Trade-off Between Dental Implant and Braces for Extracted Tooth?

When teeth are missing, replacing with implants or bridges is best. Shifting or moving teeth to fill spaces creates an imbalance to the bite and can contribute to airway issues. If the space is too small now for an implant, long term you are better off to orthodontically create space and place the implant.

Dental Implants are a great way to replace a missing tooth, but may need to have the crown attached to the top of them replaced after being in for a long time since the implants are anchored in place and don't drift with the rest of teeth. Even in our adult years we continue to grow a little and the implant tooth can appear submerged relative to adjacent teeth. However, the older you are the less you have to worry about this happening.

If you close the space using braces, you don't have to worry about maintaining an implant at all, which can be nice though it will take a long time to close the space, and you might not have the patience for that. Either way the choice is up to you and there are pros and cons to both.

When one is congenitally missing a posterior tooth or has had the tooth extracted due to decay, there are new options now to be able to close the space (TADS) which stands for Temporary Anchorage device.  This new technology, along with the Damon braces system, is something that we are utilizing in our office today as another option for patients who are missing teeth.  Traditionally, we have set the space up to have an implant placed in the missing tooth area which is still a viable option today.  When our patients come in, we go over the advantages and disadvantages of having an implant placed versus closing the space or protracting the posterior teeth forward as another treatment solution option. 
The advantages of protracting or bringing the posterior teeth forward are one will have the natural tooth that was given to us in a place of this missing space, so it tends to feel more natural due to the proprioceptive fibers, so the sensory feedback is bette long term.  Usually, the periodontal condition around a natural tooth tends to be a lot better than an implant over the duration of one’s life.  Also the cost overall is generally less expensive when you close the space versus have and have an implant done.  So, financially, the patients tend to come ahead when closing the space. 
We heavily weigh both option and consult with the patient’s general dentist and ultimately the general dentist will make the final decision on which way we go from holding the space for an implant versus closing the space.  Each person is different, the position of each tooth is different and ultimate final outcome for each patient will be different too.

The decision whether to replace a tooth with an implant or close the space with orthodontics is different for every patient. There is no "right" or "wrong." There are several factors that affect which option is best for you. Is there crowding near the tooth that was removed? Are there other reasons to have braces (like an overbite)? These are questions that an orthodontist can help answer for you when you go in for a consultation. If there are no other reasons for braces, an implant is a great choice. But if there are other reasons for orthodontic treatment, you may be able to "kill two birds with one stone."

My first thought was if the orthodontist can close up the space using braces, can't she also open up (idealize) the space with braces? With very few exceptions (e.g. wisdom teeth), it is better to replace missing teeth. I commonly use orthodontics to open up and idealize the space for the implant to replace the missing tooth.