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You are here: Home / Orthodontics / Simplifying In-Office Aligner Workflows With Case-Setup Design Services

Simplifying In-Office Aligner Workflows With Case-Setup Design Services

Dr. Melissa Shotell, DMD, MS · ·

Many doctors are excited about 3D printing and the possibility of making in-office clear aligners but do not want to go through the process of creating a treatment set-up.  A smart way of getting started with doing in-office aligners is the option to outsource the case set-up and design. There are now multiple companies offering treatment planning and design services that can provide the doctor with files ready for 3D printing the patients models for in-office aligners. Typically from my experience the design portion has always been the limiting and more challenging step in the in-office aligner workflow.

3D printing your aligner cases is awesome… spending hours of your own time isn’t always awesome…

When working with a treatment planning and design service the office workflow begins with the patient records appointment.  After records are taken instead of sending to a commercial aligner laboratory or the doctor creating the treatment set-up the doctor will send the patient records to a design service.  The design service will then create the patient treatment set-up and send to the doctor for approval.  Once the set-up has been approved there are three different options for production of the aligners:

eXeed design of a case

Option 1. The design service can manufacture the aligners
Option 2. The design service can 3D print the patient models and send to the doctor to fabricate the aligners
Option 3.  The design service can send the doctor the STL files to 3D print the models in-office and fabricate the aligners

The third option is perfect for those doctors that want to 3D print models and fabricate in-office aligners but do not want to go through the time consuming process of creating the treatment set-up or the expense of maintaining treatment planning and design software.  

Analysis of my case in eXceed software

One of the emerging leaders in the treatment planning and design space is eXceed.  After using multiple design services, I have found many attributes of eXceed’s services that are intuitive and interesting.  eXceed utilizes a doctor portal that is similar to the portals of many traditional aligner companies like Invisalign and ClearCorrect.  After creating a treatment set-up eXceed sends a treatment simulation video to the doctor for review.  The software utilized by eXceed is extremely robust with many of the same features as the large aligner laboratories including the ability to view occlusal grams, measurement grids, before and after superimposition, and detailed IPR reports.  Exceed’s software is further enhanced with the function to give the doctor control to manipulate the teeth for revisions, and option only typically available from more traditional aligner manufacturers like Invisalign.

Features of eXeed software includes super-imposition of pre-treatment and post-treatment scans (left); occlusal analysis (middle); and detailed IPR reports (right)

Another defining feature of eXceed is that every treatment set-up is reviewed a supervising orthodontist prior to being sent to the doctor.  Any revisions of the treatment set-up requested by the doctor must then be reviewed again by the supervising orthodontist prior to being sent to the doctor for approval.  eXceed’s review process leads to quality treatment set-ups that need minimal revisions prior to approval.

Vertical 3D printed models from eXeed design

The treatment planning software with eXceed is able to generate high quality STL files that can be printed on a desktop 3D printer like the SprintRay Pro 3D Printer.  The files from exceed can be created in the horizontal or vertical printing orientation for the preferences of the doctor.  Models can then be used to create clear aligners to the preferences of the doctor.

Overall I have had an excellent experience working with eXceed for my clear aligner set-ups.  As a busy clinician I do not always have the time to create all of my case set-ups.  Having a design laboratory to help during busy times allows me to focus on patient care and delivering optimal treatment results without having to spend hours at the computer creating every treatment set-up.


Are you interested in getting into clear aligner therapy but unsure if they really work? Are you a general dentist interested in getting into orthodontics but not know where to start? Check out our comprehensive fast-track clear aligner course featuring diagnosis and treatment planning, how to get started with clear aligner laboratories, the differences in technology, step-by-step clinical procedures from taking records to delivering aligners and monitoring your patients until case completion. We cover the basics to getting you started with clear aligner treatment using traditional and digital methods for recording taking, step-by-step clinical and laboratory workflows, insurance/billing and growing your clear aligner practice through innovative marketing strategies. The clear aligner course is eligible for up to 12 hours of continuing education credits.

Step-by-Step 3D Printing Your Own In-Office Clear Aligners

Interested in 3D Printing your own clear aligners? Check out our step-by-step 3d printing course featuring creating your own branded in-house clear aligners by designing and 3D printing your aligner cases. We teach you the secrets, step-by-step on how to set-up your cases (or outsource setup!) and then 3D print models for aligners, vacuum forming aligners, and then finishing and delivering them to the patient! The clear aligner course includes the entire fast-track clear aligners course mentioned above and is eligible for up to 25 hours of continuing education credits.

Orthodontics clear aligner, design service, exceed

About Dr. Melissa Shotell, DMD, MS

Dr. Melissa Shotell is a Board Certified Orthodontist and practices in a multi-specialty practice in Sonora, CA focusing on the interplay of Orthodontics and restorative treatment. Dr. Shotell received her DMD at Nova Southeastern University and advanced hospital training a General Practice Residency Certificate from The Ohio State University. After spending years in general practice treating a broad range of patients, Dr. Shotell returned to complete a certificate and master’s degree in Orthodontics from Loma Linda University. At Loma Linda University, Dr. Shotell focused her training on cutting-edge three dimensional imaging technology for diagnosis and treatment planning for interdisciplinary dentistry. Dr. Shotell considers education to be her passion and regularly consults and lectures on dental technology, clear aligner therapy, orthodontics, office efficiency and workflow, and teamwork.

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