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Uprighting a Mesially Tilted Molar using Customized Titanium Healing Abutment

Now online in the Journal of Prosthodontics, a new case report introducing a technique for minor tooth movement using elastic separating rings to upright a tilted molar using a customized healing abutment of an implant.

After removing a tooth and placing an implant at the same position, clinical difficulties may appear during restoration of the implant when the adjacent tooth starts tilting mesially throughout the implant osseointegration period. Restoring the implant without considering the reduced interdental space because of the tilted molar can reduce satisfaction of treatment outcomes.

As described in this report, a 23-year-old man presented to the dental clinic to replace his non-restorable upper right first molar with an implant. After extraction and immediate implant placement, the patient was instructed to return after 3 months of healing time. During the osseointegration period of the implant, the adjacent maxillary right second molar drifted mesially until contact with the 5 mm diameter healing abutment of the implant.

An elastic separating ring with a thickness of 1 mm was placed between the prefabricated healing abutment and the tilted molar at the first session and then replaced on a weekly basis for 2 months, until adequate mesiodistal space was gained for restoring the adjacent implant.

After treatment, the mesiodistal space for the implant prosthesis increased by 3 mm. One advantage of using rubber bands to upright the tilted teeth is that it is simple and does not require acid etching and bonding bracket with adhesive resin on the tilted tooth, making it more convenient for patients.

The minor tooth movement improves the interproximal topography and simplifies prosthetic treatment. However, tooth uprighting using this technique may not allow for the controlled forces that are seen with orthodontic wires. Only minor and limited-time tooth movement can be obtained, and only in a single direction.

Yehya, M, Alshawy, E, Alenezi, A. Uprighting a mesially tilted molar using customized titanium healing abutment of an adjacent osseointegrated implant. J Prosthodont. 2022; 1– 5. https://doi.org/10.1111/jopr.13619

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