Invisalign treatment progress checklist Growing your practice with Invisalign® treatment © 2019 Align Technology. All Rights Reserved. Align and Invisalign, among others, are trademarks and/or service marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries. MKT-0002940 Rev A 1 Aligner series: Initial AA2 Aligner: ________ of ________ Aligner wear (days): ________ ClinCheck reviewed & opened: Yes Overall tracking: Excellent Fair Note teeth with fit concern with an “X” Attachment broken/missing: Yes Check contacts with floss: Yes Note “tight” contacts with “T” Check the bite: Yes Elastic wear & precision wing engagement: As prescribed Oral hygiene: Excellent Fair Patient’s estimated daily aligner wear: 20-24 hours 12-16 hours Suggested probing questions to ask the patient: How many hours a day are they out? Do you ever miss getting them back in after lunch? Do you ever have them out for a prolonged period of time? Next aligners to dispense: ________ - ________ What areas need attention over these next aligners, ie attachment removal, open contacts, etc. Teeth #: _____________________________________________________________________________ Next visit: Aligner delivery +/- Attachments Final work-up Coached or complimented: Yes Additional notes: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 02 01 03 04 05 07 06 08 09 10 11 12 13 Maxillary Mandibular R L 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 AA1 Other ________ No No No No Off schedule No #________ Good Good + IPR 16-20 hours Poor Poor Additional aligner/scan <12 hours 15 14
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Invisalign treatment progress checklist
Growing your practice with Invisalign® treatment
© 2019 Align Technology. All Rights Reserved.Align and Invisalign, among others, are trademarks and/or service marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries. MKT-0002940 Rev A 1
Aligner series:
Initial
AA2
Aligner: ________ of ________ Aligner wear (days): ________
ClinCheck reviewed & opened:
Yes
Overall tracking:
Excellent
Fair
Note teeth with fit concern with an “X”
Attachment broken/missing:
Yes
Check contacts with floss:
Yes
Note “tight” contacts with “T”
Check the bite:
Yes
Elastic wear & precision wing engagement:
As prescribed
Oral hygiene:
Excellent
Fair
Patient’s estimated daily aligner wear:
20-24 hours
12-16 hours
Suggested probing questions to ask the patient:
How many hours a day are they out? Do you ever miss getting them back in after lunch? Do you ever have them out for a prolonged period of time?
Next aligners to dispense: ________ - ________
What areas need attention over these next aligners, ie attachment removal, open contacts, etc.
Teeth #:
_____________________________________________________________________________
Next visit:
Aligner delivery
+/- Attachments
Final work-up
Coached or complimented:
Yes
Additional notes: _____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
02
01
03
04
05
07
06
08
09
10
11
12
13
Maxillary
Mandibular
R L
8
7
6
5
4
3
21 1
2
3
4
5
6
7
8
8
7
6
5
4
32112
3
4
5
6
7
8
AA1
Other ________
No
No
No
No
Off schedule
No #________
Good
Good+ IPR
16-20 hours
Poor
PoorAdditional aligner/scan
<12 hours
15
14
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