Invisalign Before or After Implant?

HI, I had lower first molar extracted 5 months ago, the bone graft was placed at the time of extraction, now I need to get braces done to correct the overjet/overbite issue.

The orthodontist wants me to get the braces before getting implant. The treatment would last 21 months with invisalign. I am worried about loosing the bone under the missing molar if the implant is not placed soon. What are my options?

Doctor Answers 8

Implant before invisalign

Typically all permanent work, including crowns, veneers, implants are done after orthodontic treatment.  Once an implant is placed, it is "set in stone." 

Miami Orthodontist

Invisalign before or after implant?

heading says invisalign but question says braces....either way I think something should be done now.  If the teeth around and occluding with the implant supported tooth are not going to be moved at all then go ahead and get the implant and crown placed now.  If there is any question about the final position of the teeth around this area then have the dentist place a temporary crown on the implant until the ortho is done

Robert Waxler, DMD, MS
Saint Louis Orthodontist

Invisalign first and implant second.

You will not loose much bone in 21 months. If they already did a bone augmentation then you're good to go. THis way they can hold the teeth in place and also make perfect room needed for the implant. Have your dentist add a pontic in that area so while you're wearing the aligners no one can tell the tooth is great..

Michael J. Thomas, DDS
Los Angeles Dentist
3.0 out of 5 stars 2 reviews

Implant timing with Invisalign or braces

Since you are having a "bite correction" you may wish to consider delaying the implant until the orthodontics is finished, or nearly finished.  This gives your orthodontist maximum flexiblity to create an ideal bite, because an implant is absolutely fixed and cannot be moved at all.  There is no hurry to get the implant as far as bone is concerned, since several months or a year will make little difference in the amount of bone available for the implant.  The above ideas are the same regardless of whether Invisalign or braces are used.  Remember when using Invisalign the computer simulation may not actually show exactly what really happens in your mouth because there are many factors that the Invisalign software cannot model.

Brian Povolny, DDS, PhD
Seattle Orthodontist
5.0 out of 5 stars 2 reviews

Implants and Invisalign orthodontics

Dear Buttercookie:

You can safely place the implant right away before or while you are in Invisalign/orthodontic treatment.

The premise of Invisalign therapy is that one can use a computer model to predict the position of the teeth prior to movement.  This is how the aligners are manufactured.    It is possible to predict the final position of the tooth and place the implant accordingly. 

We use implants in conventional orthodontics (regular braces) all the time.  If the implants are placed in the predicted, desired position, after proper, careful planning,  the orthodontist can actually rely on them for the movement and the process happens much faster.   I do recommend fabricating the final restoration after the Invisalign treatment is finalized, yet prior to delivery of the retainers.

Consider contacting a surgically trained Prosthodontist (the specialist in restorative/cosmetic/implant dentistry) for this work, since it is the most qualified person in this field.  Since the Prosthodontist is the restorative expert, he/she will be able to place the implant in the most optimal position,  so that the final crown is properly fabricated.   You can easily locate a Prosthodontist near you on the internet.

Best of luck with your treatment,

Zev Kaufman, DDS
New York Prosthodontist

Orthodontics should be done before an implant

While there is a risk to not placing an implant soon after an extraction, the risk is associated with waiting a very long time.  Normally, the amount of time for orthodontics is not enough to worry.

Doing ortho before the implant allows one to set up the ideal amount of space for the implant.  However, sometimes it helps to have an implant in place to help with the orthodontics, so it is not a hard rule.

Lance Timmerman, DMD, MAGD
Seattle Dentist
4.3 out of 5 stars 6 reviews

Ortho before Implant?

Hi Buttercookie!

Generally it is preferable to complete the orthodontics (Invisalign/Braces) before the implant is placed.  But this really depends on how much tooth movement is expected on either side of the extraction site. 

If there will be only minimal movement of the adjacent teeth it might be very possible to place the implant, move the teeth then restore the implant after ortho is completed.

You should ask with your general dentist who should be coordinating your treatment with the specialists (orthodontist, oral surgeon... etc.) whether or not you can have the treatment done concurrently.


Dr. Alper

Steve Alper, DMD
New York Dentist
5.0 out of 5 stars 3 reviews

Implant With Invisalign

Great question! Your bone graft will do just fine without placing the implant right away. Aligner therapy orthodontics (Invisalign) is ideal for working around an area of a missing tooth. It is best to do Invisalign before placing the implant because once an implant is placed it cannot be moved so you are forced to move teeth around a fixed "tooth" which could compromise the final results. Good luck!

Brad Lockhart, DDS
Tustin Dentist
5.0 out of 5 stars 13 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.