This is not a request for advice. I am just wondering about shifting during the implant process. If a patient gets a molar extraction with bone graft, and then has to wait months before getting the implant, do the adjacent teeth shift at all during the waiting period?
General question about implants
- Thread starter Tony932
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Yes, unless some type of space maintainer is used.
The bigger question is how much shifting happens and will it present a problem for the final restoration. Usually isn't an issue with a molar site, can be an issue with a smaller pre-molar site. In theory it could be an issue with an anterior site, but the reality is that with any anterior site, there's going to be some type of temporary restoration there for esthetics that essentially negates any potential movement of the adjacent teeth.
The bigger issue that we're finding now with implants and tooth shifting is long term after an implant is restored, if a patient has any natural mesial drift occurring, you can very well see an open contact form on the mesial of the implant restoration
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Teeth don't move or shift. This is a myth perpetuated by the American Association of Orthodontists in 1963 in order to get every adolescent in braces.
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I hope you mean that with a bit of sarcasm!
If they don't, then how come, IN MY OWN MOUTH, i've developed an open contact between the mesial of my implant crown on #29 and my natural, virgin #28 twice now? I had my implant restored about 10 years ago, to a tight contact with #28 and #30, I never wore any retention device and about 4 years later I had an open contact between 28 and 29 and still a tight contact between 29 and 30. I had my wife, and orthodontist, treat my mandibular arch to close the contact between 28 and 29 (as well as deal with some of the subtle lower anterior crowding that had started in my mouth in my 30's 🙁 ) and like most ortho patients, once I had the brackets taken off, I wore my retainer for maybe a couple of weeks, and low and behold another 5ish years later, that same open contact between 29 ans 28 is opening up again, and when I try and put my 5ish year old retainer in, it no longer fits, and the plastic of my retainer hasn't changed over that time 🙂 And my long term implant patients have seen similar things, not to mention my post teenage orthodontic patients, who now are in theire late 30's through early 50's who are seeking out a second round of orthodontic care to correct their reformed anterior crowding. I am 100% convinced that any tooth with a PDL in a living person who has the natural process of bone remodeling occurring, can and does move! How much movement is all a function of occlusion, time, periodontal health and parafunctional habits of the patient
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If you have a good, clean extraction site, then an immediate implant can be a good option. If the site had previous pathology or needs to be augmented to make it a good site, then letting it heal first, with or without space maintenance is the better option. Often if it's a posterior site, whether or not I;d consider using some type of space maintainer would have more to do with how long I was anticipating it being before implant placement. If it was potentially going to be a few years, then I'm more likely to use some type of space maintainer, if it's going to be the usual 4 to 6 months for most grafting materials to mature and/or a site without grafting material but had pre extraction patholgy that needed to heal for a few months, then i'm probably not going to use space maintenance.
Like I said before, if it's an anterior tooth, there's going to be some type of esthetic space maintainer there 99.9% of the time, so it really isn't a question in that case
