Implant facilitated molar uprighting using CAD-CAM technology

The ramifications of tooth loss include poor masticatory ability and also changes to the associated retained teeth. Mesial drift of adjacent teeth may hinder ideal rehabilitation. Uprighting of mesially titled teeth can allow for implant restorations with more ideal contours. Uprighting of mesially titled teeth can be achieved through orthodontic treatment which can be assisted by dental implants for anchorage. This article introduces an osseointegrated implant- supported device called the Implant Supported Distalising Piston (ISDP) to upright two mesially tilted mandibular second molars. Two patients presented to a prosthodontics practice with implants placed several years before seeking prosthodontics treatment. The mandibular second molars were mildly mesially tilted and encroached on the space needed to design implant-supported crowns with ideal contours. CAD-CAM technology was used to design implant-supported zirconia crowns with a distalising piston placed into the distal of the crown to upright a mesially titled molar. The Implant Supported Distalising Piston successfully corrected two mesially titled molars to allow for a more ideal implant restoration.