Treatment Preferences

What are Treatment Preferences?

Treatment Preferences are a great way to communicate to ClearCorrect technicians your preferred approaches to treatment. When the Technician creates a treatment setup for review in ClearPilot, they will do so using a set of default Treatment Preferences if you have not customized your preferred approach.

As always, the treating clinician is solely responsible for patient treatment: please see our Terms and Conditions for details.

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Setting Up Preferences

When creating a new account, or if you have not previously set your preferences, you will be prompted to choose your Treatment Preferences before placing an order in the Doctor Portal. 

Select your preference options:

• Use Default Preferences: This option will apply the ClearCorrect default treatment preferences, which are aligned with Orthodontist defined ClearCorrect clinical protocols. It’s important to understand what these default settings are when treatment planning.
• Customize Preferences: By selecting this option, you will be redirected to the Preferences section in My Account. Here, you can customize the treatment preferences to align with your specific treatment style.

If you choose to proceed with the Use Default Preferences option, you can always return to the Preferences section later to make custom changes if needed.

To set up customized preferences, perform the following steps:

1.  Access the Account drop-down menu:
   On the homepage header, in the top right, navigate to the Account drop-down menu, select either My Account to review all information or choose My Treatment Preferences directly from the menu to be directed to your preferences section.
   
   

2. Setup Treatment Preferences section:
   On the My Account page, utilize the left-hand menu to navigate to Treatment Preferences where you will find the following five sections:

   • Clinical Preferences
   • Bite Correction Preferences
   • Aligner Customization
   • Mixed Dentition
   • Additional Treatment Preferences Notes

   

3. Make your selections:
   The default preference and current selection will show in the field in a bold text. To view other preference options, click the drop-down menu icon.

   The currently selected preference will show highlighted in grey and in a teal font. Any other available preference options will appear below the default preference.

   
   

4. Save Preferences:
   When you are done making your selections for your treatment preferences, click the Save button and your preferences will be applied to all future Treatment Setups.
   
   

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Understanding Treatment Preferences

Learn about the clinical significance of each Treatment Preference, what options we offer, and how we selected the ClearCorrect default preferences.

Clinical Preferences

Movement Velocity

The provider can change the movement velocity based upon the number of desired/required aligners and amount of tooth movement control.

Default Preference	Preference Option 2	Preference Option 3
Default: 0.3mm and 3° per tooth, per step.	Reduced: 0.2mm and 2° per tooth, per step (will result in increased # of aligners).	Use custom instructions (see additional treatment preferences notes section for details).

Wear Schedule

A patient's wear schedule is a decision that is determined by the Clinician and is made depending on the individual treatment goal for each patient.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
2 weeks per step The default preference is based on our clinical protocols and aligner design. We suggest changing the aligners every 2-weeks.	1 week per step A 1-week wear schedule should be considered with reduced tooth movement velocity and with patients that are still growing, such as with teen patients.	10 Days per step A 10-day wear schedule is indicated for cases when more efficiency is needed, in adult and teen patients. If the 10-day wear schedule is chosen, we recommend it is accompanied by slower tooth movement velocity.	3 weeks per step A 3-week wear schedule could be desirable when you need more time to deliver the tooth movement based on the complexity of the case.

IPR - Timing

IPR is performed only on odd steps and when interproximal surfaces are in proper position. You can customize its timing in your treatments as needed.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4	Preference Option 5
Apply all IPR at step 1. If not possible, then split to step 7 or 13 (for users with 2 week wear schedule)	Apply all IPR at Step 3. If not possible, then split to step 7 or 13 if needed (for users with 2 week wear schedule)	Apply all IPR at Step 5. If not possible then split to step 9 or 13 if needed (for users with 10 day wear schedule)	Do not apply 0.4 mm or 0.5 mm of IPR at the same tooth/step. (Split IPR bigger than 0.3 mm)	Use custom instructions (see additional treatment preferences notes section for details)

Max IPR by default is 0.5 mm per interproximal area.

