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Comprehensive Management of Implant Anchorage in the Multidisciplinary Patient Comprehensive Management of Implant Anchorage in the Multidisciplinary Patient

Author(s):

Vincent G. Kokich, Sr., DDS, MSD

Date Added:

1/1/0001


Summary:

In recent years, dental implants have become an accepted method of replacing missing teeth. Today millions of implants are placed annually to rehabilitate and reestablish patients’ occlusions. However, in many of these individuals, the teeth may be in less than ideal position to accept the integration of single implants or groups of implants with the remaining teeth. Many of these patients could benefit from orthodontics to reposition malposed teeth to enhance the overall occlusal scheme. However, if significant numbers of teeth are missing, the orthodontist is at a disadvantage because of a lack of anchorage to effect the desired tooth movement. Past studies have shown that implants can be used as anchors for both orthopedic and orthodontic movement. However, some studies describing the use of implants for orthodontic anchorage do not recommend utilizing the implant as a restorative abutment after the orthodontic movement. Although nonroot-form onplants and implants can be placed in nonavleolar bone, used for anchorage, and then removed, this type of implant anchorage is not useful in patients having many missing teeth and multiple edentulous spaces. In this type of dental patient, an interdisciplinary approach of placing the implant prior to orthodontics, using it as an orthodontic anchor, and then using the same implant as a restorative abutment may be a more appropriate and cost-effective solution. This chapter will discuss the interdisciplinary management of implants that are used for orthodontic anchorage and as restorative abutments. The article will also describe the indications for implant anchorage, methods of locating the appropriate implant position, timing of orthodontic loading, types of provisional restorations appropriate for attaching orthodontic brackets, and the effects of orthodontic loading on the integrity of osseointegration and final restoration.

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