order to move the teeth right so that’s the properties that we need to move teeth when we’re done and we want to hold those teeth in the final position for life then we need a thicker retainer so the approximate thickness just for this dental geese out there for movement retainers or aligners are usually at 030 in terms of thickness that’s i think that’s in inches and the actual retention is usually o four o so it’s like a little bit thicker not that much you’re talking like my little little little microns like tiny bit thicker but it does make a difference when you feel the retainers versus the aligners they’re much stiffer which is the goal right a little harder to get off et cetera so approximate amount of time that they last for which is why you really can’t just have one retainer and i think that’s one of the biggest misconceptions not only for dentists but also for patients is okay i’m gonna either use my last aligner as a retainer well they’re not gonna stay straight if you do that so that’s not a great idea um same thing with retainer you can’t just have one retainer you need to have many retainers throughout your lifetime and you need to factor that into your budget and that’s a really important question that you need to ask your dentist how is that going to work do they store your final image in the cloud if it’s with invisalign they do what happens if you move and go to another state how are you going to get more retainers can you just order more retainers ahead of time

and kind of stockpile them which is what i kind of recommend there are some services out there and companies out there and i think it’s going to become a lot more popular that have retainer subscription programs not only third party direct to consumer but also through your dentist so these are all fantastic questions to ask your dentist if you’re a dentist feel free to talk to me about it i have a lot of blogs on the subject i’ve helped doctors set up their own retainer subscription programs and just so there’s no miscommunication between dentists and patients of what you need to do at the end generally i will if i’m super happy with the outcome of an invisalign case i’m going to go ahead and order that vivera off the last aligner but i’m going to tell the patient they need four uppers and lowers i’ll include one with my treatment okay after that that’s on them if they want to order a pack of four i’m not gonna necessarily upsell it i’m gonna charge them maybe like three or four hundred dollars that’s about my fee for eight more for uppers and four more four lowers um but that’s my fee right i’m not making anything off that if they get it right at the time of d-bond but if they get it later there probably will be an additional fee if teeth move and you need another set that’s another scan and another delivery so that’s going to be slightly more expensive than if i just push a button to order it so i don’t know if that makes sense if you have a 3d printer in your office and a vacuum form or a biostar machine this is something you can totally do you can’t buy the invisalign branded viveira material on its own the sheets that have to be made at invisalign headquarters which takes a little more time but you can make clear retainers within your own office or you can go to a regular lab and have them made but it’s not going to be made of vivarium material personally who cares there’s a lot of other great 04 materials that are out there that to me work just as well they may not be scalloped and have the same trim line they may not be branded okay but um they are they are but in that case you know that final stl you need to find a place to store that if you’re doing that if you’re not using invisalign so and there’s a benefit to that because anytime the patient needs more they can just call you you push a button anyways i know that’s a lot of information hopefully um if you have any questions give me a poller i’d be glad to talk to you about it both dentists patients if you want to talk about stuff we do have a patient-facing facebook page so feel free to ping us or go to facebook and search dentist moderated orthodontic support group or something like that i can’t remember the exact name but you’ll see it there the banner is pink so anyways dentists please go to straightsmilesolutions.com continue to submit your questions hopefully that answered your question and yeah retainers are a really hot topic dr amanda with street smile solutions and today we’re going to be talking about the latest blog that kevin o’brien posted if you’re not familiar with his blogs they’re actually really great i’ve been following him for many years um he is amazing at taking a piece of literature like a white paper and just breaking it down to like no bs you know no sponsorships nothing like that here’s what the research says here’s the take-home message that you can use clinically so this time he reviewed and this is like one of the most common questions i get from doctors is about retention basically my take home message if you’ve seen my other videos and blogs about retention is that it’s not a one-size-fits-all approach not everyone can get one kind of retention sometimes patients come in with a personal preference maybe they’ve had an experience with a certain type of retainer before this is maybe a retrieving case or they have friends that have a strong opinion and they’re already you know leading towards