Optical Coherence Tomography (OCT) has seen broad application in dentistry including early carious lesion detection and imaging defects in resin composite restorations. This study investigates expanding the clinical usefulness by investigating methods to use OCT for obtaining three-dimensional (3D) digital impressions, which can be integrated to CAD/CAM manufacturing of indirect restorations. 3D surface topography before and after a cavity preparation was acquired by an intraoral cross polarization swept source OCT (CP-OCT) system with a Micro-Electro-Mechanical System (MEMS) scanning mirror. Image registration and segmentation methods were used to digitally construct a replacement restoration that modeled the original surface morphology of a hydroxyapatite sample. After high resolution additive manufacturing (e.g. polymer 3D printing) of the replacement restoration, micro-CT imaging was performed to examine the marginal adaptation. This study establishes the protocol for further investigation of integrating OCT with CAD/CAM of indirect dental restorations.