8 key components to creating aligners in-house with CS Model+

The rise of direct-to-consumer…everything means patients like their aligners like they like their prescriptions, air filters, contacts and propane tanks: Designed just for them, delivered in just a few days and preferably in a nicely wrapped box. When you print your patients’ aligners in-house, you can offer that speedy, easy experience that patients have come to expect; perhaps minus the cutesy packaging, but with the hugely added benefit of clinician-guided care.

With complete control over the aligner design process, CS Model+ v5 allows for a fast and straightforward treatment planning that lets you deliver aligners sooner than major third-party manufacturers, and at a smaller cost. The software also helps you to easily assess the case level of difficulty and determine if aligner treatment is possible, so you can set patients’ expectations right from the start. In addition, you can help your patients visualize their treatment setup thanks to videos that illustrate the progress made throughout treatment; thereby boosting case acceptance.

  1. CS 3600 or CS 3700 intraoral scanner

  2. CS Model+ v5 software

  3. Tokens to activate model export

  4. 3D printer (Recommend FDA-approved dental printer)*

  5. Pressure forming machine*

  6. Thermoplastic aligner sheets*

  7. Tools (Shears, polishing tool)*

  8. Packaging for aligners*

Let’s take a look at each of these in detail.

1. CS 3600 or CS 3700 Intraoral Scanner

It all starts with a digital impression. While you can use a Carestream Dental CBCT device to scan a conventional impression, we recommend that you use the CS 3600 or CS 3700 intraoral scanner to directly acquire a digital impression.  Intraoral scanners streamline your workflow by generating a digital model within minutes and providing patients with a significantly more comfortable impression experience. 

PRO TIP: While both scanners are known for their accuracy, the turbo-scan speed of the CS 3700 makes it the ideal choice for orthodontics and aligner treatment as you will need to scan both of the patient’s full arches.

CS 3700 Scanner.png

2. CS Model+ v5 software

CS Model+ will automatically convert the digital dataset into a 3D model that you can utilize for your orthodontic and aligner treatment planning needs.

You will need to install the latest version of CS Model+ software to access the new aligner design capability.  If you are currently enrolled in a CS Advantage plan, then the version 5 update is included in your plan and instructions for installing the update will be sent via email.  If you are not enrolled in CS Advantage, a one-time software upgrade to version 5 can be purchased (contact your sales representative or dealer to purchase the update).

CS Model+ introduces new functionality in version 5 to help you address your aligner treatment planning needs, and allows you to:

  • Save time thanks to Artificial Intelligence (AI), which automatically detects and labels teeth

  • Create an aligner treatment setup, and generate each step associated with the treatment

  • Assess the case’s level of difficulty via color mapping and the Degree of Difficulty index

  • Determine whether interproximal reduction (IPR) is needed, and if so, how much

  • Choose from a wide selection of attachments included within CS Model+

  • Select advanced model export settings for printing to a third-party FDA approved printer

  • Automatically obtain generated, customized patient reports

PRO TIP:  CS Model+ empowers you to deliver a more personalized orthodontic consultation, allowing you to show patients the treatment setup video that allows them to visualize their dentition transforming throughout the treatment process, engaging your patients right from the first consultation appointment while also helping you track patient compliance.

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3. Tokens to Activate Model Export

CS Model+ utilizes a token system to activate the export for generation of the 3D printed models of the intermediate steps. In order to purchase tokens, you will need to create an account on the Carestream Dental eCommerce platform if you have not done so already.  To create the account, visit the eCommerce site, select login, and then click Create Account.

Customer Registration Screenshot.png

 After you have created the account and it has been validated, you will be able to access and/or modify your credentials, place and view your orders and manage your account. 