Amount of IPR allowed

The maximum interproximal reduction per tooth, to create space for alignment while preserving tooth structure, periodontal health, and occlusal stability.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4	Preference Option 5
0.5 mm for all teeth as needed (up to distal of second premolars)	0.3 mm for all teeth as needed (up to distal of second premolars)	0.2 mm for anterior and 0.5 mm for posterior (up to distal of second premolars)	Do not allow IPR	Use custom instructions (see additional treatment preferences notes section for details)

Expansion

A transverse increase in arch width.¹

Default Preference	Preference Option 2	Preference Option 3
Arch expansion from first molar to first molar, with minor second molar movement.	Arch expansion from second molar to second molar (U-Shape form)	Use custom instructions (see additional treatment preferences notes section for details)

Expansion Limits per Quadrant

The maximum lateral movement of posterior teeth per arch segment, ensuring controlled expansion, occlusal stability, and periodontal health.¹

Default Preference	Preference Option 2	Preference Option 3
Up to 2 mm, measured on the first molar. The premolar expansion will follow the U-shape arch form	Up to 1 mm, measured on the first molar. The premolar expansion will follow the U-shape arch form	Use custom instructions (see additional treatment preferences notes section for details)

Smile Arc

The Smile Arc can be used as guidance to help establish an ideal for how the teeth should look when the patient smiles.²

Default Preference	Preference Option 2
Follow lip guidance based on frontal smiling picture	Align and level following ideal occlusion, no lip guidance

Occlusion

The ideal goal for occlusion is to have a cusp-fossa relationship when the teeth are brought into contact.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Balanced posterior and canine contacts with no anterior incisor contact	Balanced posterior and canine contacts with light anterior incisor contact	Heavy contacts (red contacts) for molars and premolars, and light canines and anterior incisor contacts	Use custom instructions (see additional treatment preferences notes section for details)

Curve of Spee (COS)

Curve of Spee is the curvature of the mandibular occlusal plane beginning at the canine and following the buccal cusps of the posterior teeth, continuing to the terminal molar.³

Default Preference	Preference Option 2
Ideal/flat Curve of Spee by combination of tipping, intrusion, and extrusion	Improve occlusion, but do not correct Curve of Spee unless requested on prescription

C-Chain

C-Chain is a combination of movements applied to reduce the interproximal space of a group of teeth. It is recommended for spacing cases aiming to tighten the contact points.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Only when requested on case prescription	For Spacing cases, 2 steps from canine to canine	For Spacing cases, 2 steps from second molar to second molar	Use custom instructions (see additional treatment preferences notes section for details)

Bolton Discrepancy

The discrepancy is determined through a calculation called Bolton analysis, which compares the sum of widths of the upper and lower teeth. It considers both the overall ratio of all teeth from first molar to first molar (12 teeth) and the anterior ratio from canine to canine (6 teeth).

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Leave spaces distal to upper lateral incisors	Leave spaces distal to upper canines	Leave equal space in the mesial and distal of upper lateral incisors	Use custom instructions (see additional treatment preferences notes section for details)

Lower Incisor Extraction Cases

Extraction area management and adjacent root angulation adjustment prior to closing the space.

Default Preference	Preference Option 2
Add a pontic/bar to the extraction site and add vertical engagers and 5 degrees of crown torque (virtual Gable Bend) in the adjacent teeth.	Use custom instructions (see additional treatment preferences notes section for details)

First Premolar Extraction Cases

Extraction area management, adjacent root angulation adjustment and engager strategy prior to closing the space.

Default Preference	Preference Option 2
Add vertical engagers in canines, second premolars and first molars. Add 7 degrees of crown torque (virtual Gable Bend) in the adjacent teeth. Add Class II or Class III elastics according to each malocclusion and add a bar in the extraction site.	Use custom instructions (see additional treatment preferences notes section for details)

Second Premolar Extraction Cases

Extraction area management, adjacent root angulation adjustment and engager strategy prior to closing the space.

Default Preference	Preference Option 2
Add vertical engagers in canines, first premolars and first molars. Add 7 degrees of crown torque (virtual Gable Bend) in the adjacent teeth. Add Class II or Class III elastics according to each malocclusion and add a bar in the extraction site.	Use custom instructions (see additional treatment preferences notes section for details)

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Bite Correction Preferences

Class II Corrections

Different ways to address the correction of a Class II malocclusion.⁴

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Upper posterior sequential distalization (50% sequence), then anterior canine to canine retraction. Add Class II elastics for molar distalizations of more than 1 mm.	Upper posterior sequential distalization (50% sequence), then anterior canine to canine retraction, and add Class II elastics ONLY for molar distalizations of more than 2 mm	Upper sequential distalization (50% sequence), canine retraction, and then incisor retraction. Do not add Class II elastics by default.	Use custom instructions (see additional treatment preferences notes section for details)

Maximum Amount of Distalization for Class II

The maximum posterior movement of upper molars to correct Class II malocclusion while maintaining anchorage control, occlusal stability, and root integrity.⁴

Default Preference	Preference Option 2	Preference Option 3
3mm maximum distalization	4mm maximum distalization	Use custom instructions (see additional treatment preferences notes section for details)