one direction it doesn’t mean it’s the right way but um always good to listen because when i see reviews that patients post about their orthodontic experience with a certain doctor one of the num i say top three complaints is about retention like there was a miscommunication or they don’t like the type that they got or they feel it doesn’t fit or they feel the relapse is due to that retention etc etc so in any case you should definitely read this blog our fixed or removable retainers better and coming into this i already kind of knew the answer again all retainers can work well obviously fixed retainers when made well when placed completely passively and bonded correctly on the right kind of patient who takes care of them the right kind of way work fantastic plenty plenty of people in their 50s 60s 70s 80s that still have their bonded retainer from decades ago you know but again all the components all the stars have to align in order for fixed retainers to be great and if they don’t they’re the worst they’re awful you’re gonna get you’re gonna have emergencies and they’re gonna happen at inconvenient times and when there’s an emergency it big things will happen big problems will happen very fast there can be pain there could be very accelerated relapse movement if it happens at an inconvenient time say you’re on vacation there’s no orthodontist nearby you may be in for a very expensive fee

to get that repaired and that is the responsibility of the patient also doctors if you’re going to place a bonded retainer that’s your patient for life now you are now married to that patient for life that means you need to spill it out as to how your warranty policy works what are the fees if it breaks usually for me i’m very very rarely gonna place a bonded retainer unless requested um or unless there’s a clinical reason for it if i choose to place it for a clinical reason say it’s like a perio splint type of thing then i’m responsible for it for life now it doesn’t mean i’m going to pay to fly that patient out to get it fixed if they move i’ll fix it but you have to come to me so you know some other doctors will do that kind of warranty thing for life as long as the patient let’s say you’re a general dentist or pediatric dentist as long as the patient continues to check in and continues to be a regular general dental patient then they will continue to warranty for life so or you can warranty it for a given period of time 30 days 60 days 90 days a year and after that any type of breakage is done at a cost of x if you’re gonna do something like that that’s totally fine too but you need to write it out and have the patient agree to it and sign it before you place that again this is where the issues happen what happens most of the time when there’s breakage on one of these there’s also going to be relapse they could they pretty much go hand in hand unless it happens like very quickly you know you realized it broke nothing moved yet you can move in just a day um you know and they get in and they get it fixed that’s usually more the exception than the rule so you need to also let the patients know that there will be an additional fee for any type of movement or relapse that might occur and like i said in bonded retainers it tends to happen quicker so that’s just my experience all right so that is my high level bonded retainer story but anyway so this is a research article he’s talking about this um the i think it’s european ejo european journal of orthodontics published it here’s the link if you want to see it and basically they said any clinical statistical differences in an assets versus a bonded over 18 months and the answer was no there’s no clinical statistical difference one of the benefits like i said of essex is that if assuming you know any let’s say they stopped wearing it for a few days or they forgot it and they didn’t wear it um as long as you’re wearing it assuming it’s made well again we’re going to say that sometimes essex made in house aren’t made well if they’re not made well they’re not gonna work so assuming it’s made well if you have some movement and you put the essex back on and you use your chewies or use your vibratory device it should straighten up i mean assuming it’s a small amount of amount of relapses but the large around metal relapse is not going to happen it’s not possible so you would need aligners that’s so it basically works like an aligner so you’d have to have relapse less than basically maybe 0.25 millimeters per tooth 0.30 millimeters per tooth so it works like an aligner one aligner so that’s the benefit of that remember essex retainers they get stretched out over time they’re not meant to last a lifetime like a bonded retainer can like a holly retainer can i can tell you my holly retainer is 28 it’s celebrating its 25th birthday and i’ve never ever had to adjust it it works just like it did the day i got it i have upper and lower i love them so mine’s my personal preference but you know you guys need to figure out what’s best for your patients so anyways yeah no difference just remember though if you’re going to debond a patient or if you’re going to finish in a liner patient and do an essex kind of retainer you are preserving or retaining what they have at the time of d bond and if you didn’t make it perfect and if the bite isn’t fully settled and all the teeth aren’t properly interdigitated where they’re supposed to be which sometimes