iTero Element with Invisalign Training Manualbook

iTero

®

Element

™

Intraoral Scanner Orthodontic

Training Guidebook with Invisalign

®

Content

02 - 09 Hardware Overview (Touchscreen, Sleeves, Wand)

10 - 11 Make It Mine / Logging In

12 - 27 Home Page (Display, Icons, Help)

28 - 48 Invisalign®Scanning Basics

49 - 77 Resources

1

Hardware

System Configuration

Touch Screen

Wheel Base

Scanner Sleeve

Wand / Touchpad

The on / off power butto n is located at the b ot t o m right-hand corner of the system under the power indicator light.

Optional counter stand may be

purchased separately

2

Wheel Base

Hardware

Wheel Locks

Power Cord

3

System Components / Touch Screen

Hardware

• High definition multi-touch 19 inch display

• Works with all clinical glove types

• Refer to Operation Manual for

cleaning and disinfection instructions

4

Scanner Sleeves

Hardware

Note: Please do not touch the wand lens.

Blue protective sleeve protects

the lens when the wand is not in use.

Confirm sleeve is completely seated prior to scanning.

Disposable sleeve is made for single use on patient scanning. Discard sleeve after every patient.

To remove and place sleeve use the side grips.

5

Wand Controls

To activate the wand touchpad, press and release both side buttons simultaneously.

Hardware

To start and stop scanning, press and release either of the side buttons.

6

Holding the Wand

Hardware

For proper ergonomics and to avoid fatigue, make sure the elbows are close to the body, holding the wand in the thin area behind the wand sleeve.

Do not cover the air vents.

7

Wand Controls

Hardware

Pressing and releasing both the buttons simultaneously will activate the touchpad. Once activated swiping the touchpad on the wand will allow movements between scan segments.

The current scanning segment is

displayed in the indicator box between the arrows.

To rotate the model on the screen press and hold the wand touchpad.

8

Care and Maintenance

Hardware

Recommended best practices for cleaning and disinfecting the Scanning Unit, Base Unit, Wheel Stand, and / or Counter Stand in between each patient use.

• Do not spray disinfectant

directly on scanner system surfaces

• Spray the disinfectant on a

towel, or use disinfectant wipes for the Scanning Unit and Base Unit

• Follow the disinfectant

Description pH Manufacturer

Birex® Quat Wipes 7.6 Biotrol Intl. CaviCide AF 12.7 Metrex CaviCide 12.5 Metrex CaviWipe CaviCide 1 12.5 Metrex CaviWipe 1

Clorox Healthcare® Hydrogen Peroxide Cleaner Disinfecting Liquid

Clorox Healthcare® Hydrogen Peroxide Cleaner Disinfectant Wipes Opti-Cide 3® Liquid 7.6 Biotrol Intl. Opti Cide 3® Wipes 7.6 Biotrol Intl. OPTIM 33TB Liquid 2.5-3.5 SciCan Inc. OPTIM 33TB Wipes 2.5-3.5 SciCan Inc. ProSpray 10 Certol ProSpray wipes Webcol® Alcohol Prep Pads 7 Medtronic

2-3 Clorox® Healthcare™

manufacturers’ instructions for appropriate contact time

• Remove residual liquid

disinfectant with a lint-free, clean cloth

*Please refer to Operations Manual for further instructions.

9

Make It Mine / Registering the System

Logging In

To register the iTero®Element™system, have the following information available*

• User Name

• User Password

• Company ID

* To retrieve User Name, User Password, and Company ID, please

contact iTero®Customer Advocacy at 1 800 577 8767.

10

Logging In

To log-in to the scanner,

 Choose the doctor name

 Enter user name and

password*

 Check the ‘Remember Me'

* To retrieve User Name, User Password, and Company ID, please

®

contact iTero

Customer Advocacy at 1 800 577 8767.

box to remain logged on to the scanner for 9 hours

11

Home Page

Home Screen Icons

Tap to set your preferences

Tap to lock the desktop

Tap to enter the Learning Center or start training

Double tap to connect to an iTero Customer Advocacy agent for remote troubleshooting (please call iTero Customer Advocacy first)

Tap anywhere on screen to close this help overlay

Tap to check the status of your orders

Tap to view notifications, updates, and other messages from Align Technology

12

Small Icons – Learning Center

Home Page

The graduation cap is the link to the Learning Center.

