NuAlign

Patient Information Sheet And Informed Consent Form

Click HERE for model Patient Consent Form (©2019-). This Patient Consent is for the exclusive use of Dental Practices who are clients of PremPlus. It is password protected – to request a password, please email or phone us.

The document is intended to explain to patients the basic details of what is involved in NuAlign’s clear aligner treatment. It also sets out the risks of treatment and includes a Consent Form for the patient (parent /guardian) to sign. Whilst we hope it covers all the matters a dental practioner would need to include, nevertheless before using it, the Dental Practioner should first make sure that it is suitable for his or her purposes and includes all the information and other content that the practioner requires.

Disclaimer: PremPlus accepts no liability or responsibility arising from any use or reliance placed on this document.

NuAlign Price List

Please phone or email us if you require further information about NuAlign product or current price list.

How To Submit A Case To Us

You can submit a new case to us using either our online instruction Portal: Click HERE for our Portal; or you can send us a Lab ticket (Click HERE for Lab ticket).

We will also need you to send to us impressions of the patient’s upper and lower teeth.If you have been supplying your patients with Invisalign®  then essentially what would work with Invisalign will work for us too!

We accept either:

a) impressions taken using an intraoral scanner (eg in STL format) or;

b) analogue silicone impressions taken using PVS, VPS, or polyether.

Sorry we do not accept alginate impressions due to the risk of shrinkage).

We also request photographs of the patient

A bite registration is useful but optional.

For more information, please see below.

Impressions

As stated above, We accept either impressions taken using an intraoral scanner (eg in STL format) or physical silicone impressions taken using PVS, VPS, or polyether. Sorry we do not accept alginate impressions due to the risk of shrinkage).

We ALWAYS require impressions of both the Upper and Lower arches even if you only envisage active treatment in one of the arches.

Please use disposable plastic trays. We need the impression to capture a 2-3 mm gingival margin, and the incisal detail which can lost in mesh-type trays.

We are happy to accept one or two step impressions but experience suggests a one step impression using a light body on heavy body works best.

When applying a light body onto a heavy body impression material try not to lift the applicatior as this could cause bubbles to form.

You may wish to clean the teeth before taking the impression to eliminate plaque and air dry to minimise any risk of bubbles of saliva interfering with the impression.

The most common problems we find with silicone impressions are drag and movement. You can minimise these risks by following these tips:

-a) try to mix the putty as quickly as you can ensuring there are no streaks. A common issue is the putty already beginning to set when the impression is started which will cause distortion as the impression is seated into position.

-b) Do not let the teeth touch the base or sides of the tray.

-c) Keep the tray under pressure but as steady as possible once it is seated correctly on the teeth.

-d) You may wish to give the putty an extra 60 seconds or so just to make sure it has fully set before removing the tray. Remove the tray gently causing as little movement as possible.

-e) Feel free to take extra impressions, leaving us to select the best ones to use.

Another common issue is not getting the distal of the furthest back molars— are you using a properly sized tray which extends beyond the last tooth and without coming into contact with the gums? Do try adding light body directly onto the distal and occlusal parts of the furthest back tooth in the arch, that way you can make sure it is fully covered by impression material.If you have trouble finding a tray that fits, we can manufacture a “special tray” using a sub-optimal impression.

The things we will be looking for in your impression are:

a) A generally “clean” impression free from imperfections like voids, tears and bubbles etc

b) An impression which is intact and does not have any thin walls. There should be no damage in the impression.

c) Fully defined gingival margins are defined (about 3 or 4mm buccal & lingual surfaces beyond the gingival margin.This way we can be sure there will be sufficient points of retention to enable the movement of the teeth.

d) Accurate occusal surfaces so that we can get a tight fit.

e) For 2 step impressions- that you have not produced a “double impression”.

Undercuts. We rely on natural undercuts to provide the necessary aligner retention but presence of excessive undercuts can cause problems eg when trying to remove the impression form the mouth and or excessive retetion of the finished aligner on the teeth. There are various techniques to deal with excessive undercuts when taking an impression but please ensure you make us aware of such issues and let us know if you need to us eliminate excess undercut in our 3D model of the teeth.

If using intraoral scanners, we accept scans from all commonly in-use scanners.

