The ortho-restorative interface

This entry was posted on Wednesday, January 3rd, 2018 is filed under Uncategorised.
Dr. Barry Buckley on using the Invisalign system to improve occlusion and align dentition.

Patient X, a 26-old-female, attended for a cosmetic consultation. Her presenting complaint was the ‘colour of my front teeth and I want to straighten my teeth’.

Extraoral examination showed a skeletal class three base with increased Frankfort mandibular plan angle (FMPA) and increased lower anterior face height (LAFH). The intraoral examination showed a class 1 incisor relationship with retroclined lower incisors. A reduced overjet and reduced overbite. Mild upper and lower crowding. The UL6 and UR2 were in crossbite, with no displacement.

The molar relationship was class 1 on the right hand side and 1/4 unit class 3 on the left hand side. Patient had a heavily restored dentition. There was severe staining/mottling of the upper anterior teeth.

Orthodontic phase

After discussing the treatment options with the patient she was happy to start with orthodontics to improve the occlusion and align the dentition. Following this, once we were happy with the overjet we would proceed with the restorative phase. Invisalign aligners were used for 16 months to align the upper and lower arches and to make space in the overjet for the restorative phase of treatment


Before Invisalign
After Invisalign
Pre-treatment clincheck plan
Post-treatment clincheck result


Upper and lower impressions and a bite registration were sent to the dental technician who was planning the restorative phase. A wax up of the planned end result was shown to the patient. She was happy to proceed with removal of the bridge replacing the UR4 and preparation of UR2-1 and UL1-2-3.

The bridge removal and preparation appointment was completed and temporaries fitted using a matrix made from the wax up. Essix retainers were made for the patient to wear full time to prevent any orthodontic relapse.

A review appointment two weeks later was used to choose the shade and ensure we were happy with shape and appearance. The permanent three-unit bridge UR5-4-3 and veneers UR2-1 and UL1-2-3 were then cemented

Before smile
After Invisalign and restorations

Dr Buckley is the co-founder of Aligner Consulting. He runs which has started 4,000 cases, making them the number one Invisalign account in Europe for 3 years consecutively. He provides both clinical and management support for the clearbraces network supporting the GDP’s that work with him. On average, each of these GDP’s now submit over 100 cases each per year.