Select this icon to access all training support materials

• Online training videos

• Training and reference documents

• Register and view webinars

13

Small Icons – Lock

Home Page

To further support HIPAA compliance, the Lock option secures the desktop and returns screen to the login page.

Locking the system for cleaning is helpful to avoid unintended entries.

14

Small Icons – Settings

Home Page

Tapping on the Settings icon brings the screen which allows the change of computer settings, scanner settings, time zone, language, add the Doctor's signature, license number, and sync the system for any new updates.

15

Settings – Scanner Settings

Home Page

Within the Scanner Settings, select the preference for the Gyro and Touchpad orientation.

For example, in the above picture, the selections are for the wand tip toward the screen for the gyro and the base toward the screen for the touchpad.

16

Settings – Scanner Settings

Change the Scan Order.

Home Page

Jaw Order Preparation Order

17

Settings – Scanner Settings

Home Page

• Enter doctor license number in the box provided

• Sign in the signature box

• Select preferred option

18

Help Overlay

Home Page

One tap on the question mark will enable a transparent overlay that will provide a brief overview. Tap anywhere to close the Help screen and return to the relevant screen.

19

Customer Advocacy

Home Page

Tapping on the headset will allow for remote assess for troubleshooting. Contact Customer Advocacy first at 1 800 577 8767.

After contacting Customer Advocacy, an agent will review the specific steps in order to connect remotely.

20

Large Icons / Orders in Progress and Past Orders

Home Page

Within the In Progress section, view an Rx, continue, view, or delete a scan.

Within the Past Orders section, view an Rx, open the order using the Viewer, or open an Invisalign®scan using the viewer or the Invisalign Outcome Simulator.

21

Patients

Home Page

To search for a patient from the iTero®database, select the Patients icon on the home page.

The Patients order list will open.

Search by patient name or chart number to find the patient.

22

Patients

Home Page

The Patients icon can be used to start a new scan, open previous scans with Viewer

and / or Invisalign®Outcome Simulator.

23

Large Icons / Messages

Home Page

Dr. Test, Test

The Messages icon is a badged icon that notifies the user of important messages from Align Technology such as product updates, upcoming educational sessions, or internet connectivity issues.

24

Large Icons / Orders

Home Page

Within the Orders icon is the list of orders that are either In Process or Past Orders.

25

Ergonomics

Home Page

Ergonomics play a key role to comfort while scanning. It’s recommended to place the patient in the supine position.

Lower the patient's head and sit comfortably with elbows on the side. Place the display on dominant side to see the screen without turning or stretching.

The wand should fit comfortably in the palm of the hand with a light grip. There is no need to grip the wand tightly.

26

Large Icons / New Scan

Home Page

℞

New Scan

Opening the new scan icon will jump to the Rx page. The Rx is the section to enter all the necessary patient information. The sections marked with a red asterisk (*) are required information.

27

Scan in Color Feature

Invisalign®Scanning Basics

Clinicians will experience real-time scan in color in both scan and view mode to make it easier to visually distinguish between gingival and tooth structure for a more precise clinical evaluation while scanning. The color scan will provide additional information to the laboratory technician when they attempt to imitate the shading of the original dentition.

28

Invisalign®Scanning Protocol - Start New Prescription

Invisalign®Scanning Basics

There are several Case Types to choose from.

®

Any special instructions for Invisalign

treatment must be noted in the Invisalign

Doctor Site.

29

Invisalign®Scanning Protocol - Guidance Hints

Invisalign®Scanning Basics

The iTero®Element™ scanner offers Guidance Hints that helps recall the scanning sequence.

Deactivate the Guidance Keys by checking the box, ‘Don’t show again’.

Reactivate the Guidance Keys in the Settings gear icon.

30

Occlusal (Upper or Lower Arch First is Optional)

Invisalign®Scanning Basics

Scan the occlusal surface in a single continuous motion.

When the wand reaches the cuspid, continue by swiping across the anterior, tilting slightly to the lingual until the wand touches the contralateral cuspid.

Proceed by moving the tip straight back to the terminal molar.

31

Lingual

Invisalign®Scanning Basics

Scan the lingual by rolling from the occlusal. Bring the cable end of the wand out to the side and maintain a vertical 45 degree angle of the wand tip to the lingual surface.

