Implant-Assisted Comprehensive Orthodontics

A 43-year-old man used to have chronic periodontitis (Fig.1 (10 years ago)).  The teeth #14 and 15 appear to have peri-endo disease (Fig.2 (taken 2 years later)).  The tooth #16 erupts and mesially shifts 3 years post #15 extraction, 2 years post #14 RCT (Fig.3).  Five months post #14 immediate implant and immediate provisional (Fig.6: 6), comprehensive orthodontics is being contemplated to correct crowding (Fig.4,8,10), cross bite (Fig.5,6: U5) and incompletely erupted UL8 (Fig.6,7 (posterior view)).

On banding & bracketing, modify UL6 provisional so that it has normal overjet with the opposing tooth (Fig.7'), i.e., more buccal than UL5 and less than UL4, and there is mesial and distal clearance to accomplish the orthodontic movement of the neighboring teeth (Fig.9' (upper left arch view)).  The implant provisional acts as an anchorage.  In return, the orthodontic treatment is also beneficial to the bone growth around the implant.

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Xin Wei, DDS, PhD, MS 1st edition 06/20/2016, last revision 05/18/2018