3-D tooth movement adjacent to single anterior implants and aesthetic outcome. A 14-20 year follow-up study

Summary

Clinical research evaluating facial changes and long-term esthetic outcomes of single implants

The treatment of younger patients who are continuing to grow and develop results in movements of teeth in relationship to the adjacent implant crown. This may alter the esthetics long-term.  The primary aim of this study was to report three-dimensional movements of teeth adjacent to single implants in the anterior maxilla, after 14-20 years of follow-up. Patient characteristics relative to tooth movement and long-term esthetic outcomes were assessed. The aesthetic evaluation was performed by the patient and the examiner, using the visual analogue scale. Dr. Nicole Winitsky was awarded the Oral Research Presentation Prize in Peri-implant Biology by the European Association of Osseointegration Scientific Committee, for this original research presentation (1). The full report of this study has been published in Clinical Oral Implant Research (2).

Results

• Tooth movement over time can cause implants to become infrapositioned.

• Movements of the adjacent teeth 70% in the palatal direction resulted in the implant crown appearing clinically shorter and more proclined relative to the adjacent tooth.

• An infraposition of >1 mm in the incisal direction was observed in 30% of patients.

• Lateral and canine implants show a greater infraposition than central incisors

• Lower anterior facial height equal or great than 70 mm & those without occlusion exhibited more infraposition  

• Most patients are satisfied with the long-term esthetics despite tooth movement, and the esthetic results are valued as higher by patients than dentists.

Clinical Relevance

Based on the results of this study, the authors recommend pre-treatment counselling regarding the expected change of normal tooth position and the possible need to change of the implant crown restoration. As a result, a screw-retained implant crown may be indicated.

Authors

References

1. Presented at the 30th Annual Scientific Meeting of the European Association of Osseointegration (EAO Digital Days), 12-14 October 2021, Oral Communication. Video republished by the Foundation for Oral Rehabilitation with permission of the author. 
2. Winitsky N, Naimi-Akbar A, Nedelcu R, Jemt T, Smedberg JI. 3-D tooth movement adjacent to single anterior implants and esthetic outcome. A 14- to 20-year follow-up study. Clin Oral Implants Res. 2021 Nov;32(11):1328-1340. doi: 10.1111/clr.13833. Epub 2021 Aug 30. PMID: 34403160.