Brought To You By Dr. Widman D.D.S.
With some frequency we see patients who have missing front teeth. Often, these patients also have other issues that require orthodontic therapy. Dental implants are usually very successful, so it’s often our first treatment option. However, a number of questions must first be addressed before we can be certain that dental implants are the best choice for replacing the missing teeth.
Our first question is how much space and bone are present? There must be sufficient space and bone to accommodate the implant while still leaving space and bone between the implant and adjacent teeth. We will consult with the periodontist or oral surgeon who will place the implant, plus, the dentist who will complete the restoration in order to determine the desired size of the implant. Often there is inadequate space and /or bone to properly fit an implant. We will determine if creating adequate space or adding bone are possible or desirable.
Occasionally we will determine that adequate space for implants cannot be provided without sacrificing a good bite or other teeth. We also find that while the space may be sufficient, the depth of bone is not and bone augmentation may be needed. If this is the case we will consider alternatives to dental implants, which can include other types of dental replacements or using orthodontic therapy to close space, allowing other teeth to substitute for the missing teeth. Sometimes we find that there is too much space or that it will be difficult to match an implant to the size of the other front teeth. Comprehensive treatment planning is essential so that the patient or parents of the patient are aware of the challenges or limitations that may be encountered.
The patient’s age is another key consideration. While it may be necessary or desirable to treat the patient at a younger age, we may have to wait a number of years between the completion of orthodontic therapy and the placement of dental implants. Dental implants should only be used to replace missing front teeth, when the patient is fully grown. For females, we often recommend waiting until the late teens and for males the early twenties. If the jaws grow after placement of dental implants, it can result in a noticeable discrepancy in the vertical position of the implant in relation to the other teeth. When it’s in the front of the mouth this can result in a rather unattractive appearance. These are just a few of the reasons why it’s imperative to receive treatment from a skilled and experienced orthodontist. If the patient is young and it will be several years before dental implants can be placed, we must consider the best method to retain the space and alignment of adjacent teeth. Choices for maintenance of space can include removable retainers, bonded bridgework, or temporary mini-implants.
Cost is another factor when determining the treatment plan. Between the cost of orthodontic therapy, possible bone augmentation, interim retainers, placement of the implant, and construction of the crown on top of the implant, replacement of even a single tooth can be quite expensive. The patient or parents of the patient should be aware of the potential expenses attached to the various options and phases so that they are certain that they can afford to complete the treatment.
Answering all these questions should involve considerable time and discussion with the orthodontist. Getting the right answers, especially before treatment begins will help improve the patients chances for a successful and attractive result.
Arnold Widman D. D. S. office is located at 1900 Hempstead Turnpike, East Meadow, Suite 202 516-794-9211