Opinions on implant

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#1 Post by **altinure** » Tue Mar 28, 2006 9:22 am

Ok.

I was just wondering if I could get your opinion on this situation.

I've been in braces for a year now. The reason I got them was because I for some reason am missing my top right lateral incisor (due to imbreeding or something, haha, kidding). I had nearly perfectly straight teeth before braces, so the main plan was to create room for an implant. They would create the room with the braces, and then I would wear a retainer for two years with a fake tooth attached. I would then get the implant.

My orthodontist made a comment at my last adjustment. He said that there wasn't a lot of room for the implant afterall, and that he might have to just close the gap. He didn't want to do this because he said it would really mess up my midline, but "we just have to work with the room we've got."

So, can you give me any opinions on this? Here's a picture of the gap. Sorry the quality is bad. It was just taken with a camera phone, but I think you get the idea.

http://img.photobucket.com/albums/v321/ ... 101125.jpg

#2 Post by **altinure** » Tue Mar 28, 2006 9:43 am

Oh yeah, I forgot to mention. If you couldn't tell from the picture, he has put a spring between the gap to try to push my teeth apart as far as he can to harness any additional room in my mouth that the powerchains didn't already accomplish, but it's more just making my teeth crooked, haha.

I guess what I'm wondering, is whether or not from what I've told you and the picture if you think the implant is still possible? If it's not, do you think closing that gap would really cause my smile to be off center?

Thanks.

#3 Post by **momof2grlz** » Tue Mar 28, 2006 9:46 am

I'm not the Doc, but I'll throw in my two cents. Have you had a consultation with an implant specialist yet? I would think he would be able to tell you if the ortho has created enough space for the implant. I know I've heard my ortho mention that implant docs call and want him to move teeth a millimeter or two for an implant. So I think they have to work together for the best outcome.

Chris

#4 Post by **altinure** » Tue Mar 28, 2006 9:50 am

Yeah, I haven't done that, but my orthodontist never suggested it. I think mainly because I'll be in grad school by the time I'm ready for the implant, so I'll be out of state then and therefore going to a different implant specialist.

#5 Post by **Betty Bat** » Tue Mar 28, 2006 10:02 am

I went to an implant specialist before I got my braces. I have a similar situation to you - baby teeth with no permanent ones behind them (it's more common than you think!). I'm going to get springs in a while, but I'm not sure when. I've been in braces for 5 months now.

So, you may as well try a consultation with an implant specialist, even if it's not the one that you are going to use long term, just to get the info.

#6 Post by **lilsisbet** » Wed Mar 29, 2006 10:50 am

Hello Altinure.....

I guess you can say I am in the same boat as you. On my left I am missing my lateral and on on my right the lateral that is there came in "peg". Unfortunately I don't have enough room on my left to make room for an impant or bridge - I don't have any gaps between any of the teeth on the left. And yes.. my midline is off. The plan for me is to veneer the peg lateral to make it look like a full lateral and to veneer the canine on my left to make it look like a lateral.

To correct the midline - which currently is too far to my left - they will have to do a bit of shaving off my canine on the right. I was told it might compromise the tooth and I may end up having to get it veneered as well. I went into this knowing that I wouldn't end up with a "Hollywood Smile" but it will be a heck of a lot better than it was originally. (Did anyone follow this - cuz I got confused).

Don't know if this helps.... but missing laterals are very common.

#7 Post by **eoberhauser** » Thu Mar 30, 2006 6:25 am

Yep same boat, just different side. I'm missing my left lateral as well, and I currently have the spring opening up a gap. The funny thing is, it never occured to me that we wouldn't be able to open a gap large enough for an implant. In my eye, you could drive a truck through the darn thing!

The second option for me when I first went for the consultation was to pull my right lateral and bring everything forward so that my smile was symmetrical. Like you, I had basically straight teeth, just my midline was terribly off b/c of the missing lateral. Maybe this is an option for you. They were going to shape the canines of course to look more like laterals. I do hope you find your solution, let us know how it goes.

