[Others]  Implant and ortho

by Bob Wu at Thu, Jul 14, 2011 4:58 PM

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Mark Kwon Replied at Fri, Aug 12, 2011 3:05 AM

ORTHO first ! IMPLANT second!

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Bernard Jin Replied at Fri, Jul 15, 2011 3:08 AM

I don't think I answered the question very well. I should rephrase: in short - I would recommend performing Ortho 1st. With Ortho, you can also develop alveolus (bone!!! :) simply by drifting dentition through a site, then away from it. To answer the 2nd question: if no forces are applied on the implant, it should integrate just fine. In fact, there is the 'RAP model' for osseous remodelling which may even facilitate osseointegration. But the concerns which I brought up previously still are important. Cheers!

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Bernard Jin Replied at Fri, Jul 15, 2011 2:51 AM

Hi Bob, Great question. Although you certainly CAN perform orthodontic and implant treatment simultaneously, my concern is whether it is practical. By that, I anticipate that orthodontic treatment will typically move teeth into/within the archform. Unless everything is done in a very exact manner, there is significant chance for undesirable obstacles. For example, an implant is placed at a site; however, an unexpected tooth movement requires the drift of another responding (i.e. anchorage vs. actively moving) tooth into the implant site. The only recourse is to either remove the implant, remove a tooth, or accept an undesirable outcome. Yet another concern is whether the orthodontic treatment exerts any force on the tooth directly (such as invisalign) or indirectly (such as adjacent bracketed dentition exerting force on the implant). If the implant has not fully integrated, the undesirable forces could actually complicate matters for the implant. IF the implant was fully integrated before orthodontic treatment started, then detrimental influences on the implant will likely be minimal (unless excessive forces - such as face masks, bite planes, or headgear are used). But remember - with an implant already integrated - your outcomes are limited since the boundaries of how far you can move your own dentition are dictated by the implant. If you plan on using a TAD, I don't think it is a problem. I know orthodontists who have ordered TADs and then used the TADs as anchorage for Dento-alveolar Cross Bite Correction. One last thing - if an implant is under sufficient force, it can move through bone (just like a tooth). Interesting, huh?

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Bob Wu Replied at Thu, Jul 14, 2011 5:07 PM

Hi everyone, When treatment planning ortho and implant on the same patient does it matter which procedure come first (provided there is enough room for implant placement prior to orthodontic tooth movement)? Is there any adverse effect on the implant if ortho is done at the same time as implant placement? ie. bone remodeling around natural tooth that might cause implant to fail? Thanks everyone