ClinCheck - Reality or Digital Special Effects?

Dr Adam Shatz is an Invisalign orthodontist currently treating himself with Invisalign. He writes about his personal experiences as a patient.
Post 24 Aug 2012, 06:17
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Joined: May 2012
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If you have viewed your own ClinCheck, you have to admit that it is a really cool 3D representation of how your teeth should be moving with your Invisalign aligners. That is, if you wear your aligners and elastics as recommended. If you have not seen your ClinCheck, ask your dentist/orthodontist to email it to you. But is the ClinCheck an accurate representation of your tooth movement with each aligner.

Yes and No. What I am saying is that the ClinCheck comes close to the real thing, but not exactly. NO, it is not 100% accurate, which is another reason why case refinements are often necessary (See my "Ask the Expert" post on "What % of Invisalign cases require case refinements?") Therefore, the success of your case depends alot on how your doctor interprets your ClinCheck, and treatment plans your case.

First, how does Invisalign come up with the ClinCheck for your case? It starts when the doctor takes your impressions, or digitally scans your teeth, along with the photos and x-rays. The doctor then fills out a prescription online for your case, indicating what the treatment goals are (ie.- relieve the crowding; deepen or open the bite; align the posterior teeth; correct the horizontal overlap of the front teeth), and preferences for how he/she wishes to correct those problems (ie.- flare the front teeth; expand the arches; use elastics; create spaces between the teeth using interproximal reduction). The doctor can be even more specific and detailed in their treatment plan, depending on their knowledge and experience level with Invisalign (ie.- put specific types of attachments on specific teeth; move the teeth in a specific order and direction; move the roots of the teeth in a particular direction). The more information the doctor provides, the closer the ClinCheck will come to the aligners eventually fabricated. All of this is then sent to Invisalign, and the process begins.

Is your doctor communicating with a real doctor or just some technician at Invisalign? I have seen this question asked on http://www.invisalign-reviews.com. The answer is a doctor, who then communicates with the technician, who eventually creates the ClinChecK, utilizing the Invisalign software.

Is the ClinCheck your doctor receives usually correct the first time? NO!!! Despite all the information given by your doctor, it is usually not 100% correct the first time around, or even the second. Not to get too technical, but when a ClinCheck is created, there are certain defaults in how the Invisalign doctor, technician and Invisalign software move teeth. It is sort of like playng telephone ( and you know how that usually ends up). These are not necessarily the way teeth actually move in real life. And to make this even more complicated, teeth do not necessarily move the same way with plastic aligners as they do with braces. So it is up to your doctor to be able to interpret and decode this cryptic 3D movie of your teeth moving. Again, with experience, comes greater understanding and insight. That is why with more difficult Invisalign cases, it takes an orthodontist or experienced general dentist to understand what they are seeing on the ClinCheck, and communicate the proper instructions. Otherwise, your doctor is depending on the Invisalign doctor to get the treatment plan right.

Once the ClinCheck is correct and approved by your doctor, why should a case refinement be necessary? The technology behind Invisalign, and the understanding of how these plastic aligners move teeth are constantly evolving. Each year Invisalign releases updates to this technology, allowing Invisalign doctors to treat more complex cases, and perform movements more easily that than in the past. These updates are from suggestions made by Invisalign providers, and worked on by other dentists,orthodontists, and. computer technicians at Invisalign to make tooth movement with Invisalign more efficient and exact relative to your ClinCheck. So the ClinCheck is still a work in progress. But because the technology is so advanced, little changes make a huge difference!

I intended to include my own ClinCheck and photos to compare. so you could see examples of what I was describing. Unfortunately, I am posting this while away on vacation, so I will have to include them in a future blog post. I am up to aligner #10 of 32, so I am approximately 1/3 of the way there. So far, so good!!! And I can see and feel a noticable and positive change in my smile and bite. It has most definitely been an educational, enlightening, and worth while experience so far! Ask me again in another 20 weeks, and you might get a different answer!

I hope everyone enjoys the remainder of their summer! I should be finishing up treatment around this time next year, or probably in the middle of a case refinement!
Dr Adam Shatz, Orthodontist
All About Smiles Dentistry - Orthodontics for Children & Adults
3471 Long Beach Road, Oceanside, NY 11572
http://www.allaboutsmilesoceanside.com