Erin

#8 Post by **Betty Bat** » Thu Mar 30, 2006 7:25 am

I'd like to modify my suggestion a little - go see your regular dentist. The implant dentist will put in the plug, but someone else (most likely your regular dentist) will shape the tooth that goes on top of it. And, he/she might be able to tell what is possible for you. In my case, my regular dentist said that he could shape an implant and put it in, even if I didn't get braces first, but the tooth would be a strange shape.

So, perhaps you could get some info about what's possible from your regular dentist as well.

#9 Post by **altinure** » Thu Mar 30, 2006 9:50 am

Yeah, I'm not sure. I guess I'll see what he says at my next adjustment. I don't really get why they can't just put a smaller implant in instead of a full sized tooth. I doubt it'd be that noticible.

#10 Post by **rainbow13** » Wed May 03, 2006 11:13 am

I understand exactly what you are going through. I am missing my left lateral incisor and am going through the whole braces/implant thing. I wore my braces for 14 months to align my teeth back into the right spots and make room for my new one. I just got my braces off and I go back next week to have the second stage of my implant surgery. (I actually had the first a few months ago while braced, ortho recommened I do that). I would definetly suggest talking to a surgeon who specializes in implants. they need to judge the area and bone structure. I had to have a bone expansion done due to the lack of bone because I never had the tooth. Your whole process sounds very familiar to me, I had the spring thing too, to move my teeth. I now have a essix retainer w/ a fake tooth in it and no one can even tell I am missing it

If you have more questions I would be happy to answer them if I can!

#11 Post by **Betty Bat** » Wed May 03, 2006 12:33 pm

Rainbow13,
You have a retainer with a false tooth in it instead of an implant? Could you say more about that? All of this discussion about osteoporosis and implants (other topics in this section) is making me a little uneasy and I was wondering if what you have might be an alternative.

Thanks.

#12 Post by **Indy** » Wed May 03, 2006 8:59 pm

Betty Bat,
Here's my 2 cents. I am at risk of needing an implant for 1 of my top 2 front teeth. I guess there is a chance my roots could resorb more (already short from old accident), but I was told by the 2nd ortho I saw that IF the tooth came out that they would just glue a fake tooth to the bracket

and then I'd procede with implant surgery. Better a fake tooth than a big gap

LOL

It sounds like rainbow13 is at the stage of having the implant (screw) put in, but it hasn't fused with the bone yet to put the more permanent and stable implant crown in place.

altinure- I agree to get a consultation or talk to your regular dentist. Mine would do the shaping of the crown, just can't do the surgical part. Therefore, he/she would have a better idea of what is possible. It would suck to go all this way with braces in hopes of fixing this problem and then be told after all that work that it's not possible!!
Good luck & keep us updated.

#13 Post by **rainbow13** » Thu May 04, 2006 4:33 am

Yep, I have my essix retainer that just has a tooth sitting in it. So when I take it out, the tooth comes too

My reason for ever getting braces was too move my teeth into position for the implant. My ortho suggested starting the implant treatment when i got the space open enough (per my surgeons agreement). I believe most implant surgery happens in two stages, First they actually place the implant into the bone. This has to heal for several months (to allow the bone to adhere to the impant and become strong). After healing you go back and have the abutment placed, which is like a little screw sticking out that they will finally place a crown onto. Right now I am at the second stage. My ortho wanted me to wait until the braces were off and everything was finished before placing that final tooth. The whole time I have had my braces, I have never had to walk around w/ a big space.(Thank goodnes...I was SO worried about that!) I have always had a fake tooth, either one w/ a bracket on it attached to my braces or now w/ my retainer. Hopefully I have explained it all correctly

#14 Post by **rsprouse** » Thu May 04, 2006 5:23 am

Your space looks a little small for an implant, but it may just be the picture. Typically a lateral will need 8-10 mm of space to look natural. You will need 3 mm of bone between the implant and the adjacent roots. It is really impossible to tell without proper diagnostic information (radiographs, ct scan, clinical diagnosis, etc). But if you measure the lateral on the other side and then measure the space you can get a good idea. If the space is within a mm or two of the other lateral then you have a good chance that an implant will work. Your dentist/prosthodontist/periodontist/oral surgeon/ortho should be able to help.

Take Care,
Rory