ClearAligner.AI — direct-to-clinic, no lab in the middle

ClearAligner.AI lets a clinic with no lab run the pipeline behind AI clear aligner design with AlignerBot, paying per case in credits, reviewing Phase-1 free and self-approving Phase-2.

Audience: Clinicians who want to run the AlignerBot pipeline on their own cases without sending them to a lab. You pay per case in credits, Cympha's central design service does the design work, and you self-approve.

You'll come away knowing: how to submit a case at /caai/cases/new, how the central design service runs OrthoPlus on your behalf, how credit consumption works on self-approve, and how this differs from a lab-mediated AlignerBot case.

Time required: Around twelve minutes to read. A real case is typically back from Phase-1 within a few hours and from Phase-2 within hours of self-approve.

Before you start

You need:

A Cympha account. You can sign up directly from the ClearAligner.AI public splash at app.cympha.com/caai, or come from clearaligner.ai, or sign up at app.cympha.com/sign-up. Any of these routes works.
A pair of intraoral scans (upper + lower STL or PLY). Bite, photos, and CBCT are nice-to-haves; only the two arch scans are strictly required.
A way to pay for credits — a credit card. CAAI uses per-case credits, not a subscription.
No lab, no workstation, no GuideMia desktop install on your end. The design runs centrally — you don't install anything.

If you came here from the lab-mediated workflow and want to know the difference: in AlignerBot — Phase-1 to Phase-2 the lab routes the case to a workstation in the lab, and the lab's Cympha Agent Manager dispatches OrthoPlus. In the CAAI flow, there is no lab — Cympha's central design service runs OrthoPlus for you.

Step 1 — Land on ClearAligner.AI and sign in

You can arrive at /caai two ways. Either you came from the public marketing splash and clicked through, or you signed in at app.cympha.com and navigated to /caai via the sidebar.

The splash at /caai lists what CAAI does in three steps — upload scans, AI plans the case, you get the design back. The hero CTA is Get started (which becomes Submit a case if you're already signed in). Signed-out visitors get a secondary Sign in CTA underneath.

If you sign up here for the first time, the Select Your Role screen still applies — pick Clinical (the clinician role); CAAI doesn't need a lab, so there's no lab manager lookup. You land back on /caai with a primary CTA pointing at /caai/cases/new.

Step 2 — Buy credits at /credits

CAAI is priced per case, not per month: one credit covers one ClearAligner.AI case end-to-end. Before you can self-approve a plan, you need at least one credit on your account.

Open app.cympha.com/credits. The page shows three packages: Single case (1 credit), Five-pack (5 credits, with the Popular ribbon), and Ten-pack (10 credits). Click Buy on the one you want. A secure checkout opens; after payment your balance updates. The prices shown on the page are the authoritative ones.

If you want to try the pipeline before committing, you can submit a case without credits. Phase-1 planning is free; the credit is charged only when you self-approve to dispatch the appliance design — and re-runs on the same case are free.

Step 3 — Submit a CAAI case at /caai/cases/new

From /caai, click the primary CTA — it routes to /caai/cases/new. The form is intentionally minimal compared with the full /cases/new page. Four sections:

Files — a drop zone for the upper and lower scans (plus anything else you want to attach). Same uploader as the regular /cases/new. The case is created as a draft on mount so uploads attach immediately.
Patient and treatment plan — patient name (required), gender, date of birth, complaints. Below that, the AlignBot params (per-jaw plan range, automatic extraction, extraction teeth, missing teeth, allowed IPR, protraction/retraction, expansion, extrusion/intrusion, middle-line alignment, Spee curve, sagittal/coronal inclinations).
Phase-2 design options — what OrthoPlus should produce after you approve the plan. Four mutually-exclusive options:
- Arch model (the default) — generate arch models suitable for bracket bonding.
- Aligner models — generate aligner shells per stage.
- Bracket bonding guide — generate bonding guides.
- Treatment plan only — stop after Phase-1 planning. Don't dispatch Phase-2 at all. Plus optional From step / To step range, Add attachments (relevant for aligner + arch model), and Generate cutting path (relevant for aligner).
Submit — promotes the draft to a real ClearAligner.AI case.

You don't pick a lab. There is no lab. ClearAligner.AI cases are handled exclusively by Cympha's central design service — they never appear in any lab's queue.

Step 4 — The central design service runs Phase-1

Shortly after submission, Cympha's central design service picks the case up and runs the same OrthoPlus planning cascade a lab workstation would run.

The result is the same artefact a lab would have produced: a .gvw (the Studio-viewable plan) with staged tooth positions over N steps, IPR map, and attachments. It's uploaded to the case, and status flips from Designing to Awaiting Approval with the system label Plan Approval Pending. You get an email from Cympha.

