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Practice Solutions: Clear-Aligner Therapy by Peter Gardell, DDS

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by Peter Gardell, DDS
Dr. Peter Gardell graduated from New York University College of Dentistry with honors. He has received numerous awards for clinical excellence and has attained faculty and clinical mentor positions at some of the most prestigious educational institutions in the United States. He has written articles and lectured extensively on many of the technologies he has implemented in his office. Dr. Gardell is a member of the American Academy of Cosmetic Dentistry.


Often when patients are approached with options for orthodontic treatment, they seem to hit a roadblock that prevents them from accepting treatment.

These roadblocks can include:
  • Fear of pain
  • Fear of commitment/length of treatment
  • Fear of unsightly wires and brackets
  • Fear of another relapse (for patients who have previously had braces)
  • Dislike of gagging and goopy impression materials
Clear-aligner therapy removed many—but not all—of these roadblocks … until now.



Modern advances have eliminated the need to take physical impressions with goopy impression material in order to correct malocclusions present in a patient's dentition. For instance, intraoral scans are now an accepted part of the workflow for ClearCorrect, and the company accepts scans from pretty much every scanner on the market. If you have a CEREC scanner, you can now send scans in place of traditional PVS impressions. This feature removes the last roadblock to treatment for our patients who have gag-reflex issues or who fear having PVS material in their mouths.

In fact, digital impressions are so accurate that doctors can now do quality control in-office, removing the potential for rejected impressions and the dreaded message, "Details lacking in X area; please re-impress patient to facilitate accurate production of trays."

When traditional impressions are rejected due to poor quality or lack of detail, both time and money are wasted. Patients are inconvenienced and can easily become aggravated with the situation. And we all know how quickly the cost of PVS material can add up. Going digital will eliminate rejected impressions from your practice's workflow.

And going digital is easy. Converting to a digital workflow will not require you to re-engineer your records appointments. The same series of photographs and radiographs (radiographs optional) will need to be taken: full upper and lower arch, lateral buccal views with teeth occluding, straight on with teeth occluding, full face (smiling and not smiling), and a full face profile shot of your patient preop. These pictures, in addition to the intraoral scan, allow treatment planning to be done with the accuracy required for safe tooth movement. The only difference with the digital workflow is that physical impressions are no longer needed.

As a CEREC dentist, I have quickly come to realize the substantial cost savings of digital impressions over traditional impressions for use with crowns, bridges, implants, etc. This is no different with orthodontics. There are no shipping costs, no impression trays are required, and there's no need for costly PVS impression material. Every dollar saved adds up quickly.

Scanning with the new CEREC Ortho software is easy, and the workflow is guided. The software takes you through the steps to capturing a beautiful digital scan. Once the scan is completed, you access a doctor's portal in order to submit the corresponding case.

Basic patient information is entered, a checklist is filled out on the desired treatment, and there is even a section where radiographs and photos can be easily uploaded. Once your case is submitted, a case number is assigned. This number is used to identify the case from start to finish. The program will amass all the information submitted (including the scans) and will send a confirmation of receipt.

You'll then receive a proposed treatment plan (called a treatment setup), often within 24 hours. With traditional PVS impressions, this can take up to a week or longer, depending on shipping and the quality of your impressions.

We all know that with clear-aligner therapy the patient can be the weakest link to his or her own success. Compliance is key. However, most people who come in for therapy have already thought long and hard about the pros and cons of straightening their teeth, and they're financially committed to the process. As a result, they're usually engaged and determined to make it work.

These are some of the same individuals who previously hit roadblocks that prevented them from moving forward with correcting their malocclusion. Fortunately, modern advances help patients feel comfortable accepting treatment and moving forward to a nicer smile.


Dentaltown Magazine
September 2025
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