So, you decided to come to grips with the beauty of your smile: correct the bite, correct the defects of the dentition and, possibly, restore the missing teeth. What to do first – turn to the orthodontist or implantologist? Is orthodontic treatment possible if some teeth are missing? Can braces be placed on implants?
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Orthodontic correction should be started as soon as possible, without waiting until there is a choice between braces and implantation.
Is orthodontic treatment possible if some teeth are missing?
Implants and braces
Before answering the question about the compatibility of braces and implants, let’s say a few words about the features of those and other dental structures.
Bracket system – an orthodontic design used to correct the bite or correct the position of the teeth when they are curved, crowded and other problems. Braces consist of locks that are attached to the surface of the teeth from the outside or inside, and an orthodontic arch. It is threaded into the locks and, due to its elasticity, creates a forceful effect on the teeth, forcing them to move in the right direction.
The use of braces is possible due to the fact that the tooth does not have a fixed fixation in the bone tissue of the jaw. It is located in the hole and is surrounded by binding fibers, which on the one hand provide its tight connection with the jaw, and on the other hand have a certain reserve of dynamics and, by stretching and squeezing, protect the teeth from mechanical stress.
This anatomical feature is also used in orthodontic treatment with braces. In response to the applied force, the hole expands slightly, with the connective tissue stretching from the side opposite to the direction of movement. New bone cells are formed there that help fix the tooth in a new position.
However, this only happens with natural teeth. As for implants, the situation with them is somewhat different.
A dental implant is essentially a prosthesis that is implanted in the bone tissue of the jaw and heals on it due to the process of osseointegration (implant engraftment). Dental construction consists of several elements:
- the implant itself (a helical titanium “root” that is implanted in the gum);
- abutment (an element that is attached to the implant and serves as the basis for the crown);
- crown (supragingival part of the implant, selected in color and shape to natural teeth).
After installation of the titanium implant, the process of protein adsorption and cell adhesion begins – a blood clot forms around the “foreign body”, which sprouts in a few days with blood vessels. Next, connective tissue is formed, which eventually transforms into bone – and the process of osseointegration is completed.
After installing the implant, it is impossible to change its position – otherwise there is a risk of rejection
The implant is held tightly in the jaw, however, the absence of connective fibers does not allow it to be displaced, like natural teeth
With high-quality dental implantation and successful engraftment, the implant is neither externally nor functionally different from natural teeth. Over time, you may even forget that you became the owner of an artificial tooth. However, the main internal difference between an implant and a natural tooth will remain forever. In the case of natural teeth, connective fibers are directed perpendicular to the plane of the tooth and connect it to the bone of the socket. But the connecting fibers are not able to attach to the titanium of the implant: they are located parallel to its surface. Due to the epithelium and connective tissue, the implant is absolutely hermetically and tightly located in the gum, however, it cannot change its position, including during orthodontic treatment.
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So, what are implants or braces first?
The answer of the experts is unequivocal: first you should contact the orthodontist, and only then – to the implantologist. There are several reasons for this treatment sequence:
Due to the peculiarities of fixing the implant in the bone tissue, an attempt to change its position can lead to loosening, and ultimately to rejection of the prosthesis.
During simultaneous implantation, the implant is inserted into the hole remaining from a natural tooth. If its position was incorrect (for example, the tooth was tilted forward or displaced relative to the axis of symmetry), the implant will have to be given the same position or resort to a more complex and traumatic operation.
If some time has passed after tooth extraction, it is very likely that adjacent teeth began to move, shortening the gap. To make room for the implant, they must first be moved apart using orthodontic equipment. If the implantation period is delayed, the braces will prevent the gap narrowing.
In some cases, for example, with crowding, the tooth can simply be removed, and the remaining teeth can be moved using braces, restoring the functionality and aesthetics of the jaw. In this case, implantation may not be necessary at all.
Correcting the bite in advance, you get a more beautiful smile, and also ensure the stability of the result during the subsequent installation of implants, their long-term functioning.
In some cases, implant placement is possible while you are still at the final stage of orthodontic treatment. Sometimes this is practiced when implantation of second molars is necessary, not affecting the position of the remaining teeth of the jaw. In this case, by the end of the orthodontic treatment, the implant engraftment will be completed, which means that the overall treatment time will be slightly reduced. However, in the vast majority of cases, treatment must be carried out sequentially.
First you need to solve orthodontic problems, and only then begin the implantation process
In the vast majority of cases, the installation of braces on implants is contraindicated
Is it possible to solve orthodontic problems if the implant is already installed?
The answer to this question depends on the clinical picture. For example, if orthodontic correction is necessary only for the front teeth, and the implants are in place of the molars, the installation of braces is quite possible and such treatment will be effective.
There are cases when the pre-installation of implants is even indicated for orthodontic treatment. This is necessary if you do not have abutment teeth (molars) that could become an immovable basis for bracket systems and thereby contribute to a simpler, more effective and faster correction.
Sometimes teeth move even after implant placement, for example, due to natural age-related changes in the jaw system. In this case, the implant, which retains its original position, may protrude slightly from the dentition. If his position was initially correct relative to other teeth, the problem can be solved with the help of braces (which, we recall, will not exert force on the implant itself).
What will happen if you once installed the implant without worrying about orthodontic problems, and after a while decided to install braces to correct the bite or other defects? If possible, the orthodontist will develop a correction scheme that allows you to change the position of the teeth without affecting the implant. In most cases, after the correction of the underlying problem, the implant will stand out a little relative to other teeth, however, a qualified orthodontist will make every effort to minimize aesthetics. Sometimes it is possible to solve the problem by replacing the implant crown. If you are not ready for a compromise, you will have to go through a rather lengthy and traumatic procedure for replacing the implant itself.
An important consideration to consider when planning orthodontic treatment and implantation is the inevitable reduction of bone tissue. In the one and a half to two years that are necessary for orthodontic treatment, atrophy will reach a noticeable level, which means the implantation operation will be more difficult or the specialist will have to resort to bone tissue growth.
Therefore, we urge you to solve the problems of occlusion and alignment of the dentition as soon as possible, without waiting until you have a choice between braces and implantation.
If you are postponing the resolution of the issue due to financial circumstances, in our clinic you can use the installment plan . And if you are worried that using braces will damage your image, we will offer you invisible or lingual braces or transparent mouth guards.
In our center you get a set of unique guarantees for dental services, including guarantees for a positive result of orthodontic treatment and its safety for 7 years after removal.
Make an appointment with the orthodontist – the initial consultation is free!
For more information visit our website Versailles Dental Clinic