they’re not um you’re preserving that which is really not the best thing so you know that can be though those last few steps in ortho are tricky um and a lot of times patients get burnt out and they ask to get their braces off a little bit early um which is fine but you probably don’t want to do an essex retainer then so that’s just one of those things that you’ll want to let patients know maybe you want to do a wraparound retainer on top they have to wear it or bonded retainer top and bottom with a wraparound retainer uh goodness there’s so many different things you can do um you could clip the invisalign or the aligners distal to the threes distal to the canines and let the bite settle for a week and then scan for the essex retainer so so many things you can do but all right hopefully i kind of blew your mind with this thank you to kevin o’brien for his great um blog post that kind of brought up

this whole conversation and if you’ll have any questions you’re welcome to go to streetsmilesolutions.com ask your questions there’s a contact us button in the top right you can schedule a complimentary conversation you can send us an email we love to have your questions and we really appreciate it all right thanks so much and we’ll talk to you soon don’t forget to check out our webinars they are all free podcasts we have so much going on visit straightsmilesolutions.com and click on the seminars tab hey this is dr amanda from straight smile solutions straight smile solutions.com and today we had a question come in on our facebook group about vivero retainers and how long they last and just retainers in general clear retainers how long they last we have a lot of other great videos and i recommend that you do some search throughout our um youtube channel to see everything we have on retainers i don’t want to um you know beat a dead horse but um i want to just really focus right now on the whole vivera versus essex retainers by vera versus other clear retainers how long they last how many you’re going to need in a lifetime and really put down a few myths and misconceptions that are out there that clearly are being spread by dental offices people that are misinformed so first of all let’s go over what is a viveira retainer and right now i’m on the invisalign or align technology website um specifically vivera retainer is a brand of clear retainers that is made by align technology or invisalign so that’s the retainers you get if at the end of your invisalign treatment you want their brand of clear retainers now not all retainers are alike so you need to be the vibero ones will actually have the align technology logo on them i can spot them a mile away they’re very very good retainers i can tell you what our fee is as a dentist what aligned technology charges us because they make them they deliver them so last i checked and i might be off by a few dollars it’s around 299 dollars for eight uppers and eight lowers excuse me four uppers and four lowers a total of eight retainers so i mean do the math eight goes into about um 30 um a little less than about 38 ish per retainer so pretty expensive and that’s the dentist lab fee and they’re probably going to mark that up for you significantly because you know we have to have the time to scan and deliver so great questions to ask so again i want to clarify that’s our fee and some dentists if they’re a diamond provider or a double diamond provider or you know any of these little hierarchies when you search them up they’re going to get a discount on that so that may not be their price that’s the regular price for us lowly lay people but um keep in mind that you’re probably maybe not even getting viveira retainers with your treatment you have to ask that’s something that you would want to get in writing before you start treatment because sometimes they’re going to assess an additional fee for retainers in general and sometimes they’re going to make in-house retainers i hesitate to have you accept an in-house retainer and you need to ask that or an off-label retainer because the quality can be all over the place and if the quality isn’t good and as a layperson or as a consumer there’s no way you’re going to know if the quality is good on that retainer it takes certain equipment to make a really really good retainer it’s very easy to under do it overdo it overcook it distort it um you know i’ve made a lot of retainers and i’ve seen great ones and i’ve seen not great ones and you could have an awesome dentist orthodontist that gives crappy retainers so and you can have an awesome outcome all those years in braces or invisalign and if the retainers aren’t good it’s gone you know and it’s not your fault but then again you’re not gonna know right so that’s why i really just want to bring this up because i want consumers to have an awareness of what to get and that question before you even start that orthodontic case should be are retainers included and how many retainers are included and how long do i should i expect these retainers to last and what happens if i need new retainers you know do i have to pay an additional fee do you have a warranty on retainers if they’re clear retainers or they call them clear retainers ask are they vivera brandon if they’re not i don’t know i’ve seen really good ones come from other labs and i’ve also seen bad ones and you’re not going to know the difference so i know if you get by veron there’s a standard of quality they will be really really good they’re all made at a good quality so personally for that reason i’m gonna ask you to ask for them by my name um other ones are actually quite good and there’s a couple other really great retainers out there i’m gonna throw a couple other brands out there and they’re also some retainer subscription clubs that are out there or orthodontic aftercare programs and i’m not necessarily going to mention them by name because i haven’t necessarily vetted them all but it’s pretty cool because at the end of treatment and you could store your image in the cloud and then anytime you need a new retainer or on a regular frequency new retainers

