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Question:
Implants and Braces?: I have 9 healthy, lower, front teeth which protrude forward and bang against my top teeth.
I've lost one upper cap (cap = crown) due to this and now have a flipper in its place. My goal is to have an implant to replace the lost cap. However, without pulling the lower teeth back, I'm afraid it's a futile goal. I'm also worried that another front cap will loosen and fall out.
Is it possible to have orthodontic correction of the lower teeth when there are no back molars to hold the brace? Could implants be done on the lower gums and then be used to secure the braces too? ...Visitor from MA
Answer:
In order for your mouth to function properly your teeth need to function in a mutually protected occlusal scheme.
The anterior (front) teeth have long conical roots, small biting surface area and are designed for ripping and tearing food. The posterior (back) teeth have shorter wider roots, large biting surface area and are for crushing food.
Biting down generates force on your Temporomandibular Joint (TMJ/jaw joint) and posterior teeth. Ideally, 40% of the force is on your TMJ (20% per side) and 60% is on your posterior teeth (30% per side). The anterior teeth do not touch. The posterior teeth protect the anterior teeth from the forces of chewing.
When you move your mandible (lower jaw) forward, left or right the posterior teeth should disclude (not touch) within 1.0mm of movement. The posterior teeth are only designed to have a force down the long axis of the root. They are not supposed to touch in lateral movement. The anterior teeth protect the posterior teeth.
This is a mutually protected occlusal scheme.
In your case, you have no posterior teeth. The forces of chewing are split between your TMJ and anterior teeth. It is not surprising that they protrude forward and bang against your top teeth.
In order to have your mouth restored to proper function you will need to have posterior teeth. If there is sufficient bone, implants are the optimal choice as part of a comprehensive treatment plan.
After osseointegration (bone growth around implants) braces can be attached to allow the front teeth to be properly aligned.
Find a dentist that is skilled in comprehensive rehabilitative dentistry. Commit to a treatment plan for lifelong dental health. Be prepared to write large checks...it will be one of the best investments you ever make.
Editorial Staff
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