Additive restorations after braces: when tooth shape needs completing
Orthodontics changes tooth position. Additive restorations may complete tooth shape when clinically indicated.
On this page
What does additive mean?
It means adding restorative material, such as composite resin, using an adhesive technique. Preserving sound tissue is the aim. It does not mean every tooth can be treated without preparation or that removing the material later is risk-free.
Why can spaces remain?
Position and size are different. A small lateral incisor can still be too narrow when aligned. Space may be deliberately distributed for a restoration; in other cases tooth position needs reassessment. Gaps alone do not establish that orthodontic treatment was incorrect. [2]
What does research show?
A 2015 clinical study followed 147 composite additions in 30 patients for four years after fixed orthodontic treatment. Its findings support this option in selected cases, but cannot guarantee the lifespan of an individual restoration. [1]
When is adding material insufficient?
When it would produce bulky teeth, contours that are difficult to clean or unsuitable bite contacts. Assessment should identify whether shape, position, gum tissues or several factors need attention. Not everyone finishing braces needs restorations.
What should we discuss first?
Which teeth need additions, the alternatives and coordination with the orthodontist. Ask to see the proposed shape and understand its limitations. In the illustration below, material is added; the teeth are not moved.
How residual gaps are closed
Drag the slider to add material to the small teeth. The dashed line shows the target shape set on the wax-up.
- Natural tooth — fixed position
- Added composite — highlighted in green
The lateral incisors are smaller than the space available, so gaps remain on both sides.
Educational model, not to clinical scale. The percentage shows demonstration progress, not a patient’s measured gaps. Clinical composite is shade-matched to the tooth.
Clinical sources
- Demirci M et al. A 4-year clinical evaluation of direct composite build-ups for space closure after orthodontic treatment. 2015.
- Bass EH. Combined Orthodontic and Restorative Approach to Esthetic Treatment of Maxillary Peg Lateral Incisor in Adolescent Female Patient: Case Report. 2017.
Further reading
- Ritter AV, Boushell LW, Walter R (eds.). Sturdevant’s Art and Science of Operative Dentistry. 7th ed. Elsevier, 2019.
- Aschheim KW (ed.). Esthetic Dentistry: A Clinical Approach to Techniques and Materials. 3rd ed. Mosby, 2015.
Editions from the proposed bibliography published after 2012. Books are listed for further reading; the explanations link to the accessible clinical studies and information above.
The information on this page is general and educational. It does not replace a medical consultation, and a treatment recommendation can only be made after examining each patient. Results differ from one case to another.
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Every treatment begins with a diagnosis: clinical examination, photographs, radiographs and, where relevant, an occlusal analysis. Only then do we discuss options.