will come to your house you can either push a button and it locks in a really low fee and realistically how often will you need to change your clear retainer you know get a new one they do wear out they do warp and there’s so many variables like there’s no way i can give a date to that some people might need to change them every two months some people may be fine for a couple years so variables might be if you grind your teeth if you clench your teeth if you have acidic saliva if you’re drinking or eating with them in if you don’t store them correctly if you don’t brush them correctly but some of the stuff is your fault and some of this stuff isn’t your fault and some of the stuff can’t be predicted so my suggestion is to plan on at least initially while you’re in the full-time wear replacing them at least a few times and then after that at least every six months to a year probably for the rest of your life i know that’s a lot of retainers maybe 10 years down the road you might be good for a year or two but you better expect on i would say you need way more than four uppers and four lowers for life you need to have a plan because it can get awful expensive and that’s why i love the idea of the subscription program now keep in mind anytime you get a new filling or new dental work you’re going to need a new scan and new retainers and again anytime you get a new filling you want to really ask your doctor hey do you have an intraoral scanner because impressions are not the same quality and will after my filling can i get a new retainer and what type of retainer will i get and what will be the cost for that don’t assume you’re going to get free retainers after a new filling they’re not even probably thinking about that you need to bring it up because if you try to jam that old retainer back on there’s no way it’s going to fit perfectly you know they can try to make it almost the same shape but it’s never the same and if you have a really great retainer it will not fit ideally and weird things are going to happen to your bite so you always should plan on getting a new retainer after a filling which is why i really encourage patients to get all their dental work done before braces before ortho or at least before retention you know all that elective stuff anything that maybe kind of needs to be replaced get it done because i mean i can tell you for me i’m not going to tell you my age but i’m kind of old and i haven’t had any new feelings since i was in high school they’re all gonna have some fillings you know a few not giant ones um but i haven’t had anything nothing has changed so guess what my retainers still fit uh several decades later from when i was in high school because i take care of my teeth i blossom brush and floss and i haven’t needed anything i’m not saying that something couldn’t happen but if you take care of your teeth you shouldn’t need new stuff done so just a little bit of encouragement but i know that if i have a clear retainer anytime i need something done i’m going to have to pay for a whole new one and that could be very expensive because some people might charge a thousand dollars you know it’s a lot of money so again great to have warranties great to have insurance a lot of doctors out there will warranty your retainers for life as long as you get your dental work done there as long as you keep coming there so all kinds of great questions to ask all right hopefully that informed you a little bit all right and then um just one company to look out for that i think is super awesome and i’m super excited about them and they’re going to have some really great retention options is a company that is going to be called pro align or straight teeth solutions they’re launching soon it’s a great company they’re going to have some great packages for retention and you don’t have to have your orthodontic to join the retention program so check it out you’re amanda from straightsmilesolutionstraightsmilesolutions.com and today we’re going to be talking about purchasing an intraoral scanner and kind of released this in preparation for chicago midwinter i know goodness with my straight smile solutions prospective clients i get this question multiple times a week so i partnered up with the team at yankee tech digital and i’m happy to introduce you to them if you want to know more about what they do to help bring you this article thank you so much to manny and michael for helping me prep this article and the content within it and i’m going to talk to you guys about these top 18 points to consider when you’re purchasing an intro scanner and if you’re going to be at chicago midwinter be sure to visit straightsmilesolutions.com ping me friend me on linkedin go to our youtube site and learn more but this is going to be a long video so hang with me as we go through this and feel free to message me with questions so first of all i just want to see off the top that to me getting into intraoral scanner is 100 a no-brainer and i know that the team at yankee tech digital agrees to i listen if you show me your numbers show me your procedure show me what you’re doing i’m going to push back and show you that you will make this profitable and you’ll be you know you’ll be in the black certainly within a very short period of time if you’re using your intraoral scanner wisely and if you’re picking the right one for the

