Pre-orthodontic Provisionalization (POP): A 3-D Blueprint for Communication

Pre-orthodontic Provisionalization (POP): A 3-D Blueprint for Communication

Robert “Tito” Norris, DDS* 1, San Antonio, TX 2

*Correspondence to: Robert “Tito” Norris.

Copyright.

© 2026 Robert “Tito” Norris, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the originalwork is properly cited.

Received: 27 August 2026

Published: 10 October 2026

Introduction

One of the most common interdisciplinary cases that presents to the dentist’s/orthodontist’s office is a patient who has experienced wear of their dentition. Historically, dentists have referred these patients to orthodontists requesting intrusion of the worn teeth so that vertical space for restorations can be created. In this traditional method, pure intrusion forces are required, and a guessing game exists regarding the precise amount intrusion of the maxillary and mandibular teeth that is ideal for that patient. This creates a nebulous orthodontic goal, and neither the orthodontist nor the dentist is confident that the ideal amount of intrusion has been accomplished in each arch. Furthermore, if wear is present on the anterior dentition, then the patient must experience an anterior open bite as teeth are intruded, resulting in compromised esthetics, chewing, and enunciation.

Case 1 below demonstrates this traditional method of intruding worn anterior teeth in preparation for definitive restorations.

A more efficient method for creating restorative space occurs when the restorative dentist performs pre-orthodontic provisionalization (POP) of all worn teeth. This establishes proper anatomy of the dentition and allows the orthodontist to utilize a combination of extrusive and intrusive forces to more efficiently achieve alignment. Furthermore, POP provides a 3-D blueprint for communication between the restorative dentist and the orthodontist, removing the guesswork and the possibility of miscommunication between the two doctors.

Case 2 below demonstrates a more modern and efficient method of creating restorative space utilizing the concept of POP.

In summary, pre-orthodontic provisionalization (POP) is an efficient and effective method to restore the natural anatomy of worn teeth prior to the placement of orthodontic appliances. POP allows the restorative dentist to dictate the size and shape of the final restorations and affords the orthodontist accurate incisal edges so that bracket placement can be more accurately performed. Furthermore, accurate incisal edges during orthodontic treatment allows efficient assessment of incisal edge display in repose and smiling throughout orthodontic treatment. POP also allows patients to enjoy enhanced esthetics, anterior mastication, and improved enunciation during orthodontic treatment. By allowing the orthodontist to employ a combination of extrusive and intrusive forces, POP provides an environment in which orthodontic treatment can be treated more efficiently with less time and fewer appointments.

*Dynaflex Corporation, St. Louis, MO, USA

**Global Diagnosis: A New Vision of Dental Diagnosis and Treatment Planning. J William Robbins and Jeffery S. Rouse. Quintessence Publishing. 2016.