A good aligner case does not start in the planning software. It starts the moment the patient sits in your chair. Every step from the scan to the approved setup affects the next one, and a small problem early in the process can cost days later.

This guide walks through a clean digital aligner workflow in six steps, with simple tips to avoid the delays that most clinics run into.

The workflow at a glance

Step	What happens	Who owns it
1. Records and scan	Photos, radiographs, intraoral scan or impressions	Clinic
2. Check and send	Scan quality check, prescription, upload	Clinic
3. Model preparation	Cleaning, trimming and segmenting the models	Planning team
4. Setup and staging	Final tooth positions, steps, attachments and IPR	Planning team
5. Review and approval	Dentist reviews, requests changes, approves	Clinic
6. Production and delivery	Models, aligners, checks and delivery	Production team

Step 1: Collect clean records and scan

Good planning starts with good records. Collect:

• Extraoral and intraoral photographs
• Radiographs relevant to the case
• A complete intraoral scan or good-quality impressions
• A bite registration that matches the patient’s natural closure

Tip: scan slowly in a dry field, and check each arch on screen before the patient leaves the chair. Rescanning later costs far more time than rescanning now.

Step 2: Check, prescribe and send

Before you upload anything, take two minutes to check:

• Are all teeth and gum margins captured, with no missing areas?
• Does the bite look correct from both sides?
• Are patient details and case notes complete?

Then write a clear prescription. State which teeth to move, which to hold, your goals for the final result and your preferences for attachments, IPR and staging. The clearer the prescription, the fewer revision rounds you will need.

Tip: keep a standard prescription template in your clinic so no key detail is forgotten.

Step 3: Model preparation

The planning team prepares the digital models. This usually includes cleaning the scan, repairing holes, trimming the model and separating the teeth so each one can move on its own. Poor scans slow this stage down or force a request for a new scan.

To learn more about what happens here, read our guide to Meshmixer for aligner models.

Step 4: Setup and staging

This is where your prescription becomes a digital plan. The team builds the final tooth positions and then breaks the movement into steps. They also plan attachments and IPR according to your instructions.

Tip: if you have a strong preference, such as limiting IPR or avoiding attachments on certain teeth, state it in the prescription. It is much easier than fixing it later.

Step 5: Review and approval

The setup comes back to you for review. This is your decision point. Check that the final position matches your diagnosis, the movements are realistic, attachments and IPR make sense and the bite looks right.

Use our checklist of 7 signs a case needs a second look to review each setup, and consider an independent check for complex cases through a QC service.

Tip: send all your change requests in one message rather than in several small ones. This avoids confusion and reduces the number of revision rounds.

Step 6: Production and delivery

After approval, the plan moves to production. Models and aligners are made, checked and delivered. Make sure the approved version of the setup is the one that goes into production, and that every set is labeled with the right patient and stage.

When the aligners arrive, check the fit at the first visit and record it. If the first aligner does not seat well, review the case early rather than waiting for several stages.

Where delays usually happen

1. Incomplete scans that need to be redone
2. Unclear prescriptions that lead to several revision rounds
3. Late approvals, where a setup waits for review for days
4. Many small change requests instead of one complete list
5. File or version confusion between the approved plan and the production file

Most of these are simple to prevent with a short checklist and one person in your clinic who owns the workflow.

A simple checklist for every case

Before you send	Done
Photos and radiographs collected
Scan checked on screen for gaps
Bite registration checked
Prescription written with goals and preferences
Patient details and case notes complete

In-house or outsourced workflow?

You can run this whole workflow yourself, hand the planning steps to a specialist team, or mix both. If you are not sure which suits you, read our guide on outsourcing clear aligner design and see our full list of services. Add your own details here about how cases are sent to you, what you need from the clinic and what turnaround to expect.

Frequently asked questions

How long does the scan to setup process take? It depends on the case, the scan quality and how fast the review happens. Ask your provider for their usual turnaround, and add your own times here if you want to quote them.

What is the most common cause of delay? Incomplete or low-quality scans, followed by unclear prescriptions.

Should I scan or take impressions? Intraoral scans are faster to send and easier to check on screen, but good impressions can also be digitized. Use what gives you the cleanest result.

How many revisions are normal? Often one or two, but a clear prescription and a complete list of changes can reduce them.

Can I send cases from a different scanner? Usually yes, if the file format is supported. Check the accepted formats with your provider before you start.

Make your next case smoother

Send us a case and see how a clear workflow feels. Visit our services page or contact OrthoAlign Solution to get started.