Smile Appearance or Implant - Which to Fix?

When I was a teen I had braces. When my braces came off I needed a root canal and an implant on the teeth where the bands were. I continued to wear my retainer.

Eventually, the crown on the implant came loose. I was told the torque from the retainer damaged my implant. My orthodontist, dentist and oral surgeon didn't foresee this. I stopped wearing the retainer.

Then my front teeth needed veneers because of an accident. They cracked because my bite is shifting back to what it was before I had braces. Another retainer would damage my implant. Doing nothing will ruin my smile. What to do?

Doctor Answers 5

To achieve a good smile and stable bite

It sounds like a complex issue that requires some good diagnostics and collaboration between an experienced restorative dentist, orthodonitst, and oral surgeon. Achieving a good smile and proper bite as well as a stable bite is certainly a reality but requires proper treatment and steps. A retainer by itself is not a cause of implant failure. So I suspect there were other issues.

  1. Begin with a consultation with all three doctors to get list of problems and possible treatments
  2. The restorative dentist should evaluate your aesthetic needs and discuss it with the orthodontist to come up with an overall treatment plan.
  3. Your bite is important, both in terms of function, but also stability as well as protecting your teeth including implants.
  4. The surgeon can evaluate the health of your implant to make sure it is well supported.

Bethesda Oral & Maxillofacial Surgeon
5.0 out of 5 stars 5 reviews

Retention after braces must be done to keep teeth aligned

Perhaps the cement seal was affected by the retainer, but the implant is likely fine. Once integrated, implant bodies do not move (unlike teeth, which is why teeth move for braces).

You likely have a few options. Consider removable appliances for orthodontics (such as Invisalign or other similar method), or normal braces with the bite as a focus. Sometimes a restorative solution is all you need (combination of crowns and veneers) as the bite can often be corrected this way. This can be nice, as wearing a retainer after completion is less critical.

A consultation or two with an experienced cosmetic dentist or prosthodontist should get you on the right track.

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

Treatment Sequence - Veneers, Implants, and Braces

In a case like yours, the most important thing is to make sure you have an experienced cosmetic/restorative dentist leading the way. You may or may not need to use braces or Invisalign to move your teeth back to an ideal position first. And when you are replacing the veneers and implant crown - it may be best to do these at the same time...or it may be okay to phase out your treatment. Do your homework, and make sure you are in capable hands. Good Luck!

Susan Goode Estep, DMD
Atlanta Dentist
5.0 out of 5 stars 3 reviews

Fixing teeth a tough question

You need to get your teeth fixed and then wear a nightguard at night to protect them. If that means replace the crown on the implant, etc., or replacing your cracked veneers.

It does sound complicated but a good dentist will solve your problem if he or she thinks outside the box.

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

Case needs team approach

Your case should very carefully be looked over by a highly trained prosthetic and periodontal team. After they determine where and how your existing bite should be stabilized and restored, they may direct you to an orthodontist.

Whenever one has a mixed (implants and natural teeth) dentition, forces and occlusal (bite) load become a pretty precise engineering plan. You are right, doing nothing will only cause more and more damage over time. Unfortunately, there is no quick fix or answer to your case, but only the fact that you should seek the right team who works well together, and who is highly trained in function, implants and aesthetics.

Anca Bazile, DDS
New York Dentist

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.