Title: Complex Orthodontic-Prosthetic Treatment – Treatment Plan, Treatment Options and Possible Mistakes
Biography: Galina Dimova
Nowadays more and more adult patients are looking for orthodontic treatment. More ofter an additional correction is needed in order to restore one or more missing teeth more. Because of that the colaboration of the dental specialists is of great importance. In our practice we have many years of experience with the complex treatment of such patients. Our team consists of an orthodontist and an implantologist.
The role of the orthodontist is to decide what the treatment plan will be in colaboration with the implantologist; to choose the right mechanics; to decide what is the appropriate retention for the particular patient.
The implantologist’s role is to determine the exact medio-distal size of the space needed to restore the missing tooth; to determine the type and the size of the implant, the operative technique and the time of insertion; to select the appropriate type of prosthetic construction; together with the orthodontist determines the appropriate retention of the opened space.
We can divide the patients in need of complex treatment into two main groups – with the need of restoring missing teeth in the distal regions and missing frontal teeth.
In the distal section, we most often replace missing second premolars or first molars due to hypodontia or caries complication. We found that when we get enough space, it is not a problem to place the implant during orthodontic treatment. We do the prosthetic recovery after finishing the orthodontic treatment.
We most often recover missing upper incisors in the front - unilaterally or bilaterally. Taking in mind the difficulties we have encountered in recovering missing teeth in the frontal areas, we concluded that it is better to finish the orthodontic treatment first and then place the implants.