Gaps & Implants - Please Help!

[Irishman]

Hi everyone,

I am really tired of trying to find the best solution to help my terrible teeth.

So as you see from the photos I have teeth missing and as a result I have huge gaps.

What I'm trying to do is straighten the lower front teeth by closing the gaps on either side of my incisors. My incisors are good and so are my canines, but the canines need moved in closer to the incisors. Once I've done this then I wanted to get implants either side on my canines left and right side. Does this make sense?

You will also notice one of my first pre molars has moved a considerable distance and you can see from the xray the angle of the tooth is significant.

I have had a smiledirect simulation of how my teeth would move with clear aligners but to be honest I'm not sure and it looks like the aligners would just move all my incisors and canines backwards into my mouth, thus closing the gaps, but I'm not sure if I could get an implant to fit between the canine and first pre molar.

Does anyone have any better suggestions?

I really stuck on this but am keen to do something as it's getting me down.

Happy to provide further details.

Many thanks in advance.

 

[MattKW]

You won't simply close gaps with aligners. Some considerations:
1. Get opinion from specialist orthodontist to close front gaps.
2. In conjunction with orthodontist, see a prosthodontist if you can afford it. Maybe the orthodontist can suggest someone with a good reputation. Get the ortho to collaborate with the prosdo. Together they will give you a much better overall plan if contemplating implants.
3. Lower right premolar looks like doubtful root canal treatment (RCT). Get opinion to see if worth saving. Might be better to extract now and place 2 implants in this area. Get other RCTs checked too because an OPG is poor resolution and you want to make sure before starting this journey.

 

[Irishman]

Hi,

Thank you so much for your prompt and detailed reply, very informative indeed and all points duly noted.

I have subsequently spoken to a well respected implant specialist and they are of the opinion that it may be more prudent to remove the premolar to allow room for a cantilevered implant. The same cantilevered type implant would also be fitted on the other side meaning one implant beside each canine teeth on the lower jaw, giving 4 teeth.

I haven't done much research on cantilevered implants but he seemed to think this would be a satisfactory solution to fill the gaps based on the location.

This would still leave a gap on my left side lower jaw beside a molar but I am fine with this.

Thanks again for your time and insight.

All the best and stay safe!