Elastics for Class II

Enhance anchorage and support molar distalization, improving anteroposterior correction and intercuspidation in Class II cases while maintaining occlusal stability.⁴

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Slit in upper canines and button cutout in lower first molars	Slit in upper canines and slit in lower first molars	Button cutout in upper canines and button cutout in lower first molars	Use custom instructions (see additional treatment preferences notes section for details)

Class III Corrections

Different ways to address the correction of a Class III malocclusion.⁴

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Lower sequential distalization (50% sequence) and anterior canine to canine retraction. Add Class III elastics for molar distalizations of more than 0.5 mm	Lower sequential distalization (50% sequence) and anterior canine to canine retraction. Add Class III elastics ONLY for molar distalizations of more than 1.0 mm	Lower sequential distalization (50% sequence), canines retraction, then incisor retraction. Do not add Class III elastics by default.	Use custom instructions (see additional treatment preferences notes section for details)

Maximum Amount of Distalization for Class III

The maximum posterior movement of lower molars to correct Class III malocclusion while preserving anchorage control, occlusal stability, and root integrity.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
1mm maximum distalization	2mm maximum distalization	3mm maximum distalization	Use custom instructions (see additional treatment preferences notes section for details)

Elastics for Class III

Enhances anchorage and supports lower molar distalization, improving anteroposterior correction and intercuspidation in Class III cases while maintaining occlusal stability.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Slit in lower canines and button cutout in upper first molars	Slit in lower canines and slit in upper first molars	Button cutout in lower canines and button cutout in upper first molars	Use custom instructions (see additional treatment preferences notes section for details)

Deep Bite Correction

An excessive vertical overlap of the maxillary over mandibular incisors, which may lead to occlusal interference and enamel wear.

Default Preference	Preference Option 2	Preference Option 3
Correct deep bite with intrusion of anterior teeth and extrusion of posterior teeth (this option will create red contact points in the posterior teeth)	Correct deep bite cases with intrusion of anterior teeth NOTE: No posterior extrusion is allowed.	Use custom instructions (see additional treatment preferences notes section for details)

Anterior Open Bite Correction

A vertical malocclusion where the incisors lack overlap, caused by skeletal, dental, or habit-related factors, often requiring intrusion, extrusion, or skeletal correction.

Default Preference	Preference Option 2	Preference Option 3
Correct anterior open bite with extrusion of anterior teeth and intrusion of posterior teeth (this will create a virtual bite jump at the end of the simulation)	Correct anterior open bite cases with extrusion of anterior teeth	Use custom instructions (see additional treatment preferences notes section for details)

Posterior Crossbite

Transverse malocclusion where the maxillary posterior teeth occlude lingually to the mandibular posterior teeth.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Always correct up to first molars	Do not correct	Always correct up to second molars	Use custom instructions (see additional treatment preferences notes section for details)

Scissor Crossbite

Transverse malocclusion where the maxillary posterior teeth occlude entirely buccally to the mandibular posterior teeth, often due to skeletal or dental arch width discrepancies, requiring expansion or interarch mechanics for correction.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Do not correct scissor crossbites if it only involves second molars.	Do not correct scissor crossbites if it involves first and second molars.	Always correct. Add cutouts for upper and lower molars (crossbite elastics) and add bilateral posterior bite ramps.	Use custom instructions (see additional treatment preferences notes section for details).

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Aligner Customization

Engagers

Some tooth movements require more control, so we provide alternative options for placing engagers to improve their effectiveness when needed.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Use standard rectangular engagers for rotations, intrusions, extrusions, and translations according to ClearCorrect Protocols	Use beveled engagers for rotations, intrusions, extrusions, and translations. The active engager surface is the beveled surface.	Do not use engagers at all	Use custom instructions (see additional treatment preferences notes section for details)

Engager Timing

Engagers are strategically placed to optimize tooth movement. Proper timing ensures efficient force application, greater comfort, and improved aesthetics.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Place all at step 1, then step 7 or 13 if needed (for users with a 2 with week wear schedule)	Place all at step 3, then step 7 or 13 if needed (for users with a 2 week wear schedule)	Place all at step 5, then step 9 or 13 if needed (for users with a 10 day wear schedule)	Use custom instructions (see additional treatment preferences notes section for details)

Note:

It is recommended to match the same strategy used for IPR timing.

Engager Removal for Revisions

Determines whether existing engagers remain in place or are removed for the refinement/new setup. This decision is based on the new tooth movements, aligner tracking, force optimization, and current engager wear.

Default Preference	Preference Option 2	Preference Option 3
Remove the engagers	Do not remove the engagers	Use custom instructions (see additional treatment preferences notes section for details)

Engager Size

Different engager sizes are offered for better fit according to the anatomy of the tooth and to improve anchorage.

