What is a dental implant?
An implant is a screw-shaped artificial root, usually made of titanium or zirconia, placed in the jawbone where a tooth is missing. Once the implant has fused with the bone (osseointegration), a tooth-like crown is made on top of it. Not requiring the neighbouring teeth to be cut down is one of the features that sets an implant apart from a bridge.
Who can have an implant?
- People missing one or more teeth whose jaw development is complete
- People with enough bone volume, or in whom it can be achieved with bone grafting
- People whose general health allows a surgical procedure
Uncontrolled diabetes, heavy smoking and some medical treatments can affect the success of an implant; these are taken into account in planning.
Why might orthodontics be needed before an implant?
When a tooth has been missing for a long time, the neighbouring teeth tilt into the gap and the tooth in the opposite jaw may over-erupt towards it. As a result, there may not be enough correctly positioned space for an implant. With orthodontic treatment:
- Tilted teeth can be uprighted to open a space of suitable width for the implant,
- Enough distance can be created between the roots for the implant to be placed,
- The bite can be adjusted to balance the load on the implant crown.
In suitable cases, these movements can be made with clear aligners; a tooth-coloured filler (pontic) can be added to the aligner over the missing tooth to keep the appearance natural.
Does an implant move with orthodontic treatment?
No. Because an implant fuses with the bone, it cannot be moved like a natural tooth. So if orthodontic treatment is needed, orthodontics is usually done first and the implant placed afterwards. If there is already an implant, the orthodontic plan is prepared around its position; in some cases the implant can also be used as a fixed anchor for moving other teeth.
Congenitally missing teeth in young people
In young people with congenitally missing upper lateral incisors in particular, two options are considered: closing the space with orthodontics, or keeping it open until growth is complete and placing an implant later. Because an implant in a still-growing person can end up out of line with the neighbouring teeth, it is usually planned after jaw development is complete. In the meantime, the space can be maintained with temporary solutions such as a plate or a bonded bridge.
Caring for implants
Implants do not decay, but the gum and bone around them can become inflamed (peri-implantitis). As with natural teeth, regular brushing, cleaning between the teeth and periodic check-ups are important.