---
title: [Webinar Recap] Why In-House Aligner Fabrication Will Change Your Practice with Dr. Lisa Alvetro
description: Discover how in-house aligner fabrication can enhance your practice, improve patient experience, and increase control over treatment with Dr. Lisa Alvetro's insights.
image: https://learn.voxeldental.com/hubfs/VOXEL%20Blog%20Images%20-%202026-09-25T090217.071.png
---

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# \[Webinar Recap\] Why In-House Aligner Fabrication Will Change Your Practice with Dr. Lisa Alvetro

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![dr. lisa alvetro aligners and retainers](https://learn.voxeldental.com/hubfs/VOXEL%20Blog%20Images%20-%202026-09-25T090217.071.png)

What if a patient could say yes to clear aligner treatment and start wearing their first aligners before the end of the day?

That was one of the possibilities Dr. Lisa Alvetro explored during our recent webinar, **“Why In-House Aligner Fabrication Will Change Your Practice.”**

Drawing from more than a decade of experience with in-house aligner workflows, Dr. Alvetro demonstrated how bringing scanning, treatment planning, 3D printing, and aligner fabrication into the practice can give clinicians greater control over treatment while dramatically reducing turnaround times.

Her message was simple: in-house aligners aren't just about replacing an outsourced manufacturing process. They can change how a practice approaches aligner therapy altogether.

Watch the 60 minute webinar: [click here](https://events.zoom.us/ejl/ApjoTUoNpaZgsHGhqdYDB89sNtDYItRrI6wYngt7O1aYEd6ztjf0~A8oZ8UvAw934_OzI-JrDHIKFXRivYaH3x-_dcKGti8NKp2VNVZ-kizmmcEWcmbTuk3D-UR4K7Axg0yDSA7y6-Kp_kJrZOvAXZZBoI-22MY8AV4kDRyNl4W-9HLN8fst-Q/81CPWKX2Qwy1ATdOFg0uFw/video/kWRbtEJESNGJOVIYG-aFNQ). (Sign in to Zoom to view).

## From Scan to Aligners in About an Hour

Dr. Alvetro opened the presentation by demonstrating what a streamlined in-house workflow can look like.

Her example started with an intraoral scan of both arches, taking approximately five minutes. The scan was then uploaded into uLab, where auto-segmentation helps prepare the case for treatment planning.

After completing the initial movements and staging, the first models could be exported and printed. Using a Formlabs Form 4B, Dr. Alvetro explained that her team can print approximately eight models in 11 minutes with fast model resin. After post-processing, the aligners themselves take roughly one minute each to fabricate.

The complete workflow? Approximately **55 minutes**.

That creates a very different experience for a patient who is ready to begin treatment. Instead of scanning today and returning weeks later, Dr. Alvetro described being able to tell a patient to go to lunch and come back ready to start treatment.

![Screenshot 2026-09-25 at 9.14.37 AM](https://learn.voxeldental.com/hs-fs/hubfs/Screenshot%202026-09-25%20at%209.14.37%20AM.png?width=864&height=482&name=Screenshot%202026-09-25%20at%209.14.37%20AM.png)

## The Biggest Advantage: Control

Speed may get a patient's attention, but Dr. Alvetro repeatedly returned to another benefit throughout the webinar: **control**.

When aligners are outsourced, the doctor's treatment intent has to be communicated to someone else and interpreted during the setup and manufacturing process. That can lead to a cycle of submitting records, reviewing setups, requesting revisions, approving treatment, waiting for fabrication, and waiting again for shipping.

With an in-house workflow, clinicians can make many of those decisions themselves and adjust them in real time.

That includes control over:

- Staging and the sequence of tooth movement
- Number of aligners
- Attachment size, shape, and placement
- Blockout
- Trim lines
- Aligner material and thickness
- Velocity of tooth movement

Those variables can also be changed throughout treatment based on how an individual patient is responding.

Rather than adapting the patient to a predetermined series of aligners, the aligner protocol can continually adapt to the patient.

![Screenshot 2026-09-25 at 9.14.52 AM](https://learn.voxeldental.com/hs-fs/hubfs/Screenshot%202026-09-25%20at%209.14.52%20AM.png?width=869&height=482&name=Screenshot%202026-09-25%20at%209.14.52%20AM.png)

## Think in Intervals, Not 50 Aligners at Once

One of the most interesting concepts Dr. Alvetro shared was her **interval aligner protocol**.

Instead of planning and manufacturing an entire treatment series upfront, she generally prefers to work in intervals of approximately 10 to 12 aligners.

The patient completes that interval, the practice scans again, evaluates the clinical response, and plans the next series.

Dr. Alvetro compared the concept to changing archwires during traditional orthodontic treatment: evaluate how the patient responded to the previous stage, then determine what should happen next.

