Clear aligner design in Maestro 3D: from STL files to printable models

What software can support—and what remains a clinical decision

Maestro 3D can support digital model preparation and tooth-movement planning, but software does not diagnose the patient or assume clinical responsibility. Before design begins, the treating clinician defines the diagnosis, objectives, acceptable compromises, need for additional diagnostics and any auxiliary mechanics.

Tool names and command locations may differ between product versions. Use official documentation and a valid licence for installation and version-specific functionality. This resource explains the clinical workflow; it is not a replacement for the manufacturer's manual.

1. Prepare the prescription and de-identified records

Create an internal case ID that does not contain the patient's name. Provide STL files or intraoral scans for both arches and the bite, photographs, diagnosis, treatment objectives, limitations and specific questions for the designer. Radiographic information, including CBCT, should only be used when clinically indicated and handled in accordance with data-protection requirements.

Before importing, record clinically relevant baseline information: crowding or spacing, incisor position, midlines, overjet, overbite, transverse relationships, periodontal risks, restorations, implants and planned procedures.

2. Inspect scans and bite registration

Review STL files for holes, noise, duplicate surfaces, blurred contact points and missing distal anatomy. The tooth–gingiva boundary needs to be sufficiently clear for segmentation and subsequent model generation. When a defect changes crown geometry or occlusion, rescanning is safer than manually inventing unknown anatomy.

Compare the virtual bite with photographs and the clinical registration. An incorrect bite at the input stage propagates through the entire plan and may create false contacts or an inaccurate vertical relationship.

3. Import models and establish orientation

Import the maxillary and mandibular models, confirm scale and orientation, and preserve an untouched source version. Align the models to clinically meaningful references rather than merely a convenient viewing angle. Keep separate files for the source data, working plan and approved plan so that the team can reconstruct the decision history.

Adopt one naming convention at this point: case ID, date, version and status. This simple control reduces the risk of printing an obsolete setup.

4. Prepare the models and segment teeth

Define clinical crown boundaries, separate teeth and verify long axes. Segmentation errors alter apparent centres of rotation, contact calculations and movement. Pay particular attention to crowded contacts, partially erupted teeth, unusual crown morphology and regions affected by scan artefacts.

Always inspect automated output manually. Gingival masks and virtual roots are modelling aids, not complete representations of patient anatomy. Compare root assumptions with diagnostic information when it is available and clinically justified.

5. Build the target clinical setup

Start with incisor position, arch form, midlines and occlusal objectives. Then allocate space and refine individual tooth positions. This sequence helps prevent local alignment from dictating an unwanted arch form or excessive proclination.

Inspect the dentition from frontal, occlusal and lateral views. Compare initial and final positions, translation, rotation, torque and vertical movement. The final simulation should follow the prescription rather than pursue a mathematically ideal arch regardless of biological and clinical limits.

6. Divide movement into stages

Once the target is defined, distribute movement across sequential aligners. Create space and establish anchorage before asking for active movement. Avoid assigning several demanding objectives to the same stage: major rotation, extrusion, torque and bodily movement have different predictability and retention requirements.

Inspect each intermediate stage, not just the beginning and end. Teeth should not pass virtually through one another, contacts should not block movement, and anchorage units should not drift unintentionally. Complex mechanics may need distinct phases and planned clinical checkpoints.

7. Plan space, IPR, attachments and anchorage

Specify IPR amounts and timing, checking access to contact points and whether the reduction is clinically feasible. Relate planned space to actual movement: it must be available before alignment or segment movement needs it.

Choose attachments for a defined biomechanical purpose. Assess the active surface, reliable transfer, occlusal interference and aligner retention. For elastics, buttons and cut-outs, define when they start and how the reactive unit is expected to respond. In complex cases, describe the force system first and then represent it in the setup.

8. Complete a clinical review before export

Use a separate clear aligner setup review checklist to verify objectives, occlusion, movement magnitude and sequence, roots, alveolar boundaries, IPR, attachments, anchorage and tracking risk. When possible, separate the design role from final clinical approval.

Record comments and the approved version number. If the setup changes after approval, repeat the review for affected stages and replace manufacturing files. A previous export must not be treated as automatically current.

9. Export models for 3D printing

Export approved stages only. Confirm model count, stage sequence and correct pairing of upper and lower arches. Use unambiguous filenames containing the case ID, arch and stage number. Before moving to a slicer, inspect mesh integrity, model base, closure and unwanted fragments.

Use the authorised export functions of properly licensed software and stay within the rights granted by your licence. Do not use unofficial methods to bypass licensing, export restrictions or product security.

10. Hand approved models into the laboratory process

Model printing is only the first manufacturing step. Document the validated printer and material profile, orientation and supports, post-processing, thermoforming parameters, trim line, polishing, labelling and final inspection. Keep the approved clinical setup separate from experimental production settings.

The complete sequence is covered in our in-house clear aligner manufacturing guide. Your workflow should make every finished aligner traceable to one approved digital model and production batch.

Digital workflow checkpoints