Once your tokens have been purchased, your account balance will be automatically credited in CS Model+ software, and the transaction summary will be automatically sent to your email address.  To view your account balance, click on the token icon in the upper right corner of CS Model+ software.  You can also purchase additional tokens from the token balance window if needed.

token icon.pngToken icon

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Token balance window

The Token balance window also allows you to access your token usage history and the list of cases that you have previously exported from CS Model+.   To view your current balance, click the Token history button in the upper right corner of the window.  

token history.pngToken history

PRO TIP: CS Model+ offers volume discount pricing, and the fee to export a case varies based on the number of cases being purchased.  For this reason, it is advantageous to purchase multiple cases at once. 

4. 3D Printer

If you plan to fabricate aligners in-house, you will need to invest in a 3D printer. While Carestream Dental does not sell 3D printers, we have been actively engaging with leading manufacturers in the dental industry to provide you with the best aligner solutions for your practice.  Visit our third-party validated 3D printer partner page to see which printers have been validated for use with CS Model+ for the printing of models required for the fabrication of in-house aligners.†

You will use the 3D printer to generate the physical model for each of the steps.  Export options in CS Model+ now include the ability to:

  • Choose whether to print the model with an ABO base, reduced base, no base, or the current acquisition

  • Select a full or hollow model

  • Determine model thickness

  • Add the patient’s name and the aligner step to the model

Be sure to check with your printer manufacturer and resin supplier for rinsing instructions and curing units recommendations for your printed models. 

PRO TIP: Adding the patient’s name and the step or aligner number can help reduce confusion when fabricating aligners.

CS Model+ Printers.png

5. Thermoforming machine

Once you have produced the 3D printed model, you will need to fabricate the aligners with a thermoforming machine.  Thermoforming utilizes a process by which a plastic sheet is heated and then a pressure is used to form and shape the sheet around the 3D printed model, generating the aligner.

You can use either a vacuum thermoforming unit or a pressure forming unit.  Both types of units follow the same basic process.

  • A thermoplastic sheet is heated and softened to prepare it for the molding process

  • Once softened, the sheet is positioned directly above the 3D printed model

  • The warmed sheet is then sucked down onto the surface of the mold using vacuum pressure (and if you are using a pressure forming unit, positive pressure is used in addition to the vacuum to help push the plastic into place around the model

  • The sheet is allowed to cool, and then now formed aligner is removed from the model

  • The aligner is then trimmed and the excess plastic removed

6. Thermoplastic Aligner Sheets

When choosing the thermoplastic material for your aligners, it’s important to consider the role of an aligner, which is to use pressure to move the teeth.  It is important to choose an aligner material that is rigid enough to move the teeth yet is flexible enough be placed over the teeth and snap onto the attachments.  Some current manufacturers include Taglus, Zendura, Ortho Technology, and Essix Ace.

Thermoplastic sheets are generally available with single-layer and multi-layer options.  While multi-layer is generally more expensive, it does produce a much higher quality aligner.

7. Tools

You will need scissors or shears to cut the aligner from the thermoplastic mold.  Once the aligners have been cut, the sharp edges will need to be smoothened using a polishing burr. 

PRO TIP: Keep in mind that if you plan to scallop the edges, you will not only need a smaller pair of sheers to make the precise cuts around each tooth, but you will also need to plan more time to trim each aligner.

8. Packaging for Aligners

Once the aligners are trimmed and polished, they are ready to be delivered to your patients.  If you would like to provide a similar experience to major third-party manufacturers, you can deliver the aligners in individually packaged resealable or thermo-sealed bags along with a case for storing the aligners when not in use. 

PRO TIP: Your brand should be present in every contact you make with your patients, so if possible, purchase aligner cases that can be customized with your practice name, logo and phone number. 

Expectations in both our day-to-day lives and the oral healthcare profession have evolved: Things should be faster, easier, less messy, more intuitive. Fortunately, digital solution sets meant to work together in any number of combinations let practices design a workflow that helps them deliver faster treatment and exceptional care and meet patients’ demands.

Requires the use of a third-party FDA approved printer, production machine, and materials.


The Digital Stream Carestream Dental Blog Administrator


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