practice that you’re doing and your particular practice philosophy so that brings me to the first item on the list which is price you know what should you be spending and how much should you be spending and there’s a huge range of prices for these and we’ll kind of go over some of the other features and i think that will help you understand the price one a little bit more but just again just something you may or may not know that there are some labs that are willing to help subsidize the financing um for intraoral scanners if you’re a loyal customer so and i do know some that are doing this so feel free to message me and i’d be glad to connect you um also there are some scanning companies that will lease scanners you know lease to own kind of stuff so you know open your mind it doesn’t hurt to ask and as my auntie would say don’t ask don’t get so why not ask right it doesn’t hurt to ask number two maneuverability so what is your plan for this scanner are you going to just park it in one op and never move it out you have a designated scam up um is this scanner going to need to be mobile from opto op is it going to need to be mobile from office to office um or are you going to need to use it portably like at a health fair or something like that so these are all things you need to talk to your team about monthly user fees some scanners have monthly fees um some don’t some do only for the first year um some don’t include the data fee so these are all things you need to ask and look into and add it into the overall cost of the spanner scanner tech support listen stuff’s gonna go wrong so who’s responsible when things go wrong um things are gonna break things aren’t gonna be connecting properly who’s gonna be helping you how quickly can they help you does that cost additional fees um i know the team at yankee tech digital can help you with that as well it’s not included in the cost of the scanner it’s an additional cost but these are all things that you need to have set up um because when things go wrong you don’t want it to bring down your operations wait so question is you know you need to hold that scanner in your hand and then hold it for a really long time and see how that feels if the darn thing is heavy you know and if you have the same team member doing it day after day after day they’re not going to be too happy with you so i mean for sure i believe everyone should be cross-trained but it also shouldn’t be something that’s done day in day now unless it’s super light so these are just things to think about too tip size and comfort if you’re working with pedo patients teen patients or geriatric patients you need the most small streamline tip that’s really comfortable because you know i’ve had some experience with some scanning units and they’re huge and they’re sharp and the edges are rough and getting back there is torture it’s really like a medieval torture device and i’m not saying that your staff member can’t finesse it to do it right because everyone can do it gently but you know if there’s even more of a learning curve to get it comfortable maybe it’s not the right one so i mean there are ones that are super petite and tiny and get get around all those edges you know without poking the patient cross arch accuracy in microns so they’re depending on what you’re doing with it if you’re scanning a whole mouth versus just a tooth for a crown there’s a different level of accuracy so you need to think about what you’re using it for and if you’re at all thinking about doing say dentures or aligners then you need to have a minimum cross arch accuracy so things to ask about because you’d hate to get something and then oh sorry i can’t use it for aligners you know replacement tip class uh tip lifespan it’s all kind of the same thing some are gonna have disposable tips some are going to have autoclavable tips the question is how much is it per disposable tips obviously do the math or how much is it for a replacement tip what’s the average lifespan of the tip and is that guaranteed so do the math see which one’s better obviously disposable chips are not that environmentally friendly but if you’re not gonna have access to your autoclave um you know and that’s gross you know so um things you gotta think about you know you gotta you gotta be osha compatible touch screen capability that is a pet peeve of mine because i’ve certainly done a lot as you know a lot of secret shopping to some of these um scan shops direct to consumer scan shops and that grosses me out when they do not respect osha with a touch screen that’s nasty i see it all the time so um make sure your your team members are following osha standards another one to talk about is file type so everyone’s pretty familiar with stls but then there’s another file format called ply ply contains more information than stl and is becoming more popular amongst cad cam software packages so these are just things you want to look into not everyone offers ply you may not even need it mode of image capture there is there are