If you are thinking of acquiring a scanner we can help you with your choice as we have preferential purchasing arrangements with a manufacturer of an excellent intraoral scanning system that we can confidently recommend. Intraoral scanners provide some excellent benefits for clear aligner treatment, including faster submission and quicker turnaround.

-Even if you only want to treat 1 arch, we ALWAYS need an impression of BOTH arches orientated in the occlusion view

-We need Upper and Lower Arch files saved as separate files.

-Check your STL file before sending it to us.

-Dont forget that if you are using our portal, you can upload your STL files on there

-Always scan at LEAST 3 to 5 mm of gum to prevent the edges flaring

-For accurate bite scans, capture as much of the occlusion as you can.

-When scanning be sure to stay on the tooth long enough for it to be fully scanned. This will help avoid any “holes” appearing in the scanned image or the software generating false extra material in the scan. Do check there are no such holes or excess material before proceeding to scan the next quadrant of teeth.

Of course we will always do our best to correct and compensate for any issues and problems that we find in the impressions but occasionally we may need to ask you to provide a new impression.

Do I Need To Submit a Bite Registration?

A Bite Registration (PVS Bite) is optional but helpful because it will add to our knowledge and evidence.

We can invariably reconstruct the bite from the impressions. We sometimes find this “reconstructed bite” gives a truer bite than a registration performed in the dentist’s chair! Perhaps this is because some  patients can get confused when asked to consciously perform such a natural act, normally done with little or no forethought!

Do I Need to Submit X-rays?

We do encourage all practioners to submit x-rays even though your instructions will describe the issues that we will be looking for in those x-rays eg implants, restorations and ankylosed teeth (for this reason x-rays are optional rather than compulsory). X-rays add to our knowledge and understanding of your patient’s case and this is nearly always helpful when preparing a treatment plan.

Did you know that you can upload digital x-rays using our NuAlignTM Portal.

We are happy to accept either full-series (FMS) or panoramic x-rays.

We Need You To Provide Photos

We need CLEAR photos taken in GOOD LIGHT and the photos must be IN-FOCUS

Why Photos Are Required:

  • Firstly, photos enable the correct initial articulation to be ascertained. This is a really important because if incorrect, each movement of teeth could cause a worse result for the patient.
  • Secondly photos help us to orientate the occlusal plane which is a line along the lower molars and premolars occlusal surfaces. To do this we need a photo of the patient smiling, otherwise our 3D model could orientate the occlusal plane too flat or tipped, making the maxillary incisors appear as though they are extruded or intruded. The Planner needs to accurately orientate the occlusal plane prior to staging the clear aligner treatment.
  • Finally, helps us to make sure there is no mix-up between patients.

We need you to provide the following poses:

a) Non-Smiling full face frontal

b) Ditto but smiling

c) Non-Smiling in-profile

d) Anterior buccal occluded

e) Right lateral bucal occluded view

f) Ditto Left.

g) Lower occlusal

h) Upper occlusal

We call this our ‘Perfect Eight’.

Click Here to see examples of the types of photos we need (this document is password protected, please contact us if you need a password).

Tips for taking your photos:

  • Use the best light possible, natural light works best
  • Do not get very close with the camara to the subject as this can cause the photograph to be out of focus
  • You will need cheek retractors and intraoral mirror
  • A plain background is best, such as a white wall
  • Invest in a decent digital camera if you do not already have one

Did you know you can send your photos to us using the NuAlignTM Portal.

What Software Do Patient's Get with NuAlign?

We know how important it is to get patient’s motivated and engaged with their treatment plan.

Currently NuAlign allows the Dental Practioner to give each patient a stripped-down view of the treatment plan to show how the planned treatment should progress and the projected end result. This can be provided either at the dental surgery with patient and dentist going through the treatment view together and/ or as a link which the Dental Practioner can send to the patient for viewing at the patient’s leisure. To access the Smart Smile Viewer click the smartphone icon in the Orders section of the Portal.

We have lots of exciting developments in the pipeline to enhance the patient experince, so watch this space!

Portal Instructions

Please read our Instructions before using the Portal / Studio Software. These instructions are password protected, if you need a password or you are interested in using NuAlign, please email or phone us (info@premplusdentallabs.co.uk : 01942-893122).

