Run AlignerBot as a solo clinician across multiple design rounds

One person can act as clinician, lab manager and operator on one workstation; this guide runs several rounds of AI clear aligner design with AlignerBot solo and helps you judge when that makes sense.

Audience: A clinician who has stood up their own Cympha lab and is running AlignerBot for their own cases on their own workstation. You act as the case owner, the lab manager, and the AlignerBot agent operator — there is no other human in the loop. You've already worked through Set up AlignerBot for your lab and the lab's AlignerBot pairing is live.

You'll come away knowing: how the multi-round Phase-1 / Phase-2 loop plays out when you wear all three hats yourself, why the structured-artefact rule (XML or .gpk) still applies even though there's no other party to enforce it, and when it's time to graduate from solo to a real designer on your team.

Time required: Around twenty-five minutes to read. A real multi-round case typically clears two or three rounds in a single working day, with most wall-clock spent in OrthoPlus.

Before you start

You need:

A Cympha lab that you control, with an AlignerBot seat on the team. One note on accounts: a Cympha account holds exactly one role, set once — so "wearing every hat" in practice means you control each of the accounts involved (the clinician account that submits, the Lab Manager account that runs the lab, and the AlignerBot seat the Agent Manager is paired to). The loop below reads the same regardless of how you split them.
A Windows workstation with GuideMia OrthoPlus installed and activated, and the Cympha Agent Manager installed and paired to the AlignerBot seat's Cympha email. The agent should show as paired. If anything in this list is unfamiliar, work through Set up AlignerBot for your lab and Install and pair Cympha Agent Manager first.
For any refinement round: either Cympha Studio's 3D review (to export an XML tooth-position file from the Phase-1 .gvw — Studio runs in the browser) or GuideMia OrthoPlus (to save a .gos.gpk transfer pack — available from app.cympha.com/downloads).
A confirmed scan set for the patient.

Why a clinician would run AlignerBot themselves instead of using ClearAligner.AI

The two paths look similar from the outside — both produce AlignerBot-designed aligners, both go through the same OrthoPlus Phase-1 / Phase-2 cascade — but the trade-offs are different:

ClearAligner.AI direct (/caai) is the lightest path: no desktop install, runs on GuideMia's central workstation, one credit per case. You get the design without owning the infrastructure. See Use ClearAligner.AI direct.
AlignerBot in your own lab is the heaviest path: you host the Windows workstation, you own the OrthoPlus seat, you run the agent. In return: no per-case credit (you've paid for the seat), the case files also live on your own machine, your own lab branding on the case, and the option to bring colleagues into the same lab later.

The solo clinician case is the in-between: you bought the OrthoPlus seat because you want full control, but you don't yet have a designer or a second clinician on staff. Cympha doesn't penalise you for being solo — the same roles and case lifecycle work whether your lab has one user or twenty.

How the round-trip plays out when you wear all three hats

The end-to-end mechanics are the same as AlignerBot — Phase-1 to Phase-2, with one practical difference: you're the only person who ever clicks anything, so the steps collapse into a tighter loop. Here's a typical day.

Round 1

As clinician, submit the case at app.cympha.com/cases/new. Search for your own lab, choose category AlignerBot, fill the patient + AlignBot params section, attach the upper and lower scans, submit.
As lab manager, open the case — it's sitting at Submitted, held by you. Move it to Designing; the status control previews who will receive it, and with the AlignerBot seat on the team it routes there.
As AlignerBot operator, you don't actually need to click anything — the agent on the workstation polls every 20 seconds, sees a case held by its paired user, claims the dispatch lock, downloads the scans into the workspace case folder, and launches OrthoPlus in planning mode.
OrthoPlus runs Phase-1 and saves its output into the workspace folder. The agent uploads the .gvw review file automatically and the case lands at Awaiting Approval with the Plan Approval Pending label — the review file arriving via the agent requests approval by itself.
As clinician, you get an email from Cympha. Open the approval page at /cases/<case-id>/approve. Review the .gvw in Studio.

You're now at a fork.

Round 2 — if you approve the Phase-1 plan

Approve the plan on the approval page. The case auto-advances: the status briefly hits Approved, then flips to Designing as the next cycle begins. On its next poll the agent claims the case again and OrthoPlus runs the Phase-2 cascade — generating per-stage aligner shells (or arch models, or bracket guides, depending on the Design kind you set at intake).

When Phase-2 finishes you get a second email from Cympha, this time with the Appliance Approval Pending label on the case. Approve, and the case advances to Delivered.

That's the two-round happy path. Most cases finish here.

Round 2 — if you request changes on the Phase-1 plan

Click Request changes instead of Approve. A confirmation dialog opens. Because AlignerBot enforces structured revision artefacts, the confirm button stays disabled until a file with extension .xml or .gpk is attached to the case. An amber notice spells out the two paths:

An XML tooth-position file exported from Cympha Studio's 3D review.
A .gos.gpk transfer pack saved from GuideMia OrthoPlus Planner.

You may be tempted to think "I'm the lab manager too, I can just chat the changes to myself" — that doesn't work. The block isn't a policy gate; it's a technical one. The OrthoPlus planner cascade has no English parser. A typed instruction has no input slot to land in. You either:

Open the .gvw in Cympha Studio's 3D review, edit the tooth positions, export them as an .xml, upload it to the case, return to the approval page, confirm.
Open the case in OrthoPlus on your workstation, edit, save the .gos.gpk transfer pack, upload it, confirm.

