Abstract
A combination of dental problems such as missing teeth, proclination of teeth and occlusal problems cannot be satisfactorily treated by prosthodontic approach alone. The rehabilitation of patients requiring an esthetic smile demands the collaboration of multiple dental specialists. the need for orthodontic tooth movement prior to restorative treatment is necessary for some patients, in order to optimize both esthetic and functional aspects of dental treatment.The present case report achieved successful implant based oral rehabilitation in a patient with absence of the right maxillary central incisor utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.
Highlights
Adult patients with missing teeth often present with a skeletal malocclusion, a reduced vertical dimension and some degree of temporomandibular disorder, which often require a multidisciplinary approach for the effective treatment of such complex cases [1]
Orthodontic movement of tooth usually become necessary when tooth is rotated medially or distally tilted or shifted extruded or intruded to enhance the relationship with the adjacent tooth and to correct alignment in combination with multiple missing teeth before starting a prosthetic treatment. [2] planning for treatment of patients who require pre-prosthetic orthodontics must always begin with a diagnostic wax-up, which is an important tool that enables both the orthodontist and the restorative dentist to visualize the final results
The orthodontist should confirm that the changes in tooth position on the diagnostic cast can be achieved in the patient’s mouth; the restorative dentist should confirm that tooth position is ideal for future restorations that are both esthetically and functionally acceptable
Summary
Adult patients with missing teeth often present with a skeletal malocclusion, a reduced vertical dimension and some degree of temporomandibular disorder, which often require a multidisciplinary approach for the effective treatment of such complex cases [1]. [2] planning for treatment of patients who require pre-prosthetic orthodontics must always begin with a diagnostic wax-up, which is an important tool that enables both the orthodontist and the restorative dentist to visualize the final results. In the maxilla, it was planned to extract first premolars to provide space for the anterior implant and to correct the class II canin relation Treatment Progress Upper and lower leveling and bite opening (of the tooth 12) was achieved with a progression of round wires (.016 ̈, .018 ̈, .020 ̈) with seconnd order bends In the maxilla, the modification of the torque of the incisors and the placement of a spring compressed between teeth 12 and 21, allowed the opening of a sufficient space to place the implant position When the space was sufficient between teeth and 21 an aesthetic cover was bonded to hide the space The mesialization of the second and third molars to close the first molars spaces requires more time but it’s corresponding to the patient’s demand (patient does not like a mandible prosthetics because of financial reasons) This pre-prosthetic orthodontic treatment exactly replies to the demand of the patient and aslo allowed her prosthodontic to place anterior implant supported crown in the new dental equilibrium and function
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