Preparing teeth for implants and dentures

Indications for orthodontic preparation

Preparation for implantation in the lateral sections

Most often, 2 clinical situations are formed in the lateral sections with missing teeth:

• With a missing tooth on the lower jaw, the teeth on the upper jaw begin to extend downward in an attempt to compensate for the loss on their own.
  The orthodontist's task is to lift (intrude) such a tooth that has protruded into the bone tissue so that the prosthodontist can place a crown of optimal height in place of the antagonist tooth.

• As a result of changes in chewing load, neighboring teeth are tilted in place of the missing tooth. This tilting and protrusion of teeth leads to periodontal disease, exposed tooth necks and sensitivity, improper tooth-to-tooth contact, and decreased chewing efficiency.
  The orthodontist's job — to return the teeth to their optimal tilt and create space for a crown.

Preparing for veneers

Sometimes a patient comes to the orthopedist with a complaint about aesthetics: do not like the shape, size, color of the teeth. In this case, aesthetic rehabilitation – installation of veneers is indicated.

But, if the patient has crowding of teeth (uneven, narrow teeth rows) or an incorrect bite, the installation of restorations without preparation can lead to negative consequences:

• Excessive preparation ("turning") of the tooth for restoration. The orthopedic surgeon will have to remove more tooth tissue to mask the uneven position of the teeth.

• Chipped and damaged restoration due to excessive chewing load with improper bite.

In most cases, treatment without orthodontic preparation is only a temporary compensation, «masking», which can further negatively affect the final result and lead to more serious complications.

Says

Mahonina Maria Sergeevna

In such clinical situations, the treatment of the patient requires a comprehensive approach. A smooth interaction between the orthopedic surgeon and the orthodontist – this is the key to high-quality preparation for rational and aesthetic prosthetics.

Smile Zone Correction for Missing Front Incisors

There is an aesthetic problem in the smile area associated with missing front teeth (such as lateral incisors). Nowadays, it is common to be missing even their rudiments – lateral incisor adentia. It does not cause any complaints as long as there are baby teeth in this place, but when the permanent bite is formed, the question of restoring the defect arises.

In these situations, the orthodontist, prosthodontist and implantologist choose a comprehensive treatment strategy. Possible solutions:

• implantation and prosthetics in place of missing teeth,

• orthodontic movement of adjacent teeth with their further restoration with veneers to create a harmonious smile.

The situation with the absence of one of the anterior incisors is less common. If the defect has existed for a long time, there may be problems with implantation in this area due to the lack of bone tissue. Then the orthodontist offers a treatment plan with moving the lateral incisor to the place of the missing central incisor, and implant prosthetics are carried out in the vacated area with sufficient bone tissue level.

Why is it important not to delay the start of treatment?"

The longer a tooth is missing, the more pronounced will be the tilting and protrusion of the teeth – orthodontic preparation will turn into a full-blown long-term treatment on a bracket system with additional elements (e.g., miniscrews).

Pulling the teeth toward the missing tooth will lead to periodontal disease, bone loss around the teeth, and gingival recession.

Bone tissue in the area of a missing tooth changes its structure over time – it atrophies and decreases in height and width. Implantation in this area will require additional surgical intervention – bone grafting (adding bone to the area of bone deficiency).

The loss of lateral chewing teeth increases the load on the remaining teeth – this can lead to increased abrasion, trauma, chipping, decreased «height» bite and the formation of a deep bite.

Partial or full orthodontic treatment?

We offer different options to solve the initial problems depending on the clinical picture and aesthetic wishes of the patient.

• If a local problem is combined, for example, the lack of a place for prosthetics, with malocclusion, we recommend a full-fledged orthodontic correction using a bracket system or aligners. This way it is possible to get the most aesthetic, functional and long-term result.

• If the closure of the remaining teeth is correct, then it will be enough to carry out treatment on a partial bracket system (braces will be installed on several adjacent teeth) only in the area of preparation for prosthetics. In the case of partial treatment, an additional support will be required - a minivan, with which the orthodontist will be able to create a place, return the teeth to the correct tilt and position.

Team approach – our strength

Our practice has utilized a team approach for many years to provide quality, reliable, predictable, and aesthetic dental treatment results.

We provide a comprehensive treatment plan that involves multiple specialists, including orthopedic and orthodontic dentists. A unified plan is created, with tentative timelines for the start of each phase of treatment.

The orthopedist plans and develops the overall treatment concept. He discusses with the orthodontist the desired result, and the orthodontist analyzes the possibility of its realization. In this situation, the orthopedist plans the movement of the teeth to the nearest millimeter and gives specific instructions to the orthodontist.