Use OrthoPlus — your first clear-aligner case end-to-end

This walkthrough takes a first case through OrthoPlus, GuideMia's clear aligner software, from raw intraoral scans to a saved .gpk with segmentation, tooth setup, staging, attachments and IPR.

Audience: A designer who already has GuideMia OrthoPlus activated on a workstation and wants to walk a clear-aligner case from raw intraoral scans to a saved project and an uploadable deliverable, the first time.

You'll come away knowing: how the workflow pages are organised, how to load scans on Data Preparation, repair them with Fix models, segment teeth, finalise the tooth setup, stage the movements with Automatic Staging, add attachments, and hand the finished work back to Cympha.

Time required: Budget a generous first session — the first walkthrough is about learning the pages. Cases go much faster once you know where everything lives.

Before you start

You need:

OrthoPlus installed and activated on a Windows workstation. If you haven't done that yet, follow Set up AlignerBot for your lab — it covers the subscription, the activation code (valid for 10 minutes, one machine), and the installer. The rest of this doc assumes the main OrthoPlus window is already open.
An upper and a lower arch scan — stone-model digitisations and intraoral scans are both first-class inputs.
(Recommended) An additional bite scan. For severe malocclusion you can mount models on an articulator (or do it virtually), scan at a different bite position, register upper and lower to it, and plan on the newly articulated jaws.

If you're running this case for a Cympha AlignerBot assignment, open it from the case folder the Cympha Agent Manager downloaded and keep your outputs in that folder — the agent watches it and uploads the deliverables back to the case.

How OrthoPlus is organised

OrthoPlus is not a locked linear wizard — the Workflow toolbar carries named pages you can jump between: Data Preparation, Case Data Processing, Tooth Segmentation, Tooth Alignment, Planning Final Positions, Movement Planning, Aligner Design, Aligner or Model Design, Bracket Bonding Guide Design, Case Restart, and Reporting. This walkthrough follows the natural order for a first aligner case.

The fully automatic alternative. The toolbar also has an AlignerBot button — the automatic treatment planning and design wizard. Its own status tip says it best: "This button will automatically finish all the required planning and design. You can just enjoy your time and watch this to be finished." It stays disabled until the data is ready. The manual walkthrough below is what AlignerBot automates — knowing it is how you review and adjust what the bot produces.

Step 1 — Load the scans on Data Preparation

On the Data Preparation page:

Load plaster model — the input labelled "Upper jaw stone model or intra-oral scan". Pick your upper arch file.
Load lower jaw scan — the lower arch.
Add additional bite scan if you have one — this is what enables re-articulating the case at a different bite position.
Optionally Load facial scan (Face Scan) and Add Pictures — face scans and 2D photos are first-class case inputs, useful for the final report.

Step 2 — Repair the scans with Fix models

Click Fix models ("This will bring up model fixing tools") — scan repair is its own named step, before segmentation.

All-in-One Fix is the single-click starting point. Its tooltip says it handles "many surface artifacts and non-manifold geometries" and "can even remove holes connecting lingual and buccal side in interproximal area". For most scanner output this is all you need.
The toolbox also carries individual, named operations for specific problems — among them Mesh Optimization, Fill holes, Remove nonmanifold, Plaster Model Scan Cleanup, Remove attachments or brackets, and Smart Fix — organised into groups so you can go after one defect at a time.
Reduce Undercuts deserves a note: it deliberately does not block out all undercuts, "because that would cause aligners to be too loose" — it reduces the level of undercuts instead. That aligner-fit thinking is baked into the tool; trust the default before overriding.

Spend more time here only if the mesh has obvious artefacts. A clean mesh makes every later step better.

Step 3 — Segment the teeth

Move to the Tooth Segmentation page.

Click Automatic Segmentation — the primary action. OrthoPlus separates the arch into individually addressed tooth meshes.
If a single tooth comes out wrong (heavily restored, partially erupted), use the Manual tooth segmentation group instead of re-running the arch: Define tooth boundary, then Segment tooth, then Adjust tooth boundary as needed. Change tooth number fixes a mislabeled tooth.
Finish with the Post Processing functions — Fix all for the jaw, Smooth all boundary, Optimize tooth orientations, Fix interproximal areas, and Smooth current tooth boundary — to clean up boundaries across the jaw in one pass.

The page shows a live Bolton Index: readout as you work — an early sanity check on tooth-size discrepancy before you plan anything.

Why this matters. Every downstream step — setup, staging, attachments, IPR — operates on individually addressed teeth. Garbage segmentation cascades into a garbage plan. Spend the extra minute now.

Step 4 — Plan and preview the tooth setup

The Initial Treatment Plan dialog is where the plan parameters live, with an Upper Jaw Plan and a Lower Jaw Plan section:

Plan Range has exactly four options — All, 3-3, 4-4, 5-5. Sometimes it makes more sense to allow moving all the teeth; sometimes it is better to move just some.
Per-jaw movement parameters (protraction/retraction, expansion, extrusion/intrusion, Spee curve, allowed IPR, and more) are all editable.
Automatic Decision lets the system determine the major control parameters — and it unchecks itself the moment you hand-edit any value, so you always know whether you're on automatic or manual.
The dialog itself prints the caveat that some parameters (lower jaw extrusions, Spee curve height) "are rough estimations. The actual results are subject to various factors." Treat them accordingly.

