IOS + CBCT: The 2026 Digital Aligner Workflow
Combining an intraoral scanner (IOS) with cone-beam computed tomography (CBCT) gives the prescribing clinician a complete 3D picture of both crown geometry and root position before a single aligner is designed. In a properly integrated digital workflow, the IOS surface mesh and CBCT volumetric data are fused into one model so that tooth movement is planned at the root level — not just at the visible crown. This is the standard that Klaer, manufactured in the UAE, was built around from day one.
Why Crown-Only Data Is No Longer Enough
For years, digital aligner workflows relied almost entirely on surface scans. An IOS captures crown anatomy with impressive fidelity — interproximal contacts, gingival margins, occlusal morphology — but it stops at the gingival crest. Everything apical to that boundary is extrapolated, not measured.
That extrapolation carries real clinical risk. Roots that appear well-spaced on a surface model may be in close proximity or even converging. Alveolar bone volume that looks adequate from the occlusal view can be paper-thin on the buccal or lingual plate. Treatment plans that ignore this routinely underestimate the amount of bodily movement required and overestimate how much tipping the periodontium will tolerate.
CBCT is not a new technology, but its integration *into* the aligner planning pipeline — rather than sitting beside it as a separate diagnostic step — is the defining shift of the current period. When the two datasets are fused before staging begins, the clinician is planning movement in biological reality, not in a geometric approximation.
What the IOS + CBCT Combination Actually Gives You
Accurate root position. The fused model shows the full tooth — crown and root — within the surrounding alveolar envelope. Axial inclinations, torque deficits, and root proximity issues become visible at the planning stage rather than as mid-treatment surprises.
True bone boundary awareness. CBCT reveals cortical plate thickness, root-to-bone distances, and the position of anatomical structures (inferior alveolar canal, maxillary sinus) that constrain how far and how fast teeth can move.
Bodily versus tipping distinction. A surface scan alone cannot reliably differentiate a tooth that needs 2 mm of bodily translation from one that needs 2 mm of crown tipping with root correction. CBCT makes that distinction explicit and stageable.
Interdisciplinary data for complex cases. For patients who will need periodontal, implant, or orthognathic co-management, the CBCT is already part of the record — no separate referral imaging is required.
How the Workflow Runs in Practice
A clinician working with Klaer follows a structured submission protocol:
- IOS acquisition — a full-arch scan (maxillary, mandibular, and bite registration) captured with any major intraoral scanner. The output is a standard STL or PLY file.
- CBCT acquisition — a field-of-view sufficient to capture the full dentoalveolar complex; most modern CBCT units used in orthodontic practice meet this requirement.
- Secure upload — both datasets are uploaded together through the Klaer clinical portal. The two files are automatically co-registered using anatomical landmarks so that the fusion is consistent regardless of how much time elapsed between the two scans.
- AI-assisted staging — the fused model drives Klaer's AI staging engine, which proposes a movement sequence that respects root positions, bone boundaries, and occlusal goals simultaneously.
- Orthodontist verification — every case is reviewed and approved by a qualified orthodontist before manufacture. This step is non-negotiable in the Klaer workflow; AI staging is a tool, not a replacement for clinical judgement.
- Manufacture and delivery — aligners are produced at Klaer's UAE facility and shipped directly to the prescribing clinic.
AI Staging and Orthodontist Verification: Where the Two Data Streams Meet
The clinical value of the IOS + CBCT fusion is realised at the staging step. Klaer's AI, powered by the kyour.ai platform (part of the aiHealth Group), uses the fused 3D model to propose incremental tooth movements that are geometrically feasible *and* biologically plausible — factoring in root length, bone density zones visible on CBCT, and the sequential interdependencies between teeth.
This does not mean AI replaces the prescribing orthodontist. It means the orthodontist reviews a plan that already accounts for root morphology, rather than spending clinical time manually correcting a crown-only plan that was never anatomically grounded in the first place.
The result is a staging proposal that a clinician can interrogate, modify, and approve with confidence — and a finished aligner series that reflects what was actually planned.
Once treatment is underway, Klaer's remote monitoring integrates weekly at-home phone imaging submitted by the patient, allowing the prescribing clinician to track progress between in-office appointments without compromising oversight.
If you are evaluating how the Klaer workflow fits your current imaging setup, the clinical team at klaer.ae can walk through submission requirements for your specific CBCT unit.
Frequently Asked Questions
Does the CBCT need to be taken at the same appointment as the IOS scan? No. The two datasets are co-registered algorithmically at the time of upload, so they do not need to be acquired simultaneously. A clinically reasonable time gap — typically within a few weeks for an active orthodontic case — is acceptable, provided there has been no significant tooth movement between acquisitions.
Which intraoral scanners are compatible with the Klaer workflow? Klaer accepts standard STL and PLY outputs, which are exported by all major IOS platforms currently in clinical use. If you are unsure whether your scanner's export format is supported, the Klaer clinical portal documentation lists verified formats.
What field-of-view is recommended for the CBCT? A full-dentition field of view capturing both arches and their supporting bone is the standard requirement. Large-volume CBCT settings used routinely in orthodontic practice are generally appropriate; the Klaer team can advise on minimum resolution requirements for your unit.
Can I submit a case with IOS data only, without CBCT? Klaer's workflow is designed around the IOS + CBCT combination because root-level data is central to how treatment is staged. Clinicians are encouraged to discuss case-specific requirements directly with the Klaer clinical team at klaer.ae.