To capture the mesial and distal interproximal anatomy, twist the wand tip right and left as the wand moves around the arch. Holding the wand tip against the tooth will help to retract the tongue.

32

Buccal

Invisalign®Scanning Basics

From the lingual, roll to the buccal at a 45 degree horizontal angle and use a rocking motion as the wand moves towards the midline to capture the interproximal anatomy.

After crossing the midline, begin on the contralateral terminal tooth and continue with the same rocking motion to capture the buccal surface from the posterior to the anterior.

Moving from posterior to anterior on the buccal reduces the interference from the cheek and provides a smoother scanning experience.

Bring the cable end of the wand towards the arch to capture the mesial interproximal anatomy and taking the cable end away from the arch will capture the distal interproximal anatomy.

33

Anterior / Incisal

Place the wand with the cuspid and lateral centered in the view finder and roll from the lingual surface over the incisal edge to the facial.

Repeat this step on the contralateral side.

Invisalign®Scanning Basics

These scans help to ensure the lingual segments and buccal segments are joined with accurate incisal surfaces.

This step is critical for properly fitting Invisalign®clear aligners.

34

Optimized Scanning

Invisalign®Scanning BasicsInvisalign®Scanning Basics

Additional Scan Feedback

Scan Color Toggle

When the Optimized Scanning Feature icon is activated, areas of missing anatomy will be highlighted in red when scanning in monochromatic mode and purple when scanning in color mode. This feature will alert you to areas that need additional scans. The color icon allows you to toggle between color or monochromatic modes. This applies to both scanning and viewing all case types.

35

Switching to Opposing Arch

Invisalign®Scanning Basics

Switch to the opposing arch by pressing on the arch on the touchscreen or use the touchpad on the wand.

Follow the same protocol for the upper as with the lower. occlusal, lingual / palatal, buccal, and incisal edge.

36

Scanning the Palate

Invisalign®Scanning Basics

• For Invisalign®+ iRecord

or iRecord scans

• Once completed the

lingual tooth anatomy

• Begin at the midline

directly behind the central incisors

• Scan in a straight line to

the soft palate

• Fill in the palate from the

midline to the teeth on each side

®

37

Bite

The final segment is the bite. Prior to scanning, confirm the patients bite. Have the patient open, use the wand to retract the cheek, and have patient close in centric occlusion. Bring the wand tip gently against the tooth anatomy.

Invisalign®Scanning Basics

Moving forward in a small wave like motion capture 3 – 4 teeth and then move to the contralateral side using the same technique.

38

Missing Scan Segments

Invisalign®Scanning Basics

Complete the following steps if there are segments missing in your scan:

• Go back to scan mode

• Complete the missing

segments that are highlighted in red

• Repeat above steps if

necessary

39

Scan Timer

Invisalign®Scanning Basics

After you are done scanning, you can use the Scan Timer icon to view your scanning time. The Elapsed Scan Time is the actual time the wand was actively scanning. The Elapsed Total Time is the time while you were in scanning mode, whether the wand was actively scanning or not.

40

Add Rx To An Existing Sent Scan – Allow Additional Workflows

Invisalign®Scanning Basics

Conditions for the Add Rx to be enabled:

• Accessible from Orders and

Patient’s icons

• For cases except restorative

and chair side milling

• Enabled up to 21 days from

the case’s scanning date

• The model has to be located

on the scanner’s base unit

41

Add Rx To An Existing Sent Scan – Workflow

Invisalign®Scanning Basics

1. Select case type

2. Add scans as needed

3. Tap on view tool 4. Send the case

42

Evaluate Digital Models

Invisalign®Scanning Basics

For production of properly fitting aligners, evaluate the digital model for the following before submitting

• Capture 2 mm of gingival tissue

• Distal wall of the terminal teeth

• Mesial and distal interproximal anatomy

• The complete incisal / occlusal

surfaces of both mandible and maxilla

• Accurate bite with the patient in

centric occlusion

43

Invisalign®Scanning Basics

Evaluate Digital Models

Distal wall of upper terminal teeth. Distal wall of lower terminal teeth.

44

Evaluate Digital Models

Invisalign®Scanning Basics

The complete incisal / occlusal surfaces of both mandible and maxilla

45

Evaluating Digital Model / Occlusal Analysis

Invisalign®Scanning Basics

Utilize the Occlusal Clearance legend to determine the distance between opposing teeth.