Then shape the arch and preview:

In the Dental Arch Setup section, fit the arch with the Width and Curvedness sliders, per jaw. Too narrow / too wide is the most common mistake on this step. Show arch curves displays the curves while you work.
Drag the Preview initial tooth setup slider — the value is the percentage the teeth will likely be moved; 100% means the teeth move all the way to the ideal arch curves. Scrub it to judge the setup before committing.
Click Finalize — OrthoPlus runs collision/IPR adjustment and the Spee-curve movement to lock in the final positions.

Step 5 — Stage the movements

On the movement-planning side:

Set Upper Steps and Lower Steps — the number of steps per jaw, set independently.
Click Automatic Staging. It reruns all tooth movements, adjusts positions mid-simulation so all collisions are eliminated, and sets key frames for every tooth — key frames render as red text in the movement table. Note that some steps may be added to the plan as a result; that's the stager resolving collisions, not a bug.
Movement limits are governed by named profiles in the System Settings dialog — Regular, Substantial translations, Substantial rotations, Substantial translations and rotations, Minor movements — with per-step and total limits underneath. Pick the profile that matches the case; edit limits only when you know why.
Review by playing the case: Playback movements (or Playback movements with soft tissues to watch the gingiva follow).

If something is wrong from a given step onward, you don't have to restart — staging can be re-planned from an arbitrary step (Plan from step).

Step 6 — Attachments

Click Automatic attachments. In the tool's own words: "The system will automatically determine which teeth need attachments or force ridges, also known as power ridges, and what kind of attachments are needed, as well as how big they should be. The system has a full set of criteria to make the initial decisions, but you can always add, delete or modify the attachments or force ridges."

Review the placements tooth by tooth and adjust where clinical judgment says otherwise — the automatic pass is a starting point, not a verdict.

Step 7 — Generate the design output

On the Aligner or Model Design page, the key decision is output type: leave the default for arch models for thermoforming, or tick With aligner/retainer files to "create aligner or retainer models for direct printing, instead of arch models for thermoforming".

Then generate — Generate Upper Models, Generate Lower Models, or Generate All Models, over an explicit Step Range if you don't want everything at once. Add/Update Case Tag places the case name and step number on the models so printed parts stay identifiable. The Review Design section lets you step through the generated arch models, trimming paths, and aligner models — and edit them — before anything leaves the workstation.

Step 8 — Save, and hand the work back to Cympha

Three artifacts matter, and they are not interchangeable:

The project file (.gos). OrthoPlus's native project. Each case keeps one stable .gos you save and reopen across sessions. It stays on the workstation — it is not the thing you upload.
The plan-review file (.gvw). The lightweight review export a doctor opens in Cympha Studio to inspect the staged plan in the browser.
The Save-for-Transfer pack (.gos.gpk). The uploadable deliverable produced when a design phase is complete — the whole project packed for transfer.

How they reach the case:

Via the Cympha Agent Manager (the unattended path). If the case folder is the one the agent manages, a .gvw review file arriving through the agent on a case in Designing automatically flips the case to Awaiting Approval with the Plan step and emails the doctor — no lab click involved. A .gos.gpk transfer pack arriving through the agent on an aligner case sitting at Approved or Changes Requested automatically fires the Appliance approval the same way.
Via the browser (the manual path). You can also upload the .gvw or .gos.gpk on the case page at app.cympha.com. Browser uploads never auto-trigger approval — the case stays where it is until someone on the lab side clicks Request Approval, so the lab can vet the files first.

What happens next

The doctor reviews on the case's approve page. Approval on the Plan step sends the case back to Designing for the appliance cycle; approval on the final cycle delivers the case. If the doctor wants changes on an AlignerBot case, they must attach a structured revision artifact — an XML tooth-position file exported from Cympha Studio's 3D review, or a .gos.gpk transfer pack — free-text change requests can't be applied to the planner.

Troubleshooting

Automatic Segmentation puts a boundary across the gum line on one tooth. Use the Manual tooth segmentation tools for just that tooth — Define tooth boundary, Segment tooth, Adjust tooth boundary. Don't re-run the whole arch.

The finalised setup looks unnatural. The arch curve is the culprit most of the time. Re-fit the Width and Curvedness sliders to the patient's actual arch shape, scrub Preview initial tooth setup again, then Finalize.

Staging added steps I didn't ask for. That's Automatic Staging eliminating collisions — it may add steps to keep every movement feasible. Review the added steps rather than deleting them.

I saved my deliverable but the case on Cympha didn't move. Check the Cympha Agent Manager tray icon is paired and the file is inside the agent's monitored case folder — files saved elsewhere aren't seen. And remember only agent-delivered files auto-trigger approval; a browser upload waits for a manual Request Approval.

Activation expired mid-setup. Activation codes are valid for 10 minutes and activate one machine. Generate a fresh code from your account page and paste it into the activation dialog.

Last updated 2026-07-30.