ones that are continuous and there’s ones that are stable continuous image capture is video based and video based in oral scanners are getting faster and easier it’s just things to find out if you need to be connected to the cloud while you’re scanning or if you can be offline so definitely ask about that and then just think about your own network and how that would work within your office and where you’re planning to use it obviously if you’re going outside your office that would not be ideal um use of powder i know everyone goes yuck powder but sometimes powdering is necessary if there’s a shiny surface so you know it’s not necessarily a bad thing but you got to think about what you’re doing open solution so i think this is a total no-brainer unless you want to be you know totally um owned by other companies so basically you want to have an open connection so that the lab can work with any capcam system that accepts stl the standard format that way the lab can use its own equipment for the 3d printing right so i think that’s definitely the way to go we all see what happens when an open system is not accepted so we talked a little bit about disposable tips already manufacturer’s warranty does the manufacturer’s warranty offer an extended warranty if so how long what does it cover multi-disciplinary functionality what are you going to use this for are you going to use it just for all liners are you going to use it for surgical guides are you going to use it for crown and bridge what are you using it for everything anything some stuff don’t know if you’re not sure you want to make sure you have multi-disciplinary functionality and lastly the automatic byte alignment registration this is also a no-brainer for me if the byte isn’t articulating you you don’t want to have to manually do that it’s kind of a pain so you want it to automatically do that so um yeah that’s pretty much it so so many things to think about but for sure message me if you have any questions or if you want me to connect you with the yankee tech digital crew i can do that as well um go to straightsmilesolutions.com to schedule a complimentary complimentary consultation hi this is dr amanda with street smile solutions we are the online resource for gps and pediatric dentists to learn more about orthodontics and how to incorporate it into their practice more productively and today i’m going to be talking a little bit just in case you missed it about the new invisalign iteral element software upgrade and what that means for you and what that means for your practice if you missed the webinar this morning i am going to show you some clips of it it was incredible dr gallery did a great job explaining and really just capturing why this software upgrade is just a game changer to use his words uh incredible so i’m going to show you a couple clips just to take that whole 42 minutes and summarize it into a few minutes on why if you don’t have an itara element you should consider getting one and if you have one make sure to download that software upgrade all right we’ll go ahead and start here in real time so she’s just moving the wand very gently over those teeth and scanning them out now a couple things i want to point out to you if you’re looking at the itero screen you can see that as she’s scanning it’s coming out in color this is a nice upgrade that was just done for invisalign previously invisalign used to scan it used to look like a yellow model but now it comes up in real time so if you look you can see that it is looking perfectly like a person’s real teeth has a real live simulation to it patients like that a lot as well as dentists like that you know kind of gives a real feel to what you’re doing you can see how easily she’s just manipulating all the way around i’m going to get all the corners of all the teeth the other thing you might be noticing is as she passes over an area if there’s an area that has a missing spot there’s something called scanning optimization scanning optimization means as she’s scanning over a spot if she misses a spot or if there’s a spot that’s a little bit unclear it will come up as purple and that’ll be a quick indication to her hey i gotta double back and just get that so that was a great summary about the color upgrade and the scanning optimization upgrade so hopefully if you have any questions about that let me know the other part i wanted to go over with you is about gpt he’s kind of calling that the gps for invisalign or atera where it tells you what goal you’re trying to get and if you got there in a nutshell so we’ll go ahead and take you there and he’ll explain it perfectly here we go for stage 11 which is where he should be today i think that’s what we’re up to elevens and going through that now let’s go through some other terminology while waiting for that there’s also something called so we’ve done optimize scouting we’ve done progress assessment or progress tracking or gpt three different names for it we also have something called the outcome simulator let’s say chris was a new patient we weren’t sure how it was going to look with invisalign or chris wasn’t sure what it was going to look like what i could do after i scan it is click on something called the outcome

