Orthodontic Site Development Before Veneers and Crowns

Restorations look and last best when they're built on well-positioned teeth. A short phase of clear aligner treatment before veneers, crowns or bridges can reduce how much tooth structure needs to be removed and make the final result more predictable. This article covers the most common pre-restorative movements.

• Less preparation: aligned teeth often need thinner veneers or less reduction to reach the desired contours.
• Better proportions: space can be redistributed so each restoration has ideal width.
• Healthier margins: correcting tipped or rotated teeth makes margins easier to place and clean.
• Improved occlusion: over-erupted or tipped teeth can be moved to restore a level plane.

Space redistribution for veneers

Uneven spacing or small lateral incisors can be addressed by moving teeth so that space is divided according to the restorative wax-up rather than simply closed. Plan the orthodontic target from the restorative design, not the other way around.

Uprighting tipped teeth

Molars that tipped into an extraction space are a classic example. Uprighting them improves the path of insertion for a bridge or the space available for an implant, and can reduce periodontal defects on the tipped side.

Intruding over-erupted teeth

Teeth that have drifted into the space of a missing opposing tooth can be intruded to restore the occlusal plane before the opposing restoration is made.

Forced eruption

Extruding a tooth with a subgingival fracture or deep caries can bring sound structure above the gumline, sometimes avoiding surgical crown lengthening. The soft tissue and bone may follow the tooth, which can be useful when developing an implant site, or may require minor periodontal adjustment afterward.

• Start with a diagnostic wax-up or digital smile design so orthodontic targets serve the final restorations.
• Keep provisional restorations adjusted as teeth move.
• Allow a stabilization period with a retainer before final impressions or scans for definitive work.
• Make sure the final retainer fits over the new restorations.

Aligners can be combined with pontics to maintain esthetics during treatment, attachments can be placed on most restorative materials with the right bonding protocol, and treatment duration for limited pre-restorative movements is often short.

Infinity Aligner certified providers can submit restorative goals with the case so the plan is designed around the final restorations.