missing tooth replacement with implant and braces in houston
Missing Tooth Replacement with Dental Implant and Braces in Houston
By Dr. Kanaan and Dr. Samo
Updated 7-24-2025
Case #1
Here is a clinical case that presents the power of combining an orthodontist with a prosthodontist at the same place for a single tooth replacement. The patient was referred to iSmile specialists to continue her orthodontic treatment and for a single tooth replacement. She is missing a tooth in her upper left side ( Upper left the first premolar).
Note how the missing tooth caused the canine to shift backward
Dr. Kanaan “our Houston orthodontist” discussed the case with Dr. Samo “our prosthodontist” for the best treatment plan. It was recommended to create 7 mm of space for a dental implant to replace the missing tooth. Based on the X-ray, we need an extra 1.8 mm of space.
However, the previous dentist was trying to make the space to the back of the canine "The red arrow in the picture". After studying the bone structure on both sides of the canine, Dr. Kanaan decided to move the canine backward, not forward, as the anterior area has a better bone. This will save the patient the need for a bone graft and will take a shorter time to finish the case. Research has shown that bone quality and quantity are two important factors in implants' long-term stability.
The red arrow represents how the dentist was trying to move the tooth forward. The left X-Ray shows how much space is needed.
When the desired space was created, Dr. Samo re-examined the area and gave the patient exciting news! She was ready for the implant procedure as the space was ready for the implant. She decided to place it on the same day.
In the meantime, Dr. Kanaan did not leave our patient with an open gap. Using the state-of-the-art 3D printer we have at iSmile Specialists, he made her a temporary retainer with a fake tooth to like like her natural teeth.
Immediately after braces removal
A temporary retainer with a fake tooth to cover the implant space
After 5 months, the implant was successfully integrated into her bone, and it was ready to receive the final abutment and crown. Dr. Samo delivered the crown, and she received a new set of retainers.
Our patient is very happy about her new smile.
Excellent outcome. Can you tell which tooth is my implant?
At iSmile specialists, we always keep a digital copy of the patient final result as a backup. We also give the patient a copy of her actual molds. Please keep them in a safe place if we happen to need them in the future.
The patient was given a copy of her printed models for a safety backup
Orthodontic Midline Correction with Missing Teeth
Case #2
Here is a challenging case of a 42-year-old patient who was unhappy with her smile, as her upper midline is shifted to the left side due to a missing upper left lateral incisor. There was no bone at all to place an implant, and she consulted Dr. Kanaan for a second opinion on whether it was possible to place an implant. We decided to put braces with light forces to create bone because she has healthy bone and no bad habits, such as smoking.
Dr. Kanaan started to create space for the tooth with light forces.
Orthodontic treatment was started, and we told the patient we would try to generate bone by applying light and intermediate orthodontic forces to allow her body to generate bone in the area. After eight months, we noticed that there was some space opening, so we progressed with more bone creation until we had enough space on the coronal part. Dr. Samo examined the patient, and he was not happy about the space inside the bone. We decided to move the root of the upper left incisor temporarily to the mesial, which will allow the doctor to place the implant without risking damaging the root of the adjacent teeth.
Notice how Dr. Kanaan made the UL1 crown tilted temporarly to create enough room for Dr. Samo to place the imlpant
So, for four months, the crown of the upper left incisor looked crooked purposely, and this created enough room for Dr. Samo to place the implant in the area. "Size 3.5 x 13 mm"
The implant was placed with collaboration between the orthodontist -Dr. Kanaan - and the prosthodontist -Dr. Samo-.
This case shows that small-diameter implants could be used in cases with strict space, and we will have long-term success. The patient came after 18 months, and the case looked excellent and stable, and the patient was extremely happy.
Excellent stabilty after 18 months.
We included here her X-rays so you can notice how her bone was generated.
missing tooth replacement with implant and braces in houston
Missing Tooth Replacement with Dental Implant and Braces in Houston
By Dr. Kanaan and Dr. Samo
Updated 7-24-2025
Case #1
Here is a clinical case that presents the power of combining an orthodontist with a prosthodontist at the same place for a single tooth replacement. The patient was referred to iSmile specialists to continue her orthodontic treatment and for a single tooth replacement. She is missing a tooth in her upper left side ( Upper left the first premolar).
Dr. Kanaan “our Houston orthodontist” discussed the case with Dr. Samo “our prosthodontist” for the best treatment plan. It was recommended to create 7 mm of space for a dental implant to replace the missing tooth. Based on the X-ray, we need an extra 1.8 mm of space.
However, the previous dentist was trying to make the space to the back of the canine "The red arrow in the picture". After studying the bone structure on both sides of the canine, Dr. Kanaan decided to move the canine backward, not forward, as the anterior area has a better bone. This will save the patient the need for a bone graft and will take a shorter time to finish the case. Research has shown that bone quality and quantity are two important factors in implants' long-term stability.
When the desired space was created, Dr. Samo re-examined the area and gave the patient exciting news! She was ready for the implant procedure as the space was ready for the implant. She decided to place it on the same day.
In the meantime, Dr. Kanaan did not leave our patient with an open gap. Using the state-of-the-art 3D printer we have at iSmile Specialists, he made her a temporary retainer with a fake tooth to like like her natural teeth.
After 5 months, the implant was successfully integrated into her bone, and it was ready to receive the final abutment and crown. Dr. Samo delivered the crown, and she received a new set of retainers.
Our patient is very happy about her new smile.
At iSmile specialists, we always keep a digital copy of the patient final result as a backup. We also give the patient a copy of her actual molds. Please keep them in a safe place if we happen to need them in the future.
Orthodontic Midline Correction with Missing Teeth
Case #2
Here is a challenging case of a 42-year-old patient who was unhappy with her smile, as her upper midline is shifted to the left side due to a missing upper left lateral incisor. There was no bone at all to place an implant, and she consulted Dr. Kanaan for a second opinion on whether it was possible to place an implant. We decided to put braces with light forces to create bone because she has healthy bone and no bad habits, such as smoking.
Orthodontic treatment was started, and we told the patient we would try to generate bone by applying light and intermediate orthodontic forces to allow her body to generate bone in the area. After eight months, we noticed that there was some space opening, so we progressed with more bone creation until we had enough space on the coronal part. Dr. Samo examined the patient, and he was not happy about the space inside the bone. We decided to move the root of the upper left incisor temporarily to the mesial, which will allow the doctor to place the implant without risking damaging the root of the adjacent teeth.
So, for four months, the crown of the upper left incisor looked crooked purposely, and this created enough room for Dr. Samo to place the implant in the area. "Size 3.5 x 13 mm"
This case shows that small-diameter implants could be used in cases with strict space, and we will have long-term success. The patient came after 18 months, and the case looked excellent and stable, and the patient was extremely happy.
We included here her X-rays so you can notice how her bone was generated.