Breaking treatment into intervals can make even complex cases more manageable. It also creates opportunities to modify treatment along the way. If the patient is responding well, movement may be adjusted accordingly. If the patient is sensitive or teeth aren't tracking as expected, the next interval can be modified.

It can also reduce waste. If a tooth stops tracking at aligner 12, there aren't dozens of already-manufactured aligners that may no longer reflect the patient's actual dentition.

## Customizing the Aligner to the Patient

In-house fabrication also creates opportunities to customize details that might otherwise be standardized.

Dr. Alvetro demonstrated how trim lines, for example, can be changed based on the clinical situation. One area might require a scalloped cut while another requires a straighter or higher cut. Those decisions can even change as treatment progresses.

Blockout can also be adjusted by region or even by individual tooth. This can be particularly useful around restorations, implants, significant undercuts, or areas where a patient has difficulty inserting or removing an aligner.

Attachments don't necessarily need to become more complicated either. Dr. Alvetro prefers simplifying her attachment strategy, frequently using wedge-shaped attachments positioned differently depending on the desired movement.

The goal isn't complexity for complexity's sake. It's giving the clinician enough control to make the appliance work for the individual patient.

## When an Aligner Stops Tracking, You Can Respond Immediately

Anyone who provides clear aligner therapy eventually encounters a tray that stops tracking.

With an outsourced workflow, that can mean another scan, another submission, another setup, manufacturing, shipping, and potentially weeks before the patient has the appropriate appliance.

An in-house workflow changes that equation.

Dr. Alvetro explained that a patient can be rescanned and, in some situations, leave with the beginning of a new series that same day.

That speed becomes particularly valuable because treatment doesn't have to continue based on a prediction made months earlier. The clinician can respond to what is actually happening in the patient's mouth.

## A New Tool for Minor Tooth Movement

Not every patient needs comprehensive orthodontic treatment.

Dr. Alvetro highlighted several situations where in-house aligners can make smaller treatments much more practical, including:

- Minor crowding
- Small rotations
- Relapse after previous orthodontic treatment
- Retainer noncompliance
- Space management before restorative treatment
- Closing or adjusting contacts
- Tooth positioning before implants
- Post-restorative adjustments
- Finishing after fixed orthodontics

Without an in-house workflow, the outside lab fee for a two- or three-aligner correction can make these cases difficult to justify.

When the aligners can be manufactured internally, the economics change—and practices can offer solutions for movements that might otherwise go untreated.

## Aligners and Fixed Appliances Don't Have to Be Either/Or

Another important takeaway was the flexibility to combine fixed appliances with clear aligners.

For some cases, Dr. Alvetro uses brackets for the heavier initial movements before transitioning the patient into aligners for finishing.

Other patients may have aligners on one arch and fixed appliances on the other.

This hybrid approach allows the clinician to select the right tool for each phase of treatment instead of forcing an entire case into one modality.

It can also improve the patient experience. Someone who is ready to get their upper braces off may be able to transition into aligners while treatment continues rather than remaining in fixed appliances until every last movement is complete.

## From Debond to Retainer Without the Wait

Once a practice has the scanning, software, printing, and thermoforming workflow in place, the same technology can solve problems beyond active aligner treatment.

One example Dr. Alvetro demonstrated was **digital debonding**.

A patient can be scanned while the brackets are still in place. The brackets can then be digitally removed from the scan, the model printed, and a retainer fabricated before the physical brackets are removed.

As Dr. Alvetro described it, braces can come off with one hand and the retainer can go in with the other.

The same concept can make it easier to move directly from braces into a short finishing series of aligners.

## In-House Aligners Can Become a Practice Differentiator

There is also a business and marketing component to bringing aligner production in-house.

Dr. Alvetro described clear aligners themselves as increasingly commoditized. What differentiates the experience is the clinician and the treatment process surrounding them.

Being able to tell patients that their aligners are **custom designed and fabricated on-site** creates a tangible point of differentiation.

Patients can see the technology. They can understand how their treatment is being customized. In some cases, Dr. Alvetro has even had highly particular patients participate in conversations about their digital setup.

That personalized experience has helped generate not only patient referrals, but referrals from other dentists looking for help with minor orthodontic movements before or after restorative treatment.

## What Does an In-House Aligner Workflow Require?

Dr. Alvetro emphasized that practices don't need an enormous laboratory to get started.

Her workflow brings together several core components:

**Intraoral scanning → Treatment planning → 3D printing → Post-processing → Thermoforming → Trimming → Delivery**

During the webinar, she demonstrated a workflow using an Alliedstar intraoral scanner, uLab treatment planning software, a Formlabs printer, Taglus aligner material, thermoforming equipment, and automated trimming.

But technology alone isn't enough.

