Problem: a woman came to Family Dental on the advice of friends - she was looking for a clinic where she could restore two missing teeth in her upper jaw. During the diagnosis, the congenital absence of several teeth (primary adentia) and the long-term absence of one of the upper teeth due to extraction (secondary adentia) were discovered. The absence of teeth caused displacement of neighboring teeth and malocclusion.
Solution: the bite was corrected using Damon braces (the normal closure of the upper and lower teeth was restored), a place was prepared for prosthetics of the two upper teeth, 2 Astra Tech dental implants were installed, 13 teeth were replaced with ceramic crowns (E.max ceramics and zirconium dioxide).
Consultation, diagnosis and development of a comprehensive treatment plan
The woman had her central front tooth removed in another clinic because the tooth had decayed. At that time, she was not ready to install a dental implant, so the tooth was covered with a suspended structure to restore minimal aesthetics:
On the upper left there is no one more tooth (long ago removed due to destruction), and there is a gap between the teeth.
After some time, the woman began to look for a clinic where she could have two teeth restored with implants so that it would be beautiful. On the advice of friends, she turned to the Family Dentistry to orthopedic dentist A.S. Ivankov.
At the consultation, it turned out that, apart from the two removed teeth, there were no fifth teeth from birth (primary adentia), that is, there were milk teeth, but the permanent teeth did not grow during the change of teeth. Since this was a long time ago, the remaining teeth have shifted, and the missing teeth have closed almost completely. Due to the displacement of the teeth, the bite is disturbed, and in some places the upper teeth overlap the lower teeth (crossbite). An incorrect bite causes overload of certain groups of teeth, so there are areas of receding gums (gingival recession) in the area of the lower front teeth.
The orthopedic dentist advised us to start preparing for prosthetics by correcting the bite. Once the correct closure of the teeth has been restored and the place for prosthetic replacement of the two upper teeth has been prepared, it will be possible to install dental implants and crowns on implants. In a correct bite there will be no overload zones, implants and crowns will last longer.
The patient consulted orthodontist M.P. Sleptsova, calculations were made using dental casts and x-rays (panoramic, TRG in lateral projection). The patient also visited an osteopath, who at Dial-Dent always takes part in the diagnosis and treatment of orthodontic patients, since all changes in the position of the teeth affect posture, the functioning of the muscles and joints of the head and neck, and the functioning of the body as a whole.
The treatment plan was drawn up at a joint consultation of an orthopedic dentist and an orthodontist - the main specialists in this treatment. The patient’s desire was this: to make it beautiful and functional, but there is no need for perfect aesthetics, it’s better to have fewer interventions. Since the 5th teeth are missing evenly in all segments, and the gaps from them are almost completely closed, it was decided not to expand the teeth in these places, but, on the contrary, to move them, finally closing the gaps between the teeth, and create even dentition. The chewing teeth are worn down and destroyed by caries, the bite needs to be made higher, so after treatment with braces, the missing height of the teeth will be restored by dental crowns.
Treatment plan:
- Hygienic preparation for complex treatment.
- Re-treatment of the canals of one upper chewing tooth with a microscope, replacement of the old pin in the tooth with a new one made of fiberglass (since there will be a ceramic crown), treatment of dental caries.
- Orthodontic treatment – expansion of the upper dentition and restoration of normal closure of the teeth, preparation of a site for the installation of 2 dental implants in the area of the central and fourth tooth on the upper jaw on the left with displacement of the canine to the center, closing the gaps between the teeth on the lower jaw.
- Osteopathic correction throughout the entire orthodontic treatment.
- Installation of two Astra Tech dental implants.
- Dental prosthetics with ceramics (on implants and three front upper teeth with ceramic crowns made of E.max ceramics, and on chewing teeth with crowns made of zirconium dioxide).
The issue of eliminating gum recession (transplanting soft tissues into the recession zone) remained outside the treatment plan for now, since the patient did not want to increase the scope of surgery. It was decided to monitor the gums after orthodontic treatment, since in this case the cause of recession is precisely the overload of groups of teeth due to malocclusion, and after eliminating the overload, the recession can stabilize.
The estimate for treatment described in detail all the stages, their sequence, duration, and the cost of treatment at each stage (payment in stages). Treatment according to a pre-compiled estimate is much more convenient for the patient - there are no unexpected unpleasant surprises, the final amount of expenses and the time required for treatment are clear.
Commentary by the chief physician of Dial-Dent, orthopedic dentist S.V. Tsukora: “Some try to save money by carrying out different stages of treatment in different clinics (one has a familiar therapist, and another offers a special offer to brush your teeth). With this approach, there is no guarantee for the entire treatment; you often have to redo someone else’s work because it is not consistent with the final result.
The right approach in difficult cases is to look for a clinic where a team of doctors works and the treatment is carried out thoughtfully, step by step! After completion of treatment, the clinic will be able to provide a guarantee for all work performed. The patient must also follow preventive measures after treatment - come for examination, have professional teeth cleaning. If all this is done in one clinic, then there will be no problems for many years.”
Correction of bite – treatment with braces
Treatment with braces lasted 2 years. Damon self-ligating braces were used for treatment. Ceramic braces were installed on the front teeth, which created greater comfort for the patient, since they are hardly noticeable on the teeth.
Due to crossbite in some areas, overbites were placed on the lower teeth at the beginning of treatment.
After achieving proper closure of the teeth, the onlays are removed without leaving any traces.
