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Ask UsImplant for Orthodontic Anchorage and Restoration: How to Approach?
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Dr. W. asks:
I have been asked by an orthodontist to place an implant for anchorage. This patient is missing teeth #30 and 31, and the restorative dentist would like the anchorage implant to eventually be restored to replace tooth #31. The training I have had in CE courses for implant anchorage is to place very small screws into the attached gingival. After the teeth have been moved, the implant screws are removed. Has anyone ever done this? I have some limited experience with bone plates used for anchorage, and I am familiar with temporary implants which are used for anchorage, but I am concerned about how the orthodontic changes will affect the final restorative result. Is any one system best suited for such treatment? What should I expect?
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5 Responses to “ Implant for Orthodontic Anchorage and Restoration: How to Approach? ”
RMO sells a complete line of mini implants for temporary anchorage with heads designed to facilitate ortho.
You can use regular implants (I would go with one with agressive threads like alpha bio or a pit easy )to get anchorage, just wait a few weeks, place a temporary acrilic crown on top of a titanium abutment ( make it a one piece, not cemented on top) and get the orthodontist to treat it like a regular 31, with a band. it works like a charm, you can estimate the size for a good crown and the gum heals nicely during the treatment so when its over you can get a great impression with a stable and predictable gum line.
cheers
In my experience of using osseointegrated implants as anchorage best results were achieved by a two-phase surgical technique after 8-12 weeks of osseointegration. This way the thread design is less important and the implant provides sufficient anchorage without loosing much sleep over the intensity of orthodontic forces and the orthotechnique applied. There are differences regarding the bone quality, of course, and my suggestion for maxillary ortho would go in favor of one of the low force systems (for example Damon, or similar). Another benefit was already mentioned by Alejandro, and that is predictability and contouring of soft tissue by the acrylic crown placement. I have been using both osseointegrated implants and miniplant screws in orthodontics, and they both work when properly indicated.
My concern with placing a regular implant rather than a small screw implant for anchorage would be that the proposed tooth movement to the desired final position is not achieved and therefore l am stuck with a nicely integrated implant in the wrong position.
To Carlo:
Implant positioning must be carefully planned in advance having in mind the final treatment goal. Therefore, orthodontist needs to be involved in planning so you don’t get stuck with nice osseointegrated implant in the wrong place. This can jeopardize the complete orthodontic and restorative therapy, and you definitely do not want to do that.
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