How a clinician runs an automatic aligner design round
Driving a round of automatic aligner design software as a clinician: review the AI plan, approve it, or request changes by uploading an updated tooth-position file.
The clinician's role in an AlignerBot case — automatic aligner design running on GuideMia OrthoPlus orthodontic software — is small, but it has one piece of structure that surprises every first-time user. This chapter walks the round end to end: opening the approval page, reviewing the staged plan in Studio, and the three actions that close the round — including the structured-input rule on Request changes.
You get an email when Phase-1 is ready
When OrthoPlus finishes its planning cascade and uploads the plan back to your case, status flips to Awaiting Approval with the Plan Approval label. You get an email titled "Design ready for your approval". The link takes you to the case's approval page.
Open the plan in Studio
The approval page lists the patient name, the status badge, the step label, and the files. Click the treatment-plan file to open it in Cympha Studio in a new browser tab. Orbit through the staged tooth positions, scrub the timeline, check the attachment placements, look at the simulated final bite. This is the same review surface a lab clinician would use — no install, no CAD seat.
Three actions, one of them structured
At the bottom of the approval page:
- Approve design — green button. Accept the plan. The case's revision bumps, the agent re-dispatches OrthoPlus in appliance mode, and Phase-2 runs.
- Request changes — rose button. Feed structured edits back into Phase-1. The dialog has one hard rule, covered below.
- Escalate to lab manager — route off the bot loop to a human lab manager.
Why Request changes blocks free text
When you click Request changes, a confirmation dialog opens with an amber banner reading "Upload one of the following first". The confirm button stays disabled until a file with extension .xml or .gpk is attached to the case.
This is not a policy gate. The OrthoPlus planner cascade has no English parser. A typed instruction in chat — "move tooth 8 buccally", "open the bite a bit", "less IPR on the upper" — has nowhere to land in the pipeline. The artefacts are the structured inputs OrthoPlus actually consumes.
The two valid artefacts
- XML tooth-position file exported from Cympha Studio's 3D review. Open the treatment plan, drag teeth in the 3D review surface, use Export tooth positions, upload the .xml to the case, return to the approval page, click Request changes again. The confirm button enables.
- .gpk transfer pack saved from GuideMia OrthoPlus Planner. If you have OrthoPlus locally, open the plan, edit, save as .gpk, upload to the case, confirm.
If you don't have OrthoPlus, the XML path is the right one. A Get the planner link in the dialog points at the downloads page if you want the desktop tool.
What happens after you confirm
The case flips to Changes Requested and the design revision counter bumps. Within about a minute the agent's next poll picks up the new revision, claims a dispatch lock, and re-runs Phase-1 with your artefact as the overlay input. The case returns to Awaiting Approval when the new plan is ready. You review again. Approve, or refine once more.
How many rounds is normal?
- One round — the rare clean case where the AI nails the plan first time.
- Two or three rounds — typical. One refinement to fix a staging quirk, then approve.
- Four or more rounds — usually a sign the intake parameters need rethinking. Consider abandoning and submitting a fresh case rather than continuing to refine.
What this changes
- For clinicians. Structured input means the AI does the thing you actually asked for. The artefact is the same shape the planner already understands, so the next round arrives correctly the first time.
- For labs. Refinements arrive as planner-ready inputs, not as designer tickets to interpret. A solo-clinician lab can run the loop entirely themselves; a multi-designer lab keeps refinements machine-consumed by default.
Try it
Open app.cympha.com and submit an AlignerBot case if you haven't already. The full clinician walkthrough is on cympha.com/docs/alignerbot-multi-round-as-clinician.
Part of Dental Case Lifecycle Management. Cympha runs every dental case as one tracked record — intake to outcome, across every doctor, lab, and supplier — instead of a dozen disconnected tools. What is DCLM? →