How To Get ABO Models From ITero: The Complete Digital Workflow Guide

Exporting American Board of Orthodontics (ABO) compliant digital models from an iTero scanner requires capturing comprehensive anatomy, retrieving the raw data through the MyiTero portal, and processing the files into a standardized geometric base format. Clinicians must export either open STL files or use integrated OrthoCAD software to generate the precise 180-degree flat-plane bite alignment and trimmed bases required for board certification. Following a validated sequence ensures file compatibility, prevents occlusion distortion, and satisfies all digital case submission criteria.

Clinical Scanning Protocol and Technical Prerequisites

To obtain diagnostic-quality digital study models that satisfy peer-review boards, orthodontic clinics must adhere to strict clinical scanning standards before attempting file export. Standard clinical scans often omit deep vestibular tissue or posterior anatomy, which are mandatory for standard American Board of Orthodontics models.

Essential Hardware, Software, and Diagnostic Benchmarks

• Hardware and Clinical Gear: iTero Element scanner (Element 2, 5D, Flex, or Lumina) updated to the latest software suite, and an active iTero subscription plan with cloud export privileges.
• Clinical Scan Depth Requirements: Capturing at least 3 mm to 4 mm of gingival height beyond the cervical margin, including the entire mucobuccal fold, alveolar process, and the distal anatomy of the terminal molars.
• Palatal Vault Coverage: Complete scanning of the hard palate, ensuring no computational voids or mesh interpolation errors exist in the rugae or vault area.
• Bite Registration Benchmarks: Multi-point bilateral bite scans captured in centric occlusion to guarantee that the maxillary and mandibular arches intercuspate exactly as they do in the patient's mouth.
• Third-Party Processing software (Optional): OrthoCAD viewer/manipulator software, or dental CAD platforms (such as 3Shape, Blue Sky Plan, or Christian Orthodontic Software) to render the geometric ABO base if you are not utilizing Align Technology’s automated service.
• Estimated Workflow Duration: 5 to 7 minutes for a high-definition clinical scan; 3 to 5 minutes for cloud sync and processing; 5 minutes for file export and base rendering.

Step-by-Step Clinical and Portal Workflow for ABO Exports

Converting raw clinical scans into a clean, segmented, and properly oriented digital study model involves a specific progression from chairside capture to digital file export. Follow these steps to ensure model integrity.

Step 1: Capture High-Fidelity Scan Data with Alveolar Extensions

The foundation of a high-quality ABO model is the raw clinical scan. Standard aligner or restorative scans often truncate the vestibule, which will cause your case to be rejected during board grading.

• Begin scanning the mandibular arch, ensuring you roll the scanner wand significantly to the buccal and lingual to capture the full alveolar process, mucosal reflections, and the lingual frenum.
• Transition to the maxillary arch, scanning from the terminal molar forward. Ensure the wand captures the full height of the labial vestibule, the incisive papilla, and the entire palatal vault.
• Perform the bite registration sequence on both the left and right sides. Ensure the patient is in true centric relation or maximum intercuspation. Verify on the scanner screen that the red/green occlusal contact map corresponds to the patient's actual clinical presentation.
• Submitting incomplete scans with digital "holes" along the gingival margin will result in distorted model bases when run through automated trimming algorithms. Ensure all holes are filled before final clinical submission.

Step 2: Access the MyiTero Portal and Locate the Patient Record

Once the scan has successfully synchronized with the Align Technology cloud, you will manage, convert, and export the file package using a web browser.

• Open a secure browser and navigate to the official MyiTero portal. Log in using your clinic’s master credentials.
• Use the search bar in the top-right corner to locate the patient. Enter the patient's exact first name, last name, or unique Chart ID.
• Click on the patient’s name to load their clinical file timeline.
• Ensure the status of the scan is marked as "Completed" or "Sent." If the scan is still in "Processing" or "Draft" status, wait for the cloud sync to finish before attempting the next step.

Step 3: Configure the Export Options and Coordinate System

Selecting the correct export parameters is critical. Choosing the wrong coordinate system will cause the maxillary and mandibular arches to separate, rendering them useless for digital diagnostic evaluation.

• Click on the specific scan date, then select the "Export" or "Download" option located in the action panel.
• Under the file format dropdown, select "Open STL" if you plan to use third-party base-building software, or choose "OrthoCAD" if you are utilizing Align’s legacy digital study model platform.
• Locate the Coordinate System selection. Select Aligned to Bite or Patient Coordinate System. This configuration embeds the correct relative position of both jaws into the files, allowing orthodontic software to load them in correct occlusion.
• Set the resolution to "High" or "Raw" to capture the highest density of triangulation mesh data, ensuring sharp incisal edges and clear occlusal anatomy.
• Click "Export" to generate the download link, then save the compressed ZIP archive to your local hard drive or secure server.