simulator and it will give me kind of a rough version of what his clinch check will look like one day and then i could show it to the patient i could send it to costa rica and i can actually send it to the patient so we’re gonna have a we can have a nowadays we can have an exact look of how the clint check is gonna look all right i see that the system has found chris and when we started i’m going to click download the treatment plan it’s found chris in the invisalign system it knows what his teeth are supposed to look like and now it’s going to run a simulation to grade us now there’s going to be three different colors that come up on the simulation a green color means that the tooth has completed its movement and is in the right spot a yellow color on a tooth would indicate that the tooth is 90 percent of the way there but maybe needs a little bit of a refinement to kind of touch something up and a gray would mean that we didn’t 100 complete the movement maybe we’re 70 65 and we might want to go and do a refinement on that so here it is let’s take a look and let’s read what the computer is telling us so here was chris’s teeth here’s what they’re supposed to look like and here’s what they do look like and you can see it’s reading that that front tooth in the middle there is nice and green there are no grays on the bottom every tooth on the bottom is where it’s supposed to be and this is a successfully completed treatment so i could say with complete confidence both by looking at his teeth and by running the gpt that chris’s teeth on the lower are officially done congratulations chris you have completed the lower treatment now let’s take a look at the top treatment let’s see how we did on the top so here we are on the top this is what his teeth are supposed to look like and here’s where they are now so you can see my top is reading that both of the lateral incisors are coming up gray which means that we didn’t 100 complete the movement and even though my eye can’t see it in the clinch check it looks okay and even the tracking look pretty good the computer’s saying nah david you’re about five to seven ten percent off on those teeth and it’s probably worthy to do a little bit of a refinement just to move those teeth a little bit more now it can actually break down the movements for you so if i look at the tooth i can see number seven is missing a little bit of buccal lingual inclination and number 10 is also missing a little bit of buccal lingual inclination now the teeth did move and i could see that number 10 did successfully translate to the buckle that’s indicated by a green over here can everyone see that green that green means that that number 10 tooth perfectly moved out to the buckle the way it was supposed to and it was also supposed to rotate can everyone see over here i’m just going to make this a little bit bigger this number 10 was doing a couple of movements it was rotating out you can see how it’s a little underlapped over here and was also coming to the buckle both of those movements the rotation to the mesial and the translation to the buccal those both happen very nicely you can see that with the green here and the green here uh but the buccal lingual inclination that root torque that i was looking for in this case didn’t happen 100 how do i know that the grain even if my eye can’t see it the computer’s saying dave there was a little bit of buckle root torque that just didn’t happen in this case no big deal i got two out of the three in the first round i’ll just go back and do a refinement now but when i do a refinement i’m able to tell the technician exactly what i want i want buckle root torque of tooth number ten to nationally like how did you know that how did you know that that was the one detail that was missing easy i got the gpt here it tells me exactly what i’m missing and exactly where i am should i fool around with tooth number 10 rotation nah do i have to fool around with tooth number 10 translation no do i have to do a refinement of the lower no everything is exactly where i want it to be i need about 10 more degrees or so of movement on the upper laterals number 7 and 10 this is a genius device this takes all the guesswork out of invisalign now we not only do this at the end of the treatment we’re also going to do this about every 10 weeks so every 10 weeks when he comes in before i even come into the room my assistant natasha is going to scan him in where he is at stage 5 at stage 10 at stage 15 at stage 20 and when i come into the room i have a report card right there telling me where i am in the case these movements are working well these movements aren’t working well this tooth is slowing down now slow down would look like yellow so we have three colors we got grain we’ve got gray or black and then we have yellow so in my case here everything came out with the right movement except for two parts of one that’s incredible i think dr galler couldn’t say it any better i appreciate his enthusiasm this is an incredible piece of technology and if you haven’t incorporated it into your practice and you’re doing invisalign it’s certainly the way to go you’re going to sell way many more cases you’re going to get better outcomes in a shorter period of time it’s totally worth the investment and if

