Dear Doctor, I am 28 years old & had a molar extracted 3 years ago; there's been teeth drift and only 20% of space is remaining. An Implant is impossible; am I correct in choosing to close the gap with Braces rather than create the gap for a Bridge to be made? Very generous of you for your help. Thank you.
Gap After Molar Extraction / Teeth Drift - Close Gap w/ Braces or Create Gap for Bridge?
Doctor Answers 4
Close space from molar extraction? in this case YES
You have a great opportunity here to close the space of a missing molar AND, "fortunately", utilize the third molar that you still have as the replacement for the second molar that will be moved forward to replace the missing first molar. In addition, two thirds of the space has already closed all by itself with no braces. Closing space in the upper like this is usually easier and you may not even need to use the "temporary anchorage devices" which are also called "mini implants". I would contact an ADA recognized orthodontic specialist and get a consultation on your overall orthodontic needs in addition to the missing tooth problem . For the cost of an implant and crown or a three unit bridge you could probably pay for at least two thirds of the whole orthodontic treatment and end up with no artificial stuff in your mouth at the end of the day. To do orthodontic treatment to re-open the space, pay for the artificial tooth to put in it, then have to TAKE OUT the third molar just does NOT seem like a good idea to me.
Replacing a missing molar or closing the space
Each approach (opening the space or closing the space) has advantqages and disadvantages. The key factor is your particular bite. Some types of bites favor one approach over the other, so you will be best served by consulting with an orthodontist to evaluate which approach is best for you. Nowadays there are more good options than ever because of the advancements in implants and also new orthodontic anchors called "TAD"s which can move teeth in ways we could not previously. The bottom line is this: you are smart to address this problem now rather than waiting for further tooth drifting to occur.
Open molar space Clear Braces
It is hard to tell what your bite is like from the photograph, but in general I recommend the teeth be placed in their original position an an implant or bridge made if possible. That being said, you should see an orthodontist for a consultation to determine what is best in your particular case. Clear braces can be used and not be very visible.
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Close molar space
Always better if you can avoid bridges or implants and just have your natural teeth. There are many factors involved in deciding if the space can be closed but I think there is a good chance that this could be done in your case....as always, it is best to seek the answer from an orthodontic specialist