[Preprosthetic orthodontic preparation and Brånemark implants]

The patient presented an important bone loss in the edentulous area 21 to 23. The 11 had a temporary crown and a removable prosthesis has replaced the anterior missing teeth. The orthodontic treatment of this class II division 1 was to be undertaken in order to reduce the maxillary proalveolie and to line up the mandibular incisors. The difficulty of the orthodontic treatment was due to the importance of the anterior edentulous area which did not allow a continuous multiring treatment but a bilateral one and a succession of anterior removable prosthesis as anchoring points. The temporary crowns on osseointegrated fixtures replacing 22 and 23 were used to obtain the final orthodontic movements needed in the orthodontic preprosthetic treatment. However, if the fixtures had been placed at the beginning of the treatment in order to use them among other anchoring points, the complete orthodontic treatment would have been faster and much easier. At that time, our major handicap was to determine the ideal position of the fixtures which would allow the orthodontic application as well as a successful cosmetic fixed prosthesis. The use of scanner, three dimensional reconstruction Scanlam, surgical stents and fixed prosthesis with inlay cores would have brought the solution to this problem. Today, the use of osseointegrated fixtures can be applied in much more complex orthodontic movements.