46

Submitting Case

Invisalign®Scanning Basics

To submit the case, simply tap on the envelope.

A prompt will appear stating that the scan will be available for treatment submission through the

Invisalign®Doctor Site in approximately 15

minutes. Select OK.

Next, click yes to launch the Invisalign Outcome

Simulator.

47

Help / Display Screen Gestures

Invisalign®Scanning Basics

• Tap on the help icon for context

sensitive overlays with instructions

• Use fingers to rotate, move, or

and tool descriptions

zoom in on the scanned model for analyzing

48

Using Eraser Tool

Resources

• Tap on the eraser icon

• Select the area to erase on the

screen

• Tap on the scanner sleeve icon

• Scan to fill area erased

• Tap on the view icon

• Confirm correction

49

Using Trim Tool

Resources

Use the Edge Trim tool if there is excessive cheek or lip artifacts that should be removed from the scan

• Tap on the scissors icon

• Circle the area to remove

• Verify the selected area

• Tap on the green check mark

• Tap on the view button to confirm area

has been trimmed as chosen

50

Tools – Deleting a Scan

Resources

• Available in scan mode

• Tap on the arch to be

deleted

• Press and hold on the

model

• Tap on the waste pail

Remove an artifact (soft tissue)

Wrong jaw scanned

Unstitched

Segment

Main model

Tooth anatomy not stitching

segment or broom icon

• Confirm deletion

• Rescan area

51

Resources

Tools – Deleting a Scan and Correcting the Bite

Clinical Scenario

The patient is able to close on maximum intercuspation and produce solid contacts on articulating paper. During scanning, the patient was not able to bite properly.

Incorrect bite registration Occlusogram display

Poor contacts

52

Tools – Deleting a Scan and Correcting the Bite

Corrective Action

Erase and rescan bi-lateral bite

Resources

1. Tap on both bite segments to delete

2. Rescan

53

Tools – Deleting a Scan and Correcting the Bite

Resources

Verify new bite registration Occlusogram display

Adequate contacts

54

Viewer

Resources

Viewer is a tool that allows the

scanner to manipulate and display the digital model for case presentations.

The icons on the left of the screen displays preset views of the model.

55

Viewer

Hide / Display

Maxilla or

Mandible

Frontal View

Resources

Select the arch to be displayed.

There are three layouts on the Viewer.

• Occlusal View (single

jaw)

Occlusal View

Gallery View

Occlusogram

• Occlusal View (upper

and lower)

• Gallery View

56

Viewer / Occlusogram

Resources

The Occlusogram tool can be

shown in any view by tapping the Occlusogram icon.

57

Viewer

Resources

In the Gallery View, the models in each window can be controlled separately for

better evaluation.

58

Resources

Viewer

Unchanged Margin Line and Ditch Changes on Margin Line and Ditch

Margin Line Ditch Cut-Out Clearance

When the case is in “iTero modeling” on the Orders tab, it’s in the early stages of modeling and there are no edits and the margin and die tools are gray (inactive).

When the modeling process is completed, the die and margin line has been edited and the changes will appear in color on the model and the icons are in color indicating that they are active.

The occlusal clearance is also visible on viewer for reference.

59

Chairside Milling – Certified Connectivity

Resources

• Dedicated Rx case type

• Ship to lab is disabled

• Scanning protocol is the

same as restorative

Certified connectivity with:

E4D Planmeca Chairside Milling System Glidewell IOS Technologies Fast Design System

• Contact your Chairside

Milling provider for more information on the integration with the iTero® Element™ Intraoral Scanner

60

Chairside Milling – Export Settings

Configure your network to download the files on the chairside milling software.

• Establishing connectivity between the milling unit and the scanner

• Customize the export settings: on the scanner, select the saving options

• Modify the number of days the file stays on the folder or manually delete all cases from the folder

Resources

Export Settings icon is active

61

Chairside Milling – Default Folder Path

Resources

Files will be saved in a shared folder on the scanner, which are accessible from any computer or design workstation. Configure the mapping for the default folder path on your network server.

In case you need assistance, please contact iTero® Customer Advocacy at 1 800 577 8767.