Once confirmed, the case flips to Changes Requested. The agent's next poll claims a fresh lock and re-dispatches OrthoPlus in planning mode with your XML or GPK applied. Phase-1 runs again, your edits baked in. Case returns to Awaiting Approval with Plan Approval Pending.

You're back at the fork. Approve, or refine again.

Round N — keep iterating until both gates are approved

There is no hard cap on the number of rounds a case can run. In practice:

One round (Approve, Approve) — the rare clean case.
Two to three rounds — typical. One Phase-1 refinement to fix a staging quirk, then approve through Phase-2.
Four or more rounds — usually a sign that the intake parameters need rethinking. Consider abandoning and submitting fresh with adjusted AlignBot params rather than continuing to refine.

Both gates have to be approved for the case to deliver: the Plan gate after Phase-1 and the Appliance gate after Phase-2. Either gate can be cycled independently. You can refine Phase-1 three times, approve, and then ship Phase-2 on the first try. Or approve Phase-1 cleanly and refine Phase-2 twice. Both paths are normal.

The structured-artefact rule applies to both gates — Request changes on the Appliance review also requires an XML or .gpk upload before the confirm button enables.

How this differs from ClearAligner.AI

Side by side, for a clinician running things themselves:

| | ClearAligner.AI direct | AlignerBot in your own lab | |---|---|---| | Where OrthoPlus runs | Cympha's central design service | Your own Windows workstation | | Where files live | Cympha cloud only | Cympha cloud + your local workspace folder | | Per-case cost | One credit on first self-approve (refinements free) | No per-case credit (you bought the OrthoPlus seat) | | Setup effort | Zero — just sign in at /caai | OrthoPlus install + Agent Manager + pairing | | Lab branding on case | None (no lab) | Yours | | Multi-user expansion later | No — /caai is single-clinician | Yes — grow your lab's team later |

A useful heuristic: at a steady, ongoing caseload the math leans toward the AlignerBot-in-your-own-lab path; for occasional cases, ClearAligner.AI is the lighter lift.

When to switch from solo to a real designer

A few signals that you've outgrown the solo model:

Approvals are starting to bottleneck on you. If another clinician at your practice is submitting cases to your lab, you're already the lab manager in real terms. Letting them submit and approve their own cases while you keep the lab-manager and AlignerBot-operator side is a clean split.
OrthoPlus is busy when you want to be reviewing. Phase-2 dispatches can take a while; if you find yourself waiting for OrthoPlus to finish on one case before you can review another, hire (or contract) a designer with their own OrthoPlus seat. Assign cases to them on /queue. Their Agent Manager dispatches their workstation independently.
You want to take vacation. A solo lab stops when the operator stops. If you want continuous coverage, you need a second user on the lab who can pick up cases when you're out.

The migration is non-disruptive: the new person signs up with the right role (Designer, or AlignerBot for another bot seat) naming you as lab manager, you approve them on My Team, and you start assigning. Cases already mid-flight stay where they are; new ones can go to either of you.

Troubleshooting

The case reached Designing but OrthoPlus never opened. Check the agent on the workstation is paired. If it is, check My Team: the case must be held by the AlignerBot seat specifically (not a plain Designer). The agent activates only for AlignerBot-seat assignments.

The agent is polling but my case stays in Designing forever. Open the case detail page and look at the Files panel. Are the scans fully uploaded (not stuck pending)? An incomplete upload leaves OrthoPlus erroring out on missing geometry. Re-upload any pending files, then click Re-run design on the case page to trigger a fresh dispatch.

Request changes confirm is greyed out. Same as ClearAligner.AI: no .xml or .gpk is attached to the case yet. Cancel the dialog, upload one, come back. Free-text changes in chat don't count.

Phase-2 doesn't dispatch after I approve Phase-1. The agent must see the case held by the AlignerBot seat. Check two things: (a) the case is still with the AlignerBot seat (look at the holder on /cases/<case-id>), and (b) the agent on the workstation that hosts it is paired. If both are fine and dispatch still hasn't happened after a few minutes, quit the agent from its tray menu, relaunch it, and use Re-run design — it also force-clears a stale dispatch lock, so you're never stuck behind a dead workstation.

I want to refine but the case is already Delivered. A delivered digital case no longer accepts file uploads, so the refinement loop is closed. To run another round on the same patient, submit a new case from the latest scans. (Delivered isn't an archive, though — the case keeps its holder for follow-ups until the lab manager clicks Mark as Finished.)

My case is escalated and stuck. Solo labs don't really have an escalation target — the lab-manager account is yours. If you (acting as clinician) clicked Escalate to lab manager by mistake, put on the lab-manager hat, open the case, and move it back to Designing so it routes to the AlignerBot seat again; use Re-run design if the agent doesn't pick it up.

The clinician chat is full of typed change requests I made before I learned about the XML rule. Those typed instructions are not invalid — they're just not actionable inputs to OrthoPlus. They live in the case history as context. The artefact you eventually upload (XML or GPK) is what actually drives the next dispatch.

Last updated 2026-07-30.