13
Digital Workflow
With any orthodontic technique, as with clear aligners, records routinely include study casts, intraoral and extraoral photographs, and panoramic and lateral cephalometric radiographs.
Additional diagnostic records may include a 3D cone beam computed tomography (CBCT) scan, periapical radiographs and any other diagnostic records necessary to begin the case.
One of the main advantages with clear aligners is that the whole procedure can be performed digitally, tracking every single movement and it is possible to ‘time lapse’ it.
13.1 Records
13.1.1 Photographs
Extraoral
Extraoral pictures should be taken with the following parameters on your camera:
- Manual mode
- F5.6
- 1/125
- ISO 100
- Flash ¼ (ring flash is strongly adviced)
Fig. 13.1 Frontal, smile and lateral photographs.
A plain white background is recommended to avoid distortion on the images.
Intraoral
Lateral pictures must be exactly at 90 degrees: if lateral photos with any other angulation are sent, it will not be possible to check if the technician has set the occlusion for the real patient situation. For this, note that ‘teeth’ will be set up by the system with the pictures, so a poor quality picture might lead to a ‘false’ initial occlusion and, if this was not identified from the very beginning, it would lead to a ‘false’ or inappropriate treatment plan.
Fig. 13.2 90 degrees pictures are mandatory both in right (a) and left (b) intraoral views.
It is important to send an overjet photograph. In the intraoral frontal view, it is also possible to check the upper and lower midlines.
Fig. 13.3 Intraoral frontal (a) and overjet (b) pictures will help create a good treatment plan.
Occlusal photographs must be sent with articulating paper marks to assist the technician in setting up the initial occlusion.
Fig. 13.4 Blue or red ink on both upper (a) and lower (b) occlusal pictures will help setting initial occlusion.
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