Orthodontic Labial Tooth Movement for Implant Site Development: A Case Report of Immediate Placement for Ankylosis...

This case report presents a novel orthodontic technique, orthodontic labial tooth movement for implant site development (OLTM-ISD), for creating adequate horizontal space before immediate implant placement in the esthetic zone. The technique was successfully applied in a 35-year-old male patient with posttraumatic root resorption and partial ankylosis of maxillary central incisors. The patient presented with recurring gingival swelling and invasive cervical resorption in teeth #8 and #9 along with buccal bone wall resorption as Elian type I and II defects, respectively. After surgical luxation of 2 ankylosed teeth, OLTM-ISD was performed using labio-coronal directed forces, achieving both horizontal space creation and vertical soft tissue augmentation. Following orthodontic treatment, immediate implant placement was executed using a fully guided surgical approach with simultaneous buccal bone grafting. After a 3-month healing period, definitive prostheses were delivered. At the 8-month follow-up, the implant-supported prostheses showed harmonious integration with stable peri-implant mucosa, and cone beam computerized tomography imaging confirmed maintenance of labial bone wall thickness exceeding 2.0 mm. This case demonstrates that OLTM-ISD can effectively utilize existing periodontal tissues for site development, particularly in cases with Elian type I or II defects. Whereas these results are promising, further prospective clinical studies are needed to establish standardized protocols and enhance predictability.