Step 5 — Review the plan free of charge

Open the email link or navigate to /cases/<id>/approve. You see the standard approve page: header with the patient name + Awaiting Approval badge + step label "Approval needed — Treatment Plan". The lab slip download. The file list.

Click the .gvw file to open it in Cympha Studio in a new tab. Orbit through the staged tooth positions, scrub the timeline, check the attachment placements. This is the same review surface a lab clinician would use — read-only access to the OrthoPlus output.

Reviewing is free. The credit charge only fires when you advance the case past Phase-1.

Step 6 — Self-approve (1 credit) or request changes

At the bottom of the approve page, three actions:

Self-approve — accept the plan. This charges 1 credit and dispatches Phase-2.
Request changes — bounce the plan back for another pass. Same structured-artefact rule as the lab-mediated AlignerBot flow: you must upload an XML tooth-position file (exported from Cympha Studio's 3D review) or a .gos.gpk (saved from GuideMia OrthoPlus) before the confirm button enables. Free-text instructions are not accepted — the planner has no way to consume them.
Escalate to lab manager — not meaningful in the CAAI flow since there is no lab.

If you self-approve, the central design service re-runs OrthoPlus in appliance mode with the Design kind you chose at intake. Phase-2 runs.

The full review-page behaviour is documented in Approve or reject a design.

Step 7 — Phase-2 returns the appliance design

OrthoPlus produces what your Design kind asked for:

Arch model — arch model STLs ready for bracket bonding.
Aligner models — aligner shell STLs per stage, optionally with attachments and cutting path.
Bracket bonding guide — bonding guides.
Treatment plan only — nothing. The case stops at Phase-1 approval; no second dispatch fires. You'd skip the rest of this step.

The appliance files are uploaded to the case. Status flips to Awaiting Approval again with the system label Appliance Approval Pending. You get a second email from Cympha.

Step 8 — Final approval and download

Open /cases/<id>/approve for the appliance step. Review the files — typically you'd download a few STLs to spot-check. Approve. Status flips to Approved and then to Delivered. No further credit is charged — the case was paid when you first self-approved.

You can now:

Download all files from the case detail page's Files section. Each file has a download icon.
Share to Patient — click the button in the case header to send the .gvw to the patient. The patient gets an invitation email from Cympha, signs up, opens /patient, and views the plan in Studio. The patient-share flow is identical to the lab-mediated flow — see Share a treatment plan with a patient and Open your treatment plan as a patient.

If you also want to enrol the patient in ortho monitoring (cadence-based photo check-ins against the planned tooth positions), see How to enroll a patient in Ortho Monitoring. Monitoring works the same way on a CAAI case as on a lab-mediated one — same .gvw, same monitoring workspace.

What success looks like

End state of one CAAI case:

One credit deducted from your balance, visible on /credits.
Two approvals in the case activity log — Treatment Plan and Appliance Design.
Status Delivered on /cases/<id>.
Files panel has the original scans, the Phase-1 plan (.gvw), and the Phase-2 appliance files matching your Design kind.
No lab involvement, no designer involvement. The case stays yours end to end.

Troubleshooting

I submitted but Phase-1 never came back. Confirm both upper and lower scans are present and confirmed (not stuck mid-upload) on /cases/<id>. The design won't dispatch without both scans. If the scans are fine and the plan still hasn't arrived after a reasonable wait, contact Cympha support.

I clicked to approve and got "Insufficient credits". Your balance hit zero before the case was paid. Buy credits on /credits and approve again — the case stays in Awaiting Approval waiting for you. Once the balance is replenished the approve action retries cleanly.

Request changes confirm button stays disabled. You haven't uploaded an .xml or .gos.gpk yet. The dialog itself surfaces the two valid paths. For an .xml, open the .gvw in Cympha Studio's 3D review and export the tooth positions. For a .gos.gpk, you'd need GuideMia OrthoPlus locally — but most CAAI clinicians don't have that, so the .xml path is usually the right one. There's no free-text rejection in CAAI.

The case shows up in a lab queue even though I'm not a lab manager. That shouldn't happen — ClearAligner.AI cases aren't lab-routed. If you see one in a lab queue, check /profile: CAAI is designed for the Clinical role, not a lab role.

My credit balance didn't move when I approved. The credit is charged once per case lifetime — if this case was already paid, re-runs and re-approvals don't deduct again. /credits shows the authoritative balance.

Can I use CAAI on behalf of a patient if I'm not a clinician? The CAAI deliverable is planning output meant for a clinician to interpret — it's a starting point for a clinical decision, not advice and not a substitute for one. Treat it exactly as you would a lab's deliverable.