How do veneers affect the treatment plan for Invisalign?

Doctor's Answers 2

I would suggest having a prototype of the veneers made with the ideal shape, size and position of your front teeth so that you and your dentist can visualize the final aesthetic result of combining Invisalign and veneers.

At the prototype stage, tweaks to the veneers can be done easily and quickly. Once you are happy with the prototype, it will be used to guide optimal positioning of your teeth using Invisalign and also as a guide for the final ceramic veneers.

Having a prototype also ensures that you get a preview of the final outcome that will guide you in making treatment decisions.

Your dentist, the ceramist (the person making the veneers) and you yourself may have very different ideas on what is aesthetic, and the prototype will help ensure a consistent aesthetic vision from start to finish.

The prototype also guides the final tooth positions programmed in Invisalign to optimize spaces and function (how your teeth bite together).

Of course, you can still have Invisalign even without having this prototype, but if you eventually do decide on veneers, it may mean that more tooth structure may need to be trimmed (shaved down with a drill) for the veneers to be fitted. In certain cases, if the veneers and Invisalign are planned seamlessly, you may even be able to get away without any tooth trimming at all.

If you do proceed with Invisalign without the aesthetic prototype, you may be very happy with the final results of just alignment of your teeth alone. Some patients can get a very satisfactory result with just alignment and bleaching.

I would discuss with your dentist about getting the aesthetic prototype so that you can fully explore all the possible treatment options in a practically risk-free manner. Nowadays, the prototype is made using a process known as Digital Smile Design (DSD) which gives us many possibilities to play around with different aesthetic setups.

This is a common problem many of my patients face. In my practice, whenever I treatment plan a case that involves both veneers as well as orthodontic movement of teeth ( with Invisalign for example), i ensure that my patient goes through a process called Digital Smile Design.

This process involves the clinician inputting a series of data, measurements and photographs into a powerful software. I then guide the software to create an proposed ideal 3D virtual smile for the patient, that is in perfect harmony with his/her lips and face.

This 3D virtual smile design is the proposed IDEAL smile for the patient and the patient will be able to see how the smile looks like against his lips and the rest of his/her face. I will then consult with the patient to see if he/she likes the proposed design and whether or not adjustments and modifications to the design needs to be made, much like how an architect would discuss a 3D model design of a house before actually building it.

This 3D smile design is then converted into a intra-oral mock up in the patients mouth, using a temporary resin material, to give the patient a visual on how the final result will look like, before even starting treatment!

Therefore, my patients who require this kind of combination treatment will be able to have a good visual on the final outcome, before starting any treatment at all, leaving very little to chance. In this way, i minimise misunderstandings and unmet expectations regarding the final outcome of the case, vs what patients imagine it to be.

Once the 3D virtual Smile Design is approved by the patient, then i will send the design software file to the Invisalign Planning Centre. This starts another process whereby, i will work closely with the Invisalign software engineers, to plan for the tooth movement that is required to move teeth into their ideal final planned position, so that as little tooth structure needs to be trimmed as possible for veneers.

Veneers will affect the treatment planning for Invisalign because we can control the tilt and movement of teeth to create an ideal position for minimal tooth preparation to be necessary to achieve the result that we have planned for in the Digital Smile Design Phase of the treatment plan. When we know what the design is for the veneers, that drives the plan for the tooth movement!

This interdisciplinary treatment planning effort requires sophisticated digital software and precise communication between myself as the dentist designing the smile and the dental technicians and engineers behind the Invisalign planning and fabrication of the porcelain veneers.

Dental technology has improved by leaps and bounds and you will be pleased to know that you in this modern age, you can see the final outcome of your smile before you actually begin on your journey.

I hope this information helps and i wish you all the best in finding a dentist that you can trust and have rapport with, to be able to design a smile for you that you have always dreamed of!

Kind Regards,

Dr Gerald Tan

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