A series of appliances including a first shell and a second shell can be designed to incrementally implement a treatment plan. The first and second shells can have cavities designed to receive teeth of a jaw. A first number of bite adjustment structures can be formed of a same material as the first shell, extending therefrom and designed to interface with teeth of a second jaw. The first number of bite adjustment structures can have a first shape and location specific to a first stage of the treatment plan. A second number of bite adjustment structures can be formed of a same material as the second shell, extending therefrom and designed to interface with teeth of the second jaw. The second number of bite adjustment structures can have a second shape and location, different than the first shape and location, specific to a second stage of the treatment plan.