Evidence Based Orthodontic Implant Site Preparation – What the Orthodontist Needs To Know

by Wertheimer Mark

Orthodontic treatment of adults often involves interdisciplinary therapy with the need for adjunctive rehabilitation, which involves the placement of implants. The evidence on biological aspects related to implants is voluminous. In order to treatment plan, execute, and deliver optimal outcomes in such cases, it is imperative that the orthodontist is knowledgeable regarding various aspects of implantology. This information is often not part of the orthodontic curricula. The lecture will include elaborate on critical aspects that should be known to facilitate optimal preparation for implants, focusing on soft and hard tissue biology, diagnostics, and biomechanical principles. It will also include information on avoiding complications in such treatment. Fundamental knowledge related to how bone, soft tissue, attached gingiva, keratinized tissue and the dental papilla are affected by implant placement is imperative in order to improve the diagnostics, planning, execution and clinical outcomes of interdisciplinary treatment where orthodontics prepares for the placement of implants. The long-term prognosis of the result and the aesthetic quality of the result are reliant upon this knowledge and your integration with other dental practitioners in the allied disciplines involved in such treatment. Forced eruption to develop bone and soft tissue, and Orthodontic Implant Site Switching (OISS) will also be discussed with clinical examples to illustrate these implant site preparation concepts. Forced eruption involves the orthodontic extrusion of compromised teeth to the point of extraction to develop bone and soft tissue for the placement of implants. OISS involves the relocation of teeth to a different site while developing an implant site in the original position occupied by the relocated teeth. Various surgical options employed to optimize outcomes will also be included. Careful planning and execution via detailed biomechanics facilitates optimal biological, aesthetic and occlusal outcomes improving the prognosis of rehabilitation. All these concepts will be discussed based on information from the peer reviewed scientific literature.

Learning Objectives

After this lecture, you will be able to understand biological aspects related to implants, bone and soft tissue
After this lecture, you will be able to understand orthodontic planning and biomechanics for implant site preparation
After this lecture, you will be able to learn about forced eruption and OISS