Osseo News Logo

The Original Dental Implant Community

Sign In

Overerupted opposing teeth: recommendations?

Last Updated: Sep 19, 2017

I have a 50 year old female patient whose LL6 and 7 have been missing for some years. She has requested implants to replace these missing teeth. UL6 has over-erupted to the extent that there is reduced inter-arch space and UL7 to the extent that there is virtually no space for restoring the implants. Enameloplasty of the opposing teeth may be sufficient to create enough space for the first molar but would have to be quite aggressive for the second molar. Appearance is not an issue. She is prepared to compromise and to just have the first molar restored. but I feel this would be a half measure. What do you recommend?

11 Comments on Overerupted opposing teeth: recommendations?

DTY

09/19/2017

Some options; 1) DO NOTHING, tell her it just won't work 2) elective endo and crowns, I hate to kill off healthy teeth, but sometimes you have to compromise for overall well being 3) extract and implant, again I emphasize that I hate to kill healthy teeth, so ...

Dr FJJ

09/19/2017

I would recommend radiographs and pictures

Merlin P. Ohmer, DDS, MAG

09/19/2017

If you can replace the 1st molar and get good occlusion, just place an implant for the 1st molar. 2nd molars frankly have minimal function. If the 2nd molar is that supererrupted, remove it. Or do nothing and let it all ride. Not placing a 2nd molar implant is hardly a compromise.

Charles Lamberta

09/19/2017

Tuff call, you have to explain that there is no easy solution. Hard to say without seeing radiographs and articulated model. Could turn out to be a nightmare especially if the over erupted teeth have brought the bone and sinus with them. Could require more rehabilitation then either you or the patient would like to get into. Good luck!

Dr. Gerald Rudick

09/19/2017

We have no photos , xrays or scan to be able to give a reliable opinion of what to do....but do consider sending her to an Orthodontist for an opinion,........they are able to intrude teeth that have become extruded.

Juan Carlos Echeverri

09/19/2017

If you have experience in orthodontics, there is and intrusion movement that will help with a situation such as this one. You need: 1)healthy periodontium on the teeth to intrude 2) TADs (Temporary anchorage devices) on both sides buccal and palatal 3) mechanical power provided by niti springs or power chain. 4) patience, as this, same as implant stability is based on bone remodeling. It can be done but it needs the above requirements and a doctor who knows orthodontics and TAD management. JC Echeverri DDS

Keith Hollander

09/19/2017

Although the enamoplasy of the second molar would be aggressive, at best you cold cover the exposed dentine with a bonded ceramic onlay, gold, or Zr crown. Worst case would be an exposure then amount of reduction is not an issue, after RCTx.

denis Cunneen

09/19/2017

Pretty straight forward (no X-rays or photos to complicate the discussion) Restoration of first molar is more than adequate occlusion. Upper second molar is entirely disposable, You could prevent further supra eruption of the second molar. crowni the maxillary first molar with a non bonded extension , onto the adjusted medial of the Second

Richard Hughes, DDS, HFAA

09/19/2017

You got to do, what you got to do, to level the Curve of Spee. We had a special lecture on this topic in dental school. You most likely will have to perform endo tx with crowns on or extract the opposing teeth. You do not want to build errors into the system.

RIchard Waghalter, DDS

09/19/2017

Mzin p2roblem is abnormal wear of teeth overt0ime and increased contact areas. There is a need to re-establish cuspid rise and remove balancing contacts and CR-CO interferences. Re-directing the occlusal contacts along the long axis of the tooth minimizes bruxism which is detrimental to implants. Take study models and do occlusal adjustments before planning or restoring any dental implants. Ring adjustments get the patient to 'fake' tension and you will see more retrusive contacts than you had ever thought possible on the posterior teeth. ALso be aware of patients with dual bites, or very long centrics, especially class two malocclusions.

Mike

09/20/2017

Upper seconds molars entirely disposable?? If you want to compress the tmjs. Cuspid rise is not as important as established proper maximum intercuspation position for the lower jaw.

Featured Products

DALI Bone Mix

DALI Bone Mix

The highest quality tissue!

Classic

Classic 50/50 Mix

Promotes osteoconduction

Provides structural integrity

DALI Bone Syringe

DALI Bone Syringe

Prefilled Mineralized Cortico-Cancellous Bone in Syringe

New

Convenient Syringe!

50/50 Cortical/Cancellous

Available in 3 sizes.

Osteogen Plug

Osteogen Plug

Combines bone graft with a collagen plug.

Classic

Eliminate hassle of mixing particulate grafts

Sold in packs of 5 or packs of 10.

Proven safe, and clinically effective

OsseoSeal Flexible Membrane

OsseoSeal Flexible Membrane

Resorbable collagen membrane derived from purified porcine pericardium

Popular

Fast hydration and excellent tensile strength

Good adaptation to various defects

Excellent tear function and duration

DALI One Graft

DALI One Graft

One-Step grafting solution!

New

100% allograft

Eliminates mixing hassle

Moldable after hydration