What are the trade-offs between braces or dental implants to close a gap left by a missing tooth?

Doctor's Answers 2

Generally speaking, having a good, well aligned and balanced bite with your OWN NATURAL SOUND TEETH, is going to be better than trying to achieve the same with dental implants, or any other man-made prosthesis.

However, there are instances whereby dental implants are indicated as part of an overall orthodontic treatment plan. Dental implants maybe suggested in situations where gaps are too large to be predictably closed with braces.

There is no cookie cutter approach to answering your question so every case has to be assessed on its unique merits and the risk and benefits discussed.

Its hard to describe absolute " trade-offs" between braces and dental implants, because there is no perfect option that would work for everyone.

Braces can take up to 2-3 years for some cases, and dental implants sometimes only 3 months. So there might be a benefit in terms of time. if you choose implants.

Theres no surgery involved in braces, but if you consider dental implants, surgery is required.

Braces moves all your natural teeth into its most favourable bite position, whereas a dental implant just replaces one single tooth.

If you dont close the gap, the neighbouring teeth might collapse into the space and the imbalance in your bite may get worse, resulting in some teeth being subjected to more stress than others. This will in turn result in uneven wear and tear of your teeth over time.

If time is not a factor, i would strongly suggest that you consider braces, to move all of your teeth to its most ideal bite and aesthetic position, if it means you can avoid getting a dental implant.

I hope my answer helps!

Kind Regards,

Dr Gerald Tan

Closing the gap using braces/Invisalign means that you will not have an artificial tooth replacement to contend with in the future. However, depending on the location of the missing tooth (front tooth/back tooth) and also the symmetry of your smile, and how you bite, this may not always be the best solution.

For example, if you were missing an upper front tooth (the central incisor), closing the gap with braces will cause a severe asymmetry in your smile which is unattractive.

Alternatively, if you are missing a back tooth (a premolar, or a molar), then closing the space by substituting the adjacent tooth for the missing one with orthodontics can be a workable solution. The effect of substitution on your bite should be considered as moving teeth a big distance away from the current position may cause an opposing tooth to lose functional contact.

If a large tooth (such as a molar) needs to be moved a significant distance without affecting the movement of your other teeth, additional anchorage must be included. This may be mini implant screws (TADs) or even headgear. This makes orthodontic treatment potentially more cumbersome. Tooth movement normally proceeds at about 1mm a month, so this means that space closure can take quite some time to complete. Moving a very large tooth is difficult to control with a removable brace system (such as Invisalign) and you should be prepared to have refinements done with fixed braces.

Choosing an implant is potentially quicker since the implant surgery and crown can be completed within 3-6 months. If the missing tooth site is very deficient in bone or gum, then additional grafting to restore the tissue volume will increase your treatment complexity and duration. This may be more critical if the missing tooth is in the aesthetic zone at the front of the mouth.

If you have an implant placed and then later on decide to get braces, the implant CANNOT be moved and the braces will have to be planned around the current implant position. This may lead to a compromised result if you are not planning to remove the implant.

Since you are young, I would prefer to avoid implants where possible since ALL dental prostheses are NOT PERMANENT. Dental implants also behave differently to natural teeth in terms of how the implant appearance will change especially in the aesthetic zone. You should be aware of the need for future prosthesis/implant replacements on average every 10-15 years. This is comparable with hip or knee replacements. This means that should you get an implant prosthesis now, you would be looking at 4-6 replacements over the course of your lifespan.

Leaving the space untreated and unrestored (not filled in with an artificial tooth) tends to cause drifting of the remaining teeth into the space and overloading of adjacent teeth which have to compensate for the missing tooth.

Similar Questions

How do I know if mini dental implants are suitable for me?

Thank you for your question about mini-implants. I get this question a lot at my practice and I am happy to share with you and other readers my views on the matter. The use of mini-implants has certainly been controversial. The key to success for any mini-implant case starts with understanding its indications and contraindications and its pitfalls when indicated wrongly. Latest scientific evidence concludes that Mini implants have limited applications, and should be considered only in certain cases. Here are some common examples when Mini Implants can be considered: 1.

Photo of Dr Gerald Tan

Answered By

Dr Gerald Tan

Dentist

How do mini dental implants differ from traditional dental implants?

“What are mini implants? ” Mini dental implants, as its name suggests, are generally of a smaller diameter (<3mm), thus they are thinner than that of normal implants. They normally come with the abutment and the implant as a piece, whereas for conventional dental implants the pieces are separated. You could picture the mini implants as nail screws and traditional implants as bolt and cap nuts. “How does it differ from traditional dental implants?

Photo of Dr Joanne Lam

Answered By

Dr Joanne Lam

Dentist

Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox