Use of osseointegrated implants in adult orthodontic treatment: a clinical report.

This article describes the complex dental treatment of an adult patient with multiple missing teeth, mild periodontitis, and a malocclusion. Titanium implants were placed in the posterior mandibular edentulous segments and became osseointegrated. The placement of the mandibular implants was originally designed for orthodontic anchorage. The mandibular implants would subsequently be used for implant-retained crowns on completion of orthodontic treatment. After a 4-month healing period, an impression was made of the implant hexes and a master cast was formed. Two-piece temporary healing abutments were placed on the implants and used to retain orthodontic brackets. The orthodontist retracted the mandibular anterior teeth using the posterior implants for anchorage. The abutment screws of the 2-piece temporary healing abutments were tightened to 20 N-cm at the insertion appointment and did not need to be tightened again during the course of orthodontic therapy. Standard orthodontic brackets were cemented to the 2-piece temporary healing abutments. Orthodontic treatment was accomplished uneventfully. Prosthodontic treatment was completed using the osseointegrated implants to replace the missing teeth. The methods described in this clinical report present clinicians with additional choices in the treatment of complex dental disease using osseointegrated dental implants.