Positional changes of the anterior maxillary teeth adjacent to single implants during 11 years + a case report

Background

Single-implant treatment introduces a new biomechanical situation in the dentate patient. Various levels of infraposition of single-implant restorations have been observed in long-term follow-up studies, but little knowledge is available on the biological mechanism behind this pattern. Another post-treatment complication that has been reported increasingly during the last decade is the loss of the proximal contact point between the restored implant's crown and the adjacent natural teeth.

Aim/Hypothesis

To assess of tooth movements adjacent to single-implant crown in a long-term study, and to discuss these changes in relation to changes after 11 years.

Material and Methods

A 19-year-old healthy female, non-smoker patient was treated with one single implant in the upper central incisor after trauma. The results of the measurements of the casts and photographs were compared with clinical photographs taken at the time of treatment (2008), after 6 years (2014), and after 11 years (2019) in function.

Results

The clinical photographs showed obvious signs of implant infraposition after 6 years. New crowns were made in the incisor region after 6 years (2014), but signs of infraposition were again present at the final examination (2019). The small measured vertical eruption of the teeth was less than the observed clinical infraposition of the implant crowns, indicating that the vertical position of the palatal may have changed in relation to the implants as well. The vertical step measured on radiograph and photograph varied approximately 1.0 mm.

Conclusion and Clinical Implications

Single-implant restoration in the anterior upper jaw may present small degrees of infraposition in long-term perspectives. Obvious dentofacial changes may take place in adult patients. The clinician should carefully consider these potential changes in the treatment-planning phase, especially in young patients but also in adults of any age, with respect to the tendency of these changes to reduce with age.