ORTHODONTICS AND IMPLANTS
Orthodontics and implants: Orthodontic treatment isn’t always straightforward, especially if a significant number of teeth are missing. With loss of teeth, adjacent or opposing teeth usually tip, drift or over-erupt leaving spaces that are not optimal for replacement of missing teeth. Orthodontic correction of these spatial relationships will aid prosthetic replacement of the missing teeth, function, hygiene and aesthetics.
Orthodontists rely on teeth to provide the anchorage to correct malocclusions. With patients having an intact dentition, dental anchorage is usually adequate to facilitate tooth movement. In some partially edentulous patients however, insufficient anchorage may present to correct the malocclusion. In these patients implants can provide additional anchorage. At times, osseointegrated implants can also be used to support restorations after completion of orthodontic therapy if treatment planning is precise. The use of implants for orthodontic anchorage requires an interdisciplinary approach and precise planning to achieve optimal results.
The orthodontic specialists at Belur Orthodontics have a vast well of experience and knowledge to draw from in both Oral Surgery and Orthodontics. You’ll be placed in the best care as our specialist team is in a unique position to manage these complex situations by liaising with different dental specialities and team members to achieve the required result.
The incorporation of orthodontic therapy into comprehensive treatment planning is a valuable adjunct, which can enhance aesthetic and functional outcomes in restorative dentistry.
When treatment planning for implant supported restorations, the orthodontist can assist the restorative dentist in several ways.
1. Orthodontics to develop the peri-implant site or bone regeneration
Aesthetic implant placement is driven by both a restorative and biological philosophy. Aesthetically the implant should be placed to satisfy the parameters of contour so that the restoration is pleasing. Biologically it should be placed to allow maintenance of both hard and soft tissue architecture. If the tooth to be replaced has not yet been removed, several determinations should be made prior to the extraction.
Too often teeth are extracted needlessly only to result in restorations which exhibit disproportionate relationships to the adjacent teeth. If bone deficiencies are present, orthodontic eruption of the tooth prior to extraction can help to increase the amount of hard and soft tissue in the future implant site. Orthodontic extrusion allows the restorative dentist to create a more harmonious gingival level and aesthetically provide the patient with a restoration that mimics the contra-lateral tooth.
2. Orthodontics to create space for implant restorations
Orthodontic therapy is also invaluable in creating space for implant placement. When teeth are lost, opposing teeth often over-erupt or drift into the edentulous space, compromising space for the restoration.
3. Implants for orthodontic anchorage
For every force applied there is an equal and opposite force; this is one of Newton’s laws of physics and much of the basis for the mechanics of tooth movement in orthodontics. Traditionally, the dentition with various intra-oral and/or extra-oral appliances is used to create anchorage for alignment and retraction of teeth.
During orthodontic treatment, the planned movement of one tooth or group of teeth causes reciprocal movement of the teeth used for anchorage. Gauging force dynamics is difficult as unwanted tooth movements often occur. These unwanted movements must be compensated for.
Interdisciplinary therapy in the adult patient can be very challenging, particularly in situations where the patient exhibits a severe attachment loss from missing teeth or severe periodontal disease. This attachment loss adds to the difficulty of estimating anchorage and stability treatment becomes exponentially more difficult.