Aligner fitting and bite finishing guide

PROBLEM	CAUSE	SOLUTION
Aligner is not fitting	Attachments may have excessive flash. Distorted initial impression or intraoral scan Aligner lag, or not enough time for movement to be expressed due to variation in bone biology or tooth morphology. Patient’s dental anatomy changed (e.g., restorations, crowns and fillings).	Remove excess flash and/or remove and rebond attachments with template fully seated Must retake impressions or intraoral scan and restart treatment Extend wear time of Aligners or backtrack an Aligner before moving forward. Ensure contacts are not binding on the teeth that are to rotate or need to take new impressions and resubmit to Whitesmile Clear Laboratory services for refinement Must retake impressions and restart treatment (Mid‑Course correction). *Complete restorations and other dental operations prior to scan/ impression
Loose aligner	Potentially due to short clinical crowns, common with teens	Use Detail Pliers for retention. Contact our support team for purchase of these tools.
Aligner popping up or rocking	-Potential tissue impingement. -Inflamed gingiva distal to the second molars (typical in teens). -Inflamed incisal papilla.	Relieve aligner impingement by trimming it. Use trimming bur to adjust the aligners.

Attachments debonded	Contaminated bond surfaces. Attachment broken from use. Attachments worn down from wear. Occlusal interference, causing patient to shear off attachment.	Replace under better isolation Section attachment template and reuse it on current tooth to rebond attachment. Never use an aligner as an attachment template. Remove and replace attachment with higher-fill composite. Adjust attachment with trimming bur to relieve.
Rotation/Extrusion of teeth not occuring	Not enough time for movement to be expressed due to variation in bone biology or tooth morphology	Extend wear time of Aligner stage; and ensure contacts are not binding on teeth that are to rotate.
Incomplete extrusion	Absolute extrusion was programmed (less predictable) than relative extrusion.	Auxiliary treatment button – inter-arch or intra arch elastic and make sure there is no contact binding.
Posterior open bite at the end of treatment	Transient posterior interference/intrusion.	Cut out premolar/molar region of Aligners; allows for settling in posterior. (Watch for rotation relapse of posterior teeth if they are not covered.) *Aligners trimmed distal to second premolar to allow passive eruption (settling)

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