Part 1 of the Instructions explains how to set up a new case on the Portal; Part 2 deals with Viewing / Changing the draft Treatment Plan in the Studio Software module; Part 3 is a brief tour of your patients’ Smart Smile Viewer; and Part 4 explains how to make a Final Check and Approve the Plan ready for aligner manufacture.

Click Here for full instructions.

Click Here for Portal.

Please Note: Portal is best viewed using Chrome Browser. Mozilla Firefox can cause browser-conflict issues. Studio Software does not work on Apple Macs unless running a PC Emulator.

Aligner Trim and Thickness

We can of course manufacture our aligners according to the dental practioner’s preferred thickness and trim method (eg scalloped, straight etc).

-Trim: If not specified, we generally trim straight with a small margin above the gingival zenith.

-Thickness: if not specified, the thickness will normally be between 0.5mm but less than 1mm.

T&Cs Summary

1. NuAlign aligners are supplied by PremPlus which is a trading name of Complete Dental Solutions Laboratories Ltd, 85 Hamilton Street, Atherton, Manchester, M46 0TG, Tel: 01942 893 122; registered in England & Wales, number: 07744458.

2. PremPlus is a DAMAS audited laboratory and a member of the Dental Laboratories Association.

3.The aligners are made using a silicone or intraoral scanned impressions of the upper & lower arches supplied by the dentist.

4. The Dentist must assess the patient’s orthodontic treatment, dentition, oral health and suitability for clear aligner treatment.

5. The Dentist should submit a Clear Aligner prescription / instruction either online through the NuAlign portal or using one of our NuAlign Lab Tickets.

6. A draft Treatment Plan will be prepared based on the Dentist’s instructions. The Dentist is responsible for checking and approving the plan’s suitability and obtaining the relevant patient’s consent and approval.

7. The aligners and any attachment templates will be manufactured and supplied once the draft Treatment Plan has been approved.

8. Unless otherwise agreed the cost will be in accordance with our NuAlign Price List current when the Treatment Plan is approved. You will also be given a confirmation of the cost with the draft Treatment Plan. Unless otherwise agreed our prices are inclusive of the cost of the digital Treatment Plan and any aligner bonding templates used for the placement of bonded attachments. Approval of the Treatment Plan by the Dentist constitutes your Order for us to proceed with manufacture

9. Payment is due 30 days after invoice or if we agree to payment on monthly statements, 14 days after delivery of the relevant monthly statement.

10. PremPlus will supply the required number of clear aligners and any attachment templates according to the Treatment Plan.

11. You acknowledge that PremPlus and any and all agents, servants, employees or companies or persons associated with our supply of NuAlign aligners will not be liable for any adverse consequences if the patient was not suitable for clear aligner treatment, for the consequences of any erroneous acts or omissions of the Dentist or his or her staff in the performance of your services, assessments, examinations etc. Likewise we cannot accept responsibility for problems resulting from inaccurate impressions or inaccurate or incorrect information provided by the Dentist or patient or if the product is used with other appliances or in order to facilitate different desired outcomes or by different means from those provided for in the Treatment Plan approved by the Dentist for PremPlus’ use. The dentist is responsible for both the assessment and treatment of the patient and the suitability of the Treatment Plan. Neither PremPlus nor any employees servants agents contractors or other companies associated with the supply of the NuAlign product, practice dentistry. The treating practitioner acknowledges he or she is solely responsible for prescribing and administering treatment.

12. PremPlus is not responsible for the adverse consequences of Patient non-compliance or any failure to provide the patient with appropriate support and advice.

13. It is acknowledged that the result of clear aligner treatment is in the final analysis unpredictable and that as such no guarantee of a successful outcome can or is given. Results will vary from patient to patient.

14. Faults, defects, breakages or loss of aligners or retainers should please be notifed as soon as possible to avoid delays in treatment and to minimise any remission.

Not Signed Up Yet for NuAlign?

We would be delighted to discuss the benefits of the NuAlign system with you. Email info@premplusdentallabs.co.uk to register your interest or ring our Orthodontic Director, Paul, today on 01942 893122 to discuss in detail how you too can Join The Revolution.

You can also learn more about NuAlign by CLICKING HERE 

Play the video below for a peek at our 3D Design Studio software. This is used to view, amend and approve the draft treatment plan created by the Orthodontic Planning Team based on the instructions given by the Dental Practitioner using our Portal.

Back to Portal Page