Treating Peg Laterals with Invisalign + No-Prep Veneers

Hello,

This is Apgujeong Yonsei Baro Dental Clinic, an orthodontic clinic in Apgujeong.

Today’s case from Apgujeong Yonsei Baro Dental Clinic involved a combination of Invisalign treatment and no-prep veneers.

Q. Can peg laterals also be treated with Invisalign alone?

When the front teeth are spaced or the lateral incisors are small, simply arranging the teeth in a straight line may not be enough to achieve a complete esthetic result.

In particular, because peg laterals are small in size, treatment may need to involve not only organizing the space with orthodontics but also adjusting the proportions of the teeth.

The patient introduced today also had both spaced front teeth and peg laterals.

The teeth alignment and bite were first organized with Invisalign, and the peg lateral areas were naturally restored to a more appropriate size with no-prep veneers (Gelami), completing balanced tooth proportions.

Through this actual treatment case, in which esthetics were improved without removing any tooth structure, you can see how orthodontic treatment and no-prep veneers can work together.

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The patient visited us for orthodontic treatment because the front teeth were spaced.

The lateral incisors were small peg laterals.

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During orthodontic consultations, I often hear people say, “My front teeth are large.”

However, when we actually examine the inside of the mouth, the front teeth are often normal in size.

They only appear that way because they are not properly aligned.

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The teeth strictly follow the principles of perspective. The central incisors may appear that way because the two front teeth are positioned lower or project slightly forward.

Even if a tooth is just 1 mm farther forward than the adjacent tooth, it may look larger than it really is. Conversely, if it is recessed by just 1 mm, a shadow may form and make it look smaller than it actually is.

A treatment plan was established to close the spaces orthodontically and leave room for the Gelami veneers to fit beautifully.

In June 2023, the first set of 14 aligners was delivered to the clinic, and the patient began wearing the first aligner.

About four months later, in October 2023, the patient had finished all 14 aligners and came in on the day the additional aligners were planned.

A small amount of space was still present.

The blue arrows indicate the hooks for the elastics used to improve the bite relationship.

At the interim checkup, we checked whether the facial and dental midlines were properly aligned, as well as the left-right tilt of the occlusal plane, before proceeding with the production of the additional aligners.

The second set of aligners was delivered to the clinic in November 2023, and all treatment through the second set was completed in February 2024.

The additional-aligner treatment period was three months.

This was the appearance immediately after completing orthodontic treatment and just before the no-prep veneers were placed.

The attachments required for Invisalign treatment were still attached to the teeth.

The orthodontic treatment was completed while leaving pre-calculated spaces on both sides of the small peg laterals.

These spaces were filled with no-prep veneers.

Both peg laterals were balanced with no-prep Gelami veneers.

This is the appearance of the no-prep veneers restored on both lateral incisors, viewed from the occlusal surface.

A fixed wire retainer can be made after the no-prep veneers are bonded.

Apgujeong Yonsei Baro Dental Clinic follows the treatment philosophy that there is no need to become more beautiful at the expense of oral health.

Gelami requires no tooth reduction at all.

For those who are considering Invisalign treatment and are curious about the treatment process, here is a summary.

Initial consultation: May 2023

Start of Invisalign treatment: June 2023 (first set)

Additional aligners planned: October 2023

Start of additional treatment: November 2023 (second set)

Completion of orthodontic treatment: February 2024

Completion of no-prep veneers: March 2024

The total treatment period was 10 months, and the patient wore the 14 aligners in the first set for four months.

The orthodontic treatment was completed after wearing the additional aligners for only three months, so the actual orthodontic treatment period was seven months.

The remaining three months consisted of waiting for the aligners and the production period for the no-prep veneers.

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At first, the two central incisors clearly looked large. However, once the alignment and vertical levels were corrected and the peg laterals regained a normal size with veneers, the central incisors no longer looked large at all.

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The spaces were also finished neatly.

The bite, which many people are concerned about before Invisalign treatment, is also satisfactory.

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With Invisalign treatment and no-prep veneers, the overall appearance looks more refined than it did initially.

As we have introduced many times before, spaced teeth are a type of malocclusion that can be treated quickly and effectively with Invisalign orthodontics.

Spaced teeth are among the types of malocclusion that can be treated most predictably with Invisalign.

However, when peg laterals are also present, an important part of treatment planning is to consider not only closing the spaces but also what final tooth proportions should be created.

Orthodontic treatment and esthetic treatment should not be carried out as separate processes. They should be planned together from the beginning to achieve a more natural and stable result.

Apgujeong Yonsei Baro Dental Clinic pursues treatment that preserves the health of the teeth while creating natural esthetic results.

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