Step 4: Generate or Apply the Geometric ABO Base

To satisfy board specifications, your model must sit on a geometric base with precise angles (e.g., 115-degree posterior angles, 55-degree anterior angles, and a flat 180-degree rear plane). You can generate these bases using automated digital model builders.

• Unzip the downloaded folder to locate your individual maxillary and mandibular STL files.
• Import both files into your preferred orthodontic CAD software (such as OrthoCAD, Blue Sky Plan, or an online model-builder service).
• Align the dental arches with the software's virtual coordinate plane. Position the occlusal plane parallel to the horizon.
• Set the base thickness. The standard total height of both models in occlusion should measure exactly 70 mm (approximately 35 mm per arch, with a minimum base thickness of 12 mm at the thinnest anatomical point).
• Trim the borders to clean, sharp angles that reflect standard ABO geometric cuts, ensuring the rear planes of both bases are perfectly flush so the model can be displayed upright on a flat surface in stable occlusion.
• Export the finalized files as a combined binary STL package.

Technical Specifications for ABO Digital Submissions

Digital models submitted for board evaluations, diagnostic records, or referral packages must conform to rigid file specifications. The table below outlines the ideal parameters for iTero exports.

Troubleshooting Common iTero Export Failures and Base Alignment Errors

Converting raw clinical scans into diagnostic-grade files can sometimes present errors, particularly with portal configurations and mesh triangulation. Here are the most common failure modes and their direct technical solutions.

Incomplete Vestibular Boundaries or Holes in the Mesh

• Root Cause: Inadequate physical scanning sweep along the mucobuccal fold, or moving the scanner wand too quickly, causing the algorithm to interpolate missing data points and create an open boundary.
• Actionable Fix: When reviewing the scan chairside, toggle on the "Fill Holes" tool or visual heat map. If any grey or transparent voids exist above the mucogingival junction, place the scanner wand back on the adjacent teeth and sweep slowly into the sulcus to capture the missing anatomy before sending the case.

Maxilla and Mandible Disconnected in Third-Party Software

• Root Cause: Exporting the files from the MyiTero portal using "Raw Coordinate System" or "Scanner Coordinates" rather than the aligned bite coordinates.
• Actionable Fix: Re-enter the MyiTero portal, click "Export," and change the coordinate setting to "Aligned." If using third-party CAD software, ensure you import both the upper and lower arches simultaneously into the same workspace to maintain the embedded coordinate relationship.

Missing "Export" Button on the MyiTero Portal

• Root Cause: Your clinic is assigned a user role with restricted administrative access, or your current iTero subscription plan does not include the open-format STL export license.
• Actionable Fix: Log in using the clinic’s primary administrator account. If the issue persists, contact Align Technology customer support to verify that your service contract includes "Open STL Export" capabilities.

Distorted or Over-Segmented Occlusion on the Virtual Model

• Root Cause: The patient shifted their jaw during the bilateral bite registration phase of scanning, or the software falsely registered a cheek or tongue surface as an occlusal contact point.
• Actionable Fix: Delete the bite scan on the iTero interface. Instruct the patient to swallow and bite down firmly on their posterior teeth. Rescan the bite registration, ensuring the scanner captures at least three to four teeth on both sides of the arch to guarantee a stable computational lock.

Frequently Asked Questions

Is there a fee to export open STL files from iTero for ABO models?

Depending on your office's monthly subscription tier and contract type with Align Technology, open STL exports may be included at no additional charge, or they may require a nominal per-case transaction fee. Ensure your account is configured for open exports to prevent unexpected billing.

Should I export files as "Raw" or "Aligned to Bite" for ABO cases?

Always select "Aligned to Bite" (or the "Patient Coordinate System") when exporting files. This selection ensures that the spatial relationship of the maxillary and mandibular teeth remains locked in centric occlusion when imported into external modeling, planning, or diagnostic software.

How do I trim the digital bases to exact ABO angles?

The MyiTero portal itself does not automatically trim models to precise geometric bases. Once you export the aligned STL files, you must import them into diagnostic software like OrthoCAD or an open-source dental platform to apply, trim, and polish the standard 115-degree and 130-degree geometric bases.

Can I submit color PLY files directly to the ABO portal?

The American Board of Orthodontics typically prefers standardized monochrome (grey or white) digital study models for clinical examinations, as color maps can obscure wear facets and fine anatomical features. Ensure your final exported files are rendered in a clean, non-textured format before submitting them.

What should I do if my model bases are too thin after trimming?

If the base is too thin, you must increase the total height parameter in your model-building software. The standard total height of the combined, occluded arches should be set to 70 mm. Increasing this value adds computational material to the floor of the mandibular model and the ceiling of the maxillary model without altering clinical anatomy.

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