The answer to whether you can get braces if you have implants is generally yes, but the presence of a dental implant fundamentally changes the nature of the orthodontic treatment. A dental implant is a permanent tooth replacement consisting of a titanium post surgically placed into the jawbone, which supports a prosthetic crown. The post is fixed in place through osseointegration, where bone tissue fuses directly onto the implant’s surface. Because the implant is permanently fused to the bone, it cannot be moved by the forces applied during orthodontic treatment, requiring a specialized treatment plan.
How Implants Differ from Natural Teeth Movement
Natural teeth can be straightened because they are surrounded by the periodontal ligament (PDL), a thin layer of connective tissue. The PDL suspends the tooth within the jawbone and allows for slight movement. When braces apply continuous, light force, the ligament transmits pressure and tension to the surrounding bone.
On the pressure side, specialized cells called osteoclasts break down bone tissue (resorption). Simultaneously, the tension side stimulates osteoblasts, which build new bone. This biological remodeling allows the natural tooth to slowly move into its new position.
A dental implant lacks the PDL and the biological mechanism for movement. The titanium post is in direct, rigid contact with the jawbone, known as absolute osseointegration. Therefore, orthodontic force applied to an implant does not trigger the bone remodeling cycle. The implant functions as an immovable object, dictating how the surrounding natural teeth must move.
Strategic Use of Implants in Orthodontic Planning
Since the dental implant is an immovable fixture, the orthodontist plans all tooth movement relative to its fixed position. This immobility provides a valuable tool known as “absolute anchorage.” In traditional orthodontics, any tooth used as an anchor point experiences reciprocal, undesired movement in the opposite direction.
The fixed implant eliminates this reciprocal movement, offering a stable base from which to push or pull other teeth with complete control. For example, if the orthodontist needs to move an entire arch of teeth backward to correct an overbite, they can anchor a wire or spring to the implant, knowing the anchor point will not shift. This technique allows for complex and precise movements, such as uprighting tilted teeth or closing spaces.
In some cases, the orthodontist may use a smaller, temporary device called an orthodontic mini-implant (TAD). Unlike a permanent dental implant, a TAD is a small screw temporarily placed in the bone to act as an anchor and is removed once treatment is complete. Whether using a full implant or a TAD, the fixed position of the device determines the final alignment of the natural teeth.
Sequencing Implants and Orthodontic Treatment
The timing of implant placement heavily influences the orthodontic treatment plan, requiring coordination between the restorative dentist and the orthodontist. The ideal and most common sequence involves completing orthodontic treatment first, followed by implant placement. Braces move the natural teeth into their final positions, correcting the bite and creating the precise space required for the future implant.
This “braces-first” approach allows the implant to be placed in the optimal location for aesthetics and function once the surrounding teeth are aligned. The second scenario involves receiving orthodontic treatment when an implant already exists. The orthodontist must first confirm the existing implant’s position is acceptable for the final, corrected bite.
If natural teeth are moved around an existing implant, the implant’s crown may no longer fit the newly aligned bite or may appear aesthetically out of place. In these instances, the existing crown is often replaced with a new one designed to match the final position and shape of the newly straightened teeth. This ensures a functional result that integrates perfectly with the corrected smile.