A brace despite crowns, bridges or implants
An implant does not move. Everything else can be worked out.
Adults often bring replacement teeth with them. That does not rule out orthodontic treatment – but it determines the order.
Crowns
A crowned tooth can be moved like any other; the root decides, not the crown. Brackets bond less well to ceramic than to enamel – special primers or lightly roughening the surface solve that. Bear in mind: after treatment the tooth stands differently, and an old crown may then no longer match in colour and shape.
Bridges
A bridge joins several teeth rigidly. They can only be moved together – individually is not possible. If separate movement is needed, the bridge must be cut apart or removed beforehand. That belongs in the planning and in the treatment and cost plan, not in a surprise after three months.
Implants
An implant is fused to the bone and cannot be moved. That is sometimes an obstacle – and sometimes an advantage: as an immovable point it is excellently suited as an anchor against which other teeth are pulled.
The order
If you are planning both, the order is: orthodontics first, then the implant. The orthodontist aligns the neighbouring teeth and creates exactly the space the later crown needs; only then is the implant placed. The other way round does not work. For details on implant planning, see the Implantat-Berater.
And the gums
Before any treatment comes a look at the periodontium. Where bone is being broken down by inflammation, any force accelerates the loss. More on this at the Parodontologie-Berater.
The key points at a glance
- Crowned teeth can be moved – the root decides. Brackets bond less well to ceramic; that can be solved.
- A bridge joins teeth rigidly. If separate movement is needed, it must be cut apart beforehand.
- An implant does not move – but it is well suited as a fixed point for anchorage.
- The order is always: orthodontics first, then the implant.
Answered briefly
Frequently asked questions
Yes, as long as the teeth that are to be moved have their own roots. The implant stays where it is. Whether that fits the treatment goal is shown by the planning.
Not necessarily, but it happens. If the tooth stands differently afterwards, the shape may no longer fit; with front teeth this is more noticeable. Factor in the possibility before you begin.
Often yes. If it has to be cut, a gap arises that is restored in the meantime. That is effort, but not a reason for exclusion. Have the orthodontist and dentist plan together.
Then the first question is whether the gap is closed, or kept open and restored. Both are possible; the decision is made before treatment, because it determines the entire course.