I work in a multidisciplinary clinic and we see patients coming to visit us with lost teeth every day and looking for a solution and they also have some teeth alignment issues. It is important for these patients are examined by both the restorative dentist and orthodontist for the best treatment outcome before deciding on what is the best treatment solution. This is because the main problem with a dental implant is it fuses with the bone and can’t be moved with orthodontic treatment.
When there is an associated malocclusion, the position of the teeth around teeth, in general, is not in the ideal position and the correction of the bite requires teeth to move in either a forward/backward manner or transversely due to arch expansion. In the ideal situation, some of these cases will require teeth extraction to achieve the best aesthetic result. In these cases, dental implants may be totally unnecessary as the space can be totally closed through orthodontic treatment. This, however, will be dependent on the location of the missing teeth.
However in cases when correction is malocclusion does not require extraction, it is still advisable to have the malocclusion corrected first before placement of the dental implant as the position of the adjacent teeth and bite changes with orthodontic treatment. Therefore, placement of dental implants when teeth are in the corrected position will ensure the dental implant to be placed in the best position and the shape of the restored teeth in the most aesthetic manner.
If a dental implant was placed without any orthodontic consideration or assessment, patients may face the dilemma of
- Having to remove the dental implant to facilitate the orthodontic treatment which will require surgery
- Remove a good tooth to make space for movement,
- Accept a compromise result.
Also, if you lost your tooth for a prolonged period of time, the adjacent teeth may also become tipped or drift into the space of the missing tooth. If you decide not to correct have your malocclusion corrected, the size, position, and shape of a dental implant may be less than ideal. In patients with a deep overbite and require a dental implant in the anterior region, the longevity of this dental implant will also be compromised due to dental trauma from the deep bite.
Patients with missing teeth and with alignment issues should be treated in a multidisciplinary approach. Orthodontics ideally should be done first where necessary. Therefore, I strongly advise anyone with missing teeth and also have teeth alignment issues to be examined by a team of restorative and orthodontists for the best treatment outcome.
