Why Do Braces Brackets Need to Be Removed when Doing an Implant Impression?

Question

My implant dentist insists on my braces brackets next to the empty space awaiting the crown be removed but my orthodontist insists the opposite because of the possibility of my teeth shifting within the time it takes the impression to be made. What are your opinions. I agree with my orthodontist in not wanting to remove the brackets to help hold the space. The space is being held by wire & spring between the two brackets. Thank you,

Lance Timmerman, DMD, MAGD · Answer

If the orthodontics are complete, then the brackets should come off anyway.  If they are not complete, I suggest not dealing with the implant until the orthodontics is complete.

	Brackets from braces will either tear the impression material or come off when the tray comes out.  This material is different than the alginate that most orthodontists use.

	In MY office, I would suggest braces removal, final retainer created (essix or hawley) and implant impression taken.

	There may be more to the story, so perhaps an exam by a third dentist would help you.

James J. Awbrey IV, DMD · Answer

The wire will definitely need to be removed prior to the impression, however, if you can have the brackets removed in the morning, for your dentist to get his impression, and have the brackets rebonded the same day that will be fine. Removing the brackets on the adjacent teeth will only help facilitate the removal of your crown impression.  The impression material can be quite rigid and very difficult to remove with brackets remaining on the teeth.  The other method, is remove the wire prior to the impression and fill the brackets with a wax to remove undercuts and than take your impression.  This will also work.  You can than immediately replace the wire and spring to maintain that space.  If the space is not maintained exactly after the impression is taken he will have difficulty seating that crown back onto the implant.  That is a given.  I think many times the general dentist does not understand how quickly that space can change, especially for a patient in active appliances,  if it is not maintain exactly after the impression is taken. If not, when the crown shows up two weeks later he will either have to alter the crown or adjacent teeth to get the crown to fit or take a new impression and start over.  A lose - lose situation for all parties.

	Best regards,

	Dr. Jim Awbrey

Why Do Braces Brackets Need to Be Removed when Doing an Implant Impression?

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Why Do Braces Brackets Need to Be Removed when Doing an Implant Impression?

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