Default Preference	Preference Option 2	Preference Option 3
3 mm	2 mm	4 mm

Anterior Bite Ramps

The placement of the bite ramp is designed to ensure proper contact between the upper and lower teeth. This helps achieve the desired occlusal guidance and functional improvement.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4	Preference Option 5
Add bite ramps on all upper anterior teeth* when anterior intrusion is more than 1 mm *NOTE: The term 'anterior teeth' refers to the teeth from canine to canine.	Add bite ramps in upper centrals and laterals when anterior intrusion is more than 1 mm	Add bite ramps only on upper canines when anterior intrusion is more than 1 mm	Do not add bite ramps	Use custom instructions (see additional treatment preferences notes section for details)

Posterior Bite Ramps (For Anterior Open Bite Cases)

Posterior bite ramps are placed in the occlusal surface of posterior teeth.

Default Preference	Preference Option 2	Preference Option 3	Preference Option 4
Add bite ramps to lower first and second molars	Add to upper and lower first and second molars	Do not add bite ramps	Use custom instructions (see additional treatment preferences notes section for details)

Posterior Bite Ramps (For Posterior Crossbite Cases)

Designed to disarticulate posterior teeth, eliminating occlusal interferences, enhancing transverse correction and stability.

Default Preference	Preference Option 2	Preference Option 3
Add bite ramps to first and second molars while the crossbite is being corrected	Do not add bite ramps	Use custom instructions (see additional treatment preferences notes section for details)

Missing/Extracted Tooth

• Pontics are utilized in the anterior region when a tooth is missing or when the patient has open spaces ≥ 3 mm.
• Bars are utilized in the posterior region when tooth is missing or when the patient has open spaces ≥ 3 mm.

Default Preference	Preference Option 2	Preference Option 3
Plan pontics on anteriors and bars on posteriors	Plan pontics on both anterior and posterior	Keep space and don’t plan for pontics or bars for missing/extracted tooth

Erupting Teeth

A guide helps to hold a space in the arch for a tooth that is erupting. There are two shapes to select from: a tooth shape or a bubble shape guide.

Default Preference	Preference Option 2	Preference Option 3
Plan guides for erupting teeth	Plan eruption bubbles for erupting teeth	Keep space and don’t plan for eruption guides

Trimline Height

Refers to the vertical extension of the aligner beyond the gingival margin, determining how much the material overlaps the gingiva to enhance mechanical retention and force transmission

Default Preference	Preference Option 2
High and flat (1.5 mm +/- 0.5 mm)	Low and flat (0.5 mm +/- 0.5 mm)

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Mixed Dentition Preferences

Mixed Dentition - Movement Velocity

Adjust the movement velocity according to the desired/required number of aligners and the level of control over tooth movement.

Default Preference	Preference Option 2	Preference Option 3
Standard movement per tooth, per step – up to 0.3 mm translation, intrusion, and extrusion. 3 degrees rotation.	Reduced movement per tooth, per step (will result in increased # of aligners) – up to 0.2 mm translation, intrusion, and extrusion, 2 degrees of rotation.	Use custom instructions (see additional treatment preferences notes section for details)

Mixed Dentition - Engagers

Some case types may need engagers to be placed on the teeth, they can be placed in different positions to allow for more anchorage or to aid in the control of complex movements.

Default Preference	Preference Option 2	Preference Option 3
Add horizontal engagers on all first fully erupted upper and lower permanent molars. No engagers on anterior teeth.	Add horizontal engagers on all first upper and lower fully erupted permanent molars and deciduous molars and permanent incisors.	No engagers at all

Note:

Use in patients presenting with Mixed Dentition is not approved in all markets. Refer to the IFU for your market for approved indications.

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References
1. Mosby's Medical Dictionary, 8th edition. “Expansion” retrieved April 10 2019 https://medical-dictionary.thefreedictionary.com/expansion
2. “The importance of incisor positioning in the esthetic smile: the smile arc” by D.M. Sarver. PMID: 11500650 DOI: 10.1067/mod.2001.114301
3. Farlex Partner Medical Dictionary © Farlex 2012. Curve of Spee. (n.d.) Farlex Partner Medical Dictionary. (2012). Retrieved January 5 2022, from https://medical-dictionary.thefreedictionary.com/curve+of+Spee
4. Malocclusion of the Teeth.  Seventh Edition" by E. H. Angle, M.D., D.D.S. Published by S.S. White Dental Manufacturing Company, Philadelphia, 1907. Chapter 2, pages 28-59.

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