The Role of Orthodontic Treatment in Preparing the Potential Implant Prosthetic Space for Implant-Supported...

Background and Objectives: When a single missing tooth must be replaced, the best solution is the placement of an implant. In adults, most of the time the space for implant is totally or partially closed due to the shift in the adjacent teeth. The objective of the study was to describe the clinical parameters, treatment choices, and outcomes associated with orthodontic space opening for single-tooth implants in various treatment solutions, as well as to determine their influence on the variation in the dimension of the edentulous space. Materials and Methods: An observational prospective cohort study was designed in which patients with a single missing tooth were selected to be included in the study. After the clinical examination two groups were formed: patients who opted for fixed orthodontic treatment (metallic or sapphire) to open space for implant and patients who opted for alignment to achieve this (with Invisalign or Spark). All subjects received orthodontic treatment. A dental chart was created for each patient which included demographics, clinical data, orthopantomography (OPG), profile cephalograms, and photographs. The potential implant prosthetic space was measured during orthodontic treatment to observe the space dimension evolution in time. Results: In total, 97 patients were included in the study, 60 women and 37 men, with ages between 14 and 60 years. Edentulous spaces dimensions were opened from 1-4 mm to 5-6 mm (39.18% patients), 6-8 mm (48.45%), and >8 mm (12.37%). Both types of orthodontic treatments were effective in opening the potential prosthetic space for implant. Conclusions: Large prosthetic spaces and older edentulism tend to require longer treatments. Older patients had experienced edentulism for a longer period, indicating a correlation between age and the duration of tooth loss. Metal fixed orthodontic appliances were used in exceedingly long treatments, while aligners/sapphire brackets were used in short-medium durations. For the study group, fixed appliances and aligners proved to be effective in opening the space for future implants.