you’re a gp you can use it for a million other things if you’re not sure what you can use it for please message me on linkedin or send me an email info at straightsmilesolutions.com you can visit my website wwe we’re here to tell you about scanners and about ortho and about how you can increase your production we’re not affiliated with any one scanner system we just happen to love the itero element and we want to tell you about it and thank you invisalign i don’t think you knew that i was going to use your video but it was so great i had to share it with everyone hey this is dr amanda with straight smile solutions and today we’re going to be talking about the itero 5d scanner slash the neri scanner and i just went to a webinar that it kind of explained it a little bit more and normally i don’t really get that much into which scanner is better for you because it’s really whatever works best in your hands and here at streets mount solutions we’re all about launching and scaling ortho and there’s a lot of scanners that work for this right so it’s just your personal price point what systems you want to use stuff like that normally the itero is really expensive and it has pretty high monthly fees so one of my doctors are not that interested in it but with the release of this newest 5d neri scanner i since my clientele for the most part are pediatric dentists and general dentists i can see how this would be really useful for your practice so i just wanted to kind of let you know what i heard in the webinar and just kind of relay it back um just so you have an idea but you can go to itero.com click on products and see a little bit more about the scanner but the cool thing about the scanner is it does everything the regular iteras do you know obviously it’s a scanner it’s a way to capture 3d imaging capture data almost like intra-oral photography the quality is super good but they have the time lapse which is really helpful um where you can chart pathology in terms of recession um attrition abstractions and show the time lapse of it over time that’s really powerful but on top of that the newest thing for this one is going to be the neri feature which is basically almost like an x-ray it’s not an x-ray because you’re doing it from the occlusal and you can see here in this picture right here and this is what you’re used to seeing right on eye tarot but this one with the 5d you’re actually able to see decay from an occlusal standpoint which the benefit of course if you’re a general or pediatric dentist i mean that’s awesome because let’s say you either don’t have the insurance authorization to take x-rays or there’s a lot of crowding or the patient is not tolerable and doesn’t tolerate x-rays well maybe it’s a little kid or something like that or a geriatric patient or just somebody who has difficulty with x-rays or philosophically doesn’t like x-rays um this is a great feature because it’s totally non-invasive there’s no risk there’s no exposure you can clearly see the incipient decay here um and you don’t have to take an x-ray so is it the gold standard no it’s not a bitewing so you obviously before you decided to do a fill you might need to confirm with an x-ray but it’s a great way just as a screening tool that’s 100 non-invasive to especially in crowded patients you know so i think it’s awesome i think it’s definitely a game changer um in your practice to think about doing something like this um they did not say what the price point was and i couldn’t really find it on the website i’m sure it’s crazy expensive they did mention that you could upgrade an element to not an element one assuming you have all the hardware and software um and everything like that but um yeah i mean i think if you’re thinking about it it’s a great idea i mean obviously you need to make a decision it makes even more sense if you’re doing ortho there’s a lot of reasons for this because you’ve got the outcome simulator and a lot of the other features so hopefully this helps um you’ll want to if you’re interested contact the team at itero i don’t work for them i really don’t care if you get it or not but i just wanted to let you know that it’s there and what it does and i can see value in it that’s pretty much what i wanted to tell you all right thanks so much don’t hesitate to send us more questions you can go to straightsmilesolutions.com to submit your questions inquiries and we’d be glad to make some content around it if we think it’s something that’ll help people alright take care hi i’m dr amanda and i’m an orthodontist i’m also the ceo of straight smile solutions we help dentists all over the world understand orthodontics better we work with all systems braces appliances and brands of aligners and we support all systems and brands this video will share content that is the property of invisalign and align technology we’ve made this video upon request of 40 000 plus doctors subscribers and followers to help them achieve better outcomes with their invisalign cases we do not work for align

technology all opinions expressed in this video are the opinions of straight smile solutions and not align technology thank you to align technology for continuing to support us educating and helping their doctors and letting us share this video around the world through youtube instagram facebook tick tock linkedin and all of our social media platforms together we unite to make more smiles if you have questions or concerns about this video please contact us directly at www.straightsmilesolutions.com enjoy the video