62

Resources

OrthoCAD

®

The OrthoCAD®software is the digital model viewer for all your orthodontic cases.

After you send the cases on your iTero

®

Element scanner, it can be viewed, managed and analyzed with this powerful tool from any office computer or workstation

Some clinical applications for this software are:

• Communicate between dental offices -

printing or emailing the 3D models

To export STL or view model, Install OrthoCAD®on a workstation.

®

Call iTero

Customer Advocacy at 1 800 577 8767 for instructions.

• Perform diagnostic analysis of the 3D

orthodontic models

• Presenting cases to patients for discussion

of the treatment plan

63

MYALIGNTECH

Resources

MyAligntech* is designed to effectively manage patient cases and the orthodontic models

produced by the iTero® scanner.

* To retrieve User Name, User Password, and Company ID,

please contact iTero

®

Customer Advocacy at 1 800 577 8767.

64

MYALIGNTECH Account Administrator

Resources

To log on as an Account Administrator

• Select Profile on the MyAligntech landing page

• Select Practice Management

65

MYALIGNTECH Account Administrator

MyAligntech landing page

will provide many options.

Click on the Orders link at the top of the page to view all orders.

Orders that require further action are listed in the

Actions box.

Resources

On the right side, the

Notification section shows

alerts to communications from Align Technology.

The Quick Search enables the search for orders using various parameters.

66

MYALIGNTECH Order Information Page

Resources

There are several options in the Actions line

• Open File to view the

model

• Export the file to send

the file to 3rd parties*

• Change Lab to order

* Please contact iTero®Customer Advocacy at 1 800 577 8767 for software installations.

a new milling model and send it to the lab

67

MYALIGNTECH Exporting STL Files

To export STL files from a workstation and send them external parties, follow these steps.

Resources

1. Click o n ex p o r t .

To export STL or view model, install OrthoCAD®on a workstation. Call iTero

®

Customer Advocacy at 1 800 577 8767 for instructions.

2.Export type.

3. Data Format.

4. Export.

68

Invisalign® Doctor Site

Log into the Invisalign®Doctor Site

(IDS) through the link on the MyAligntech website to access

patient case files.

After sending a digital impression from the scanner, it may take up to 15 minutes for it to be available on

Resources

the IDS site for submission.

The digital scan may be associated with a prescription in IDS prior to submitting the Invisalign order.

69

Invisalign® Outcome Simulator

Resources

The Invisalign®Outcome Simulator is a software tool that shows patients the simulated outcome of their Invisalign treatment.

To use the Invisalign Outcome Simulator,

• Simply scan the patient under

the Invisalign or Invisalign +

iRecord® case type

• Send the case

• Go to the Orders or Patients

page to open the case with Invisalign Outcome Simulator

70

Invisalign® Outcome Simulator

Resources

The clinician can make real time adjustments to the simulated outcome as the clinician is showing the patient.

This tool will provide additional information for the patient in their decision to accept treatment.

The clinician will still be creating a ClinCheck®treatment plan in

the Invisalign®Doctor Site and submitting the case for production.

71

Invisalign® Outcome Simulator

Access the Invisalign®Outcome Simulator through these sites:

Resources

Orders’pageview

MYALIGNTECH

72

Progress Assessment

Resources

Open case from Orders or Patients

Correct Axis Lines (optional)

73

Progress Assessment

Resources

Access IDS Database

Analyzing progress assessment

74

Progress Assessment

Resources

Assessment Tools

Stage Controls

Legend

Page Buttons

Report Panel

Stage Button

Stage Slider

The Progress Assessment tool includes a report that is a color-coded tooth movement table to assist the doctor in making treatment decisions to track the

®

patient's progress to their ClinCheck

treatment plan.

75

Customer Advocacy

Resources

Contact iTero®Customer Advocacy at 1 800 577 8767.

Order disposable scanner sleeves, articulators, and patient brochures online at the iTero Store (www.store.itero.com)or click on the iTero Store tab in MyAligntech.

Check MyAligntech and Messages for upgrade notifications and information on the monthly iTero Advanced Training

Webinars.

Align Technology, Inc. 2560 Orchard Parkway San Jose, CA 95131

76

PDF Files

iTero®Element™Operation Manual

Invisalign®Outcome Simulator Quick Reference Guide

STL Export Instructions

iTero Element Video

Resources

77