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 and extend from the first cavities and be designed to interface with teeth of a second jaw. The first number of bite adjustment structures can have a first shape and location. A second number of bite adjustment structures can be formed of a same material as the second shell and extend from the second cavities and be 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.