Inter-occlusal appliance for implant site augmentation and optimal implant positioning: a ten-year follow-up case report

Aim: Orthodontic implant site augmentation was proposed for exodontia of a hopeless tooth to improve bone architecture before implant installation. However, the use of orthodontic appliances to perform slow vertical movements and tooth extraction demands an interdisciplinary approach, increasing time and costs. The aim of this study is to present a technique of orthodontic implant site augmentation by the use of an inter-occlusal appliance. 

Case report: A 48-year-old patient presented cervical external resorption and root fracture at the upper left central incisor. A slow orthodontic extraction of the tooth was performed by the use of an inter-occlusal appliance. After extrusion, the tooth was extracted and the implant was immediately placed. Tooth was extruded 6 mm in 8 months, at a slow rate of extrusion (0.75 mm/month) along the tooth long axis, resulting in the formation of new bone at the apex and alveolar crest, leveling its height with neighboring teeth.

Results: An increase in keratinized gingiva was observed. Final restoration was installed one year later, with adequate subgingival contour. No complications were observed after 10 years of follow-up.

Conclusions: The use of an inter-occlusal appliance provided a simple method for orthodontic extraction and implant site development, allowing optimal implant positioning with no surgical augmentation procedures.