Case report: aligners before veneers reduced preparation in the aesthetic zone
A case report in the International Journal of Esthetic Dentistry describes a patient whose anterior teeth were first aligned with clear aligners and only then prepared minimally, just enough to receive ultra-thin ceramic veneers.
A sequence that changes how much is removed
The team around Villalobos Tinoco, writing in The International Journal of Esthetic Dentistry, describes a patient unhappy with the appearance of her smile. The left central incisor overlapped the right one, the incisal edges were mildly worn, and the shade of the teeth did not match her expectations.
Instead of compensating for the irregular position with preparation and thicker ceramic, an approach that in the aesthetic zone can consume a considerable amount of enamel, the plan was split into two phases. Clear aligners first brought the anterior teeth into a correct position within the arch. Only then were minimally invasive preparations carried out, dimensioned only for ultra-thin ceramic veneers, which were cemented under complete rubber dam isolation.
The authors stress that it is precisely this sequence that makes the procedure conservative: when the tooth is already in place, the restoration does not have to correct position, only shape and shade. Aligners, they add, are more acceptable to patients than brackets because they are less noticeable and because the patient removes and replaces them. The final result, according to the report, met the patient's aesthetic and functional expectations.
Limitations
This is a single case report, without a control group and without long-term follow-up data. It supports no conclusion about the durability of ultra-thin veneers or about the stability of the achieved tooth position.
For the practice
- With aesthetic requests involving malpositioned anterior teeth, it pays to assess before preparation whether a short orthodontic phase would reduce the required ceramic thickness.
- Alignment before veneers needs a clear agreement with the patient about time: two phases mean a longer overall course than preparing straight away.
- After the orthodontic phase, retention remains an obligation, because without it exactly the position that allowed the conservative preparation can be lost.