The patient visited the orthodontist every 1.5 months.
Osteopathic correction was carried out after almost every visit to the orthodontist. The osteopath relieves accumulated tension in the bones of the skull and masticatory muscles, which facilitates the movement of teeth and reduces pain after installing new equipment or replacing arches. Treatment by an osteopath helps stabilize the result of bite correction.
As a result of orthodontic treatment, the dentition is aligned and space is created for prosthetics of the two upper teeth.
To temporarily restore the aesthetics of a smile, the missing central tooth is hidden using a hinged structure.
Is it possible to put braces after implantation?
When there is already an implant, it is permissible to install staples, but provided that there is absolutely no pressure on the artificial root. This technology is acceptable:
- Bite correction is planned on the incisors and canines, and the implant is implanted instead of the chewing tooth (premolar, molar).
- Installation of implants instead of missing molars, which will subsequently be used as the basis for a braces system.
- With age-related deformation of the dentition, the previously installed implant retains its position in the bone. Fixing braces in this case does not put any stress on it.
You can put braces on crowns if they are installed on living units with roots. Braces on crowns placed on implants are not installed.
Dental prosthetics in Moscow together with orthodontic bite correction can be carried out in the German center of aesthetic dentistry SDent. The comprehensive work of specialists will allow you to achieve the desired result in a shorter time.
Installation of dental implants
Two Astra Tech dental implants (Sweden) were installed. These are reliable implants that have been installed at Dial-Dent for more than 15 years. Astra Tech implants perfectly into bones due to the quality, as well as modern materials and technologies used in their manufacture.
After 4 months it was possible to begin dental prosthetics.
Dental prosthetics with ceramics
After correcting the bite, the gum recession stopped, as the overload of the teeth was eliminated, the patient did not complain about tooth sensitivity, and did not want to have another operation for the sake of aesthetics, so a soft tissue transplant was not performed and the gum level was not changed. This is decided before dental prosthetics, since the shape of the dental crowns depends on the level of the gums.
At the first stage of prosthetics, wax modeling was performed - models of dental crowns were made from wax so that the patient could evaluate the type of restorations before preparing the teeth.
Temporary dental crowns are then made from the wax models. Temporary dentures help the patient get used to the new sensations of teeth closing and appearance. You can make adjustments at this stage to make permanent crowns more perfect. In addition, temporary crowns are needed so that the gums take the desired shape in the area of the implants, since there have been no teeth there for a long time, and the gums become smooth, but should look like an arch.
A few weeks later, when the gums had returned to normal shape, impressions were taken for permanent ceramic crowns.
Dental crowns were made in Dial-Dent’s own dental laboratory (teeth with crowns are marked on jaw models):
Prosthetics of the front teeth requires excellent aesthetics, so crowns for all front teeth are made of E.max ceramics (including implants). E.max ceramics make it possible to make very thin restorations characterized by the natural translucency of the enamel. To make teeth on implants look natural, the abutment (the base for the crown installed on the implant) is also made of ceramic. For chewing teeth, strength is more important, so the crowns for the chewing group are made of zirconium dioxide.
Partial braces
Orthodontists use this type of construction in cases where it is necessary to correct deficiencies in only one of the jaws or at the initial stage of complex treatment. Partial braces are used for minor malocclusions caused by the misalignment of one or two teeth. The system is optimal when it is necessary to correct local tooth curvature in one area of the dental row.
This design is installed on only one jaw, and this is a very convenient solution: a partial braces system is significantly cheaper in cost than a full-fledged one, and it also does not create inconvenience when chewing food. But to use it, a number of conditions must be met.
Dial-Dent specialists who restored the beauty of your smile
- Orthopedic dentist A.S. Ivankov - treatment planning, coordination of specialists’ work, dental prosthetics with ceramic crowns.
- Orthodontist M.P. Sleptsova - treatment with braces, preparation for dental prosthetics.
- Implant surgeon V.P. Alaverdov – installation of dental implants.
- Osteopathic doctor V.V. Bystrov – osteopathic correction during the period of occlusion correction.
- Dentist-therapist – treatment of dental caries, root canal treatment with a microscope.
- Dental hygienist E. Smirnova – professional dental hygiene.
- Dental technician D.V. Wolf – making dental crowns from ceramics.
- Dental assistants – S. Shchelkova, A. Antoshkina, M. Erkimbekova.
See other examples of the work of Dial-Dent specialists here.
Make an appointment for a consultation by phone +7-499-110-18-04 or through the form on the website. You can ask questions about dental prosthetics to the chief doctor of the clinic, Sergei Vladimirovich Tsukor, at
Braces for missing teeth
So what then? Should I leave an empty space where the tooth fell out and put on braces first and wait a couple of years? Also not an option. Firstly, to install braces, some teeth are necessary - they will be supporting for fastening the system and for influencing the dentition. Secondly, under pressure the gaps formed will close
, there will simply be nowhere to place the implant, and the bite will not be corrected, and it will be extremely difficult to predict the final result.
The solution is to install temporary mini-implants
, designed for a certain load, and when the dentition has already taken the correct shape - replace it with permanent ones.
In any case, each dentition is individual, and each problem of malocclusion will require its own individual approach. It is impossible to advise two different people with malocclusion on the same treatment regimen: the orthodontist first conducts x-ray diagnostics
and dental examination, and only then provides recommendations.
For such recommendations, come to our appointment! Registration is carried out by phone 597-05-05
or using
the online application form
.
