When the elimination of defects in the dentition is possible without implantation

     Defects in the dentition are a common problem with which patients turn to the dentist. Elimination of defects in the dentition should be timely, that is, at the first signs, in childhood. This will make it possible to have a beautiful smile, as well as save the patient from possible complexes about his teeth. Such patients are shown an orthodontic examination, which will determine the need for dental implantation. In what cases is it possible to eliminate a defect in the dentition without implantation? What examinations should be carried out to understand that implantation is not needed?

Why is it important to eliminate defects in teeth in time?

      Ordinary orthodontic preparation is carried out at the request of the patient, if, in addition to defects in the dentition, the patient has a dental anomaly or deformities that have arisen as a result of untimely correction of defects in the dentition, especially defects that have arisen during the growth of the jaws in childhood.

     Basically, defects in the dentition require renewal for an aesthetic smile, normal chewing and to prevent the occurrence of dental deformities. If the defect of the dentition does not resume, then due to the vertical drift, the antagonists will move vertically, and as a result of the distal and mesial drift, the teeth that are next to the defect will shift, rotate and tilt towards the defect. These phenomena were formed in the process of evolution precisely to compensate for the abrasion and loss of teeth.

Patients who seek medical help do not always do it in a timely manner, so defects in the dentition are very often complicated by dental and jaw deformities and anomalies. Therefore, in order to properly plan the rehabilitation of the dentoalveolar apparatus, it is necessary to conduct an examination of each such patient by an orthodontist.

What is it about? The fact is that defects in the dentition provoke dento-jaw deformities. Therefore, the correction of such deformities is a necessary stage of treatment. If the deformation is insignificant, then it is possible to grind the antagonists and some change in the shape of the prosthetic construction to compensate for other forms of deformation - the medial and dental shift of the teeth, which combine the defect of the dentition, their rotation and inclination.

When is it possible to correct defects in the dentition without implantation?

     If the patient has a dento-maxillary anomaly and a defect in the dentition, then the place in the dental arch that has arisen due to the absence of a tooth (extraction or adentia) can be used for orthodontic movement of individual teeth in segments of the dentition with a shortage of space. But sometimes detailed planning of orthodontic treatment may reveal that there is no need for a dental implant.

     So, dear colleagues, not all defects in the dentition should be renewed with dental implants. In cases of lack of space for individual teeth, that is, in the presence of a dento-maxillary anomaly, a place in the dental arch formed from a defect in the dentition is used to align the teeth. Such orthodontic "preparation" can sometimes leave the implantologist without work. After all, do not forget about the responsibility to the patient, including legal. Will the specialist do the right thing if he does not offer orthodontics in such cases?

     Together, the implantologist and the orthodontist develop options for a treatment plan for each individual clinical case, which is complicated by a dento-maxillary anomaly or deformity.

Algorithm for examining patients with dental problems

     At a clinical appointment, a complete implantological and orthodontic examination of the dentition is performed. It includes an analysis of the thickness and height of the alveolar ridge, the thickness of the gingiva and cortical plates, the height of the alveolar process, the presence of periodontitis, the distance from the sinus or mandibular process.

     Examination of each patient should consist of an examination of the face and facial signs of anomalies, intraoral signs, examination of the functions of the oral cavity, conducting candillar tests, analysis of the CDM, OPTG and TRG. Based on these data, a diagnosis is made.

There are cases when the orthodontist is able to improve the conditions for implantation:

• Move individual teeth along the alveolar process to restore its thickness.
• Orthodontic extrusion of fragments of roots or teeth to be removed to preserve bone.
• Classic is the intrusion of antagonistic teeth that have shifted into place as a result of vertical drift.
• Renewal of bone thickness above the sinus and above the mandibular nerve by distalization of the medially located teeth.

     Thus, one should not rush to offer the patient dental implantation, because his clinical case may not be so hopeless.