Dr. Alvetro stressed that the doctor should understand every step of the process before delegating it. That doesn't mean the doctor needs to personally manufacture every aligner. In fact, much of the workflow can be delegated.

Instead, the practice needs clearly defined roles, dedicated time for production, and a clinical or laboratory team member who understands the entire workflow.

## More Than Just Aligners

The economics become even more compelling when the equipment isn't dedicated to a single application.

A 3D printer used for aligner models can potentially also be used for models, indirect bonding workflows, retainers, and other dental applications.

Meanwhile, the ability to manufacture a handful of aligners internally makes smaller corrections economically practical without incurring an outside laboratory fee for every case.

As printers become more economical, resin costs continue to evolve, and software and hardware integrations improve, the barrier to bringing these workflows into the practice continues to decrease.

## Bringing More of the Workflow Under Your Control

Perhaps the biggest takeaway from Dr. Alvetro's presentation was that in-house aligner fabrication isn't simply about saving time or reducing a lab bill.

It's about **control**.

Control over when treatment begins. Control over staging. Control over attachments and trim lines. Control over how quickly you respond when treatment isn't tracking. Control over whether a patient needs two aligners or 40. And control over the experience you deliver to your patients.

For Dr. Alvetro, that flexibility has opened the door to everything from comprehensive orthodontic treatment to minor restorative corrections and next-day relapse treatment.

And for practices already investing in intraoral scanning and 3D printing, aligner fabrication may be one of the most practical ways to put that technology to work every day.

**Ready to explore in-house aligner fabrication?**

Voxel Dental Solutions can help practices build an integrated digital workflow—from intraoral scanning and treatment planning to 3D printing, thermoforming, trimming, and implementation. Whether you're looking to start with simple touch-up cases or bring comprehensive aligner production in-house, the right workflow can help make the transition more predictable for your entire team.

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Voxel Dental is a dedicated team of dental technology consultants and support specialists, offering complete digital workflow solutions to dental practices across the US and Canada. Have a question? Team Voxel can answer it!

## Related Articles

[![luxcreo direct print aligners](https://learn.voxeldental.com/hubfs/VOXEL%20Blog%20Images%20(12)-2.png)](https://learn.voxeldental.com/blog/direct-print-aligners-perfecting-the-clear-aligner-workflow-with-luxcreo)

[ORTHODONTICS](https://learn.voxeldental.com/blog/tag/orthodontics) [3D Printers](https://learn.voxeldental.com/blog/tag/3d-printers) [ALIGNERS/RETAINERS](https://learn.voxeldental.com/blog/tag/aligners-retainers)

### [Direct Print Aligners: PERFECTING THE CLEAR ALIGNER WORKFLOW with LuxCreo](https://learn.voxeldental.com/blog/direct-print-aligners-perfecting-the-clear-aligner-workflow-with-luxcreo)

When the Voxel team got back from the AAO 2024 in New Orleans, it was abundantly clear - direct print aligners are all the rage. The technology capable of completing a...

![Mark Bacino](https://learn.voxeldental.com/hs-fs/hubfs/1-3.png?width=45&name=1-3.png) 

[Mark Bacino](https://learn.voxeldental.com/blog/author/mark-bacino) 

[Read More](https://learn.voxeldental.com/blog/direct-print-aligners-perfecting-the-clear-aligner-workflow-with-luxcreo)

[![clear aligners](https://learn.voxeldental.com/hubfs/VOXEL%20Blog%20Images%20(26)-1.png)](https://learn.voxeldental.com/blog/traditional-clear-aligners-vs.-direct-print-aligners-the-next-frontier-in-ortho)

[ORTHODONTICS](https://learn.voxeldental.com/blog/tag/orthodontics) [3D Printers](https://learn.voxeldental.com/blog/tag/3d-printers) [ALIGNERS/RETAINERS](https://learn.voxeldental.com/blog/tag/aligners-retainers) [LUXCREO](https://learn.voxeldental.com/blog/tag/luxcreo)

### [TRADITIONAL Clear Aligners vs. Direct-Print Aligners: The Next Frontier in Ortho](https://learn.voxeldental.com/blog/traditional-clear-aligners-vs.-direct-print-aligners-the-next-frontier-in-ortho)

Three words have been all the rage in ortho lately: "Direct Print Aligners". But, is the future here today?

Here at Voxel, we've watched, evaluated, and tested for...

![Mark Bacino](https://learn.voxeldental.com/hs-fs/hubfs/1-3.png?width=45&name=1-3.png) 

[Mark Bacino](https://learn.voxeldental.com/blog/author/mark-bacino) 

[Read More](https://learn.voxeldental.com/blog/traditional-clear-aligners-vs.-direct-print-aligners-the-next-frontier-in-ortho)

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