Clinical efficacy of combined orthodontic and implant-supported prosthodontic treatment for dentition defects with dentofacial deformities

Background and objectives

Dentition defects accompanied by dentofacial deformities compromise oral function, facial aesthetics, and quality of life. Conventional prosthetic approaches often fail to address underlying occlusal disharmony and skeletal imbalance. Implant-supported prosthodontic rehabilitation is the gold standard for replacing missing teeth, but optimal outcomes require precise implant positioning, adequate bone volume, and harmonious occlusion. In patients with malocclusion or dentofacial asymmetry, poor interarch relationships can lead to non-axial implant loading, peri-implant soft tissue tension, and aesthetic compromise, increasing the risk of mucositis, bone resorption, and prosthesis failure. Orthodontic treatment before implant placement aims to redistribute interdental spaces, correct tooth inclination, and establish a functional occlusal plane, thereby facilitating prosthetically guided implant positioning. This study (Medicine (Baltimore), 2026) evaluated the clinical efficacy and patient-centred benefits of combining orthodontic treatment with implant-supported prosthodontic rehabilitation in individuals with dentition defects and dentofacial deformities.

Methods

The study was approved by the Ethics Committee of Xinhua Hospital. A total of 104 patients with dentition defects and dentofacial deformities treated between September 2019 and September 2024 were included. The control group (n = 53) received conventional implant-supported prosthetic restoration only. The observation group (n = 51) underwent fixed orthodontic treatment (e.g. straight-wire or edgewise systems) to redistribute spaces, correct malocclusion, and adjust axial inclination; approximately six months after orthodontics, implant placement and prosthetic restoration were performed using the same surgical protocol as the control group. Baseline characteristics (age, sex, bone density, alveolar bone height, periodontal health) were comparable between groups. Outcomes were assessed at 12 months: masticatory function (0–10 score), occlusal relationship (balanced contact), aesthetic satisfaction (VAS 0–10), peri-implant probing depth (PD), proportion of sites with PD ≤ 4 mm, implant survival, postoperative complications (pain, swelling, mucositis, implant loosening, prosthesis fracture), and overall patient satisfaction (5-point Likert scale). Statistical comparisons used t-tests, Mann–Whitney U, and chi-square or Fisher exact tests as appropriate.

Results

At 12 months, the observation group had significantly higher masticatory function scores (9.15 ± 0.71 vs 8.27 ± 0.82; P < .001), a higher proportion of patients with balanced occlusal contact (92.2% vs 77.4%; P = .037), and higher aesthetic satisfaction (VAS 9.31 ± 0.64 vs 8.38 ± 0.76; P < .001). Peri-implant soft tissue conditions were more favorable in the observation group: mean probing depth was 3.12 ± 0.49 mm versus 3.46 ± 0.55 mm in the control group (P = .001), and 92.2% of sites maintained PD ≤ 4 mm versus 81.1%. Implant survival was 100% in the observation group and 96.2% in the control group (difference not statistically significant). The total complication rate was significantly lower in the observation group (7.8% vs 22.6%; P = .037), with fewer reports of pain, swelling, mucositis, implant loosening, and prosthesis fracture. Overall patient satisfaction (Likert scale) was significantly higher in the observation group (4.4 ± 0.5 vs 3.8 ± 0.6; P < .001), and a higher proportion reported being satisfied or very satisfied (90.2% vs 75.5%; P = .047).

Conclusions and clinical relevance

Within the limitations of this retrospective design, combining orthodontic treatment with implant-supported prosthodontic restoration was associated with improved masticatory function, better occlusal balance, higher aesthetic satisfaction, healthier peri-implant soft tissues, fewer postoperative complications, and greater patient satisfaction at 12 months compared with implant restoration alone. The findings support integrating orthodontic correction into preimplant treatment planning for patients with dentition defects and dentofacial deformities to optimize functional and aesthetic rehabilitation outcomes.

Reference: Yang J, Sheng H, Wei R. Medicine (Baltimore). 2026;105(5):e47506. PMC12863768. https://pmc.ncbi.nlm.nih.gov/articles/PMC12863768/