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OrthodonticsTechnology2 min read · July 22, 2026

by Dr.ssa Irene Ferrara

From file to smile: how a digital orthodontic plan is built

Scan, case study, simulation, aligner production, check-ups. What happens behind the scenes between the first visit and your first aligner.

Between the day you decide to align your teeth and the day you wear your first aligner there is work you never see. It is worth describing, because that is where the result is decided.

1. Collecting the data

You do not plan on an impression «by eye». Complete data is needed: an intraoral scan of both arches and the bite, standardised photographs of the face and arches, radiographs appropriate to the case. They are the starting picture, and will also serve later for comparison.

2. The case study

This is the phase that separates a plan from a tray. Occlusion, available space, tooth inclination, profile and periodontal health are analysed. We decide what has to move, by how much and in what order — and also what must not be touched.

It is also when we establish whether the case is genuinely treatable with aligners, with fixed appliances or with a combination: the choice follows the case, not the request.

3. The simulation

From the digital model a movement simulation is generated, step by step. It serves two purposes: designing the sequence and showing it to you. Seeing the starting position and the planned one makes the decision far more concrete.

An honest clarification: a simulation is a plan, not a promise. It represents the planned objective, while individual biology and consistency of wear influence the real path. That is why we hold check-ups and, if needed, re-plan.

4. Production

From the plan, aligners are generated or the fixed appliance is customised. Each step corresponds to a programmed movement of limited extent: it is the sum of small displacements that produces the result.

5. Check-ups, where the plan meets reality

At check-ups we verify that teeth are following the simulation. When reality diverges — it happens, and it is normal — we act: attachments are added, timings are changed, and in some cases we rescan and re-plan the remaining part.

What depends on you

With aligners, a great deal: they must be worn consistently according to the schedule, removed only to eat and to clean your teeth. A perfect plan with intermittent wear gives an intermittent result. It is the variable that weighs most, and the only one we cannot control.

Sources

Frequently asked questions

Does the 3D simulation show a guaranteed result?

No. It is the planned project, not a promise of outcome. The real path also depends on individual biological response and consistency of wear, which is why it is verified at check-ups.

How long must I wear aligners each day?

They must be worn according to the prescribed schedule, removed only to eat and clean your teeth. Consistency is the factor that most influences success.

What if a tooth does not follow the simulation?

It happens and it is manageable: it is assessed at a check-up, attachments can be added, timings changed, or the remaining part rescanned and re-planned.

Clinical review: Dr.ssa Irene Ferrara

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