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Implant Facilitated Molar Uprighting using CAD/CAM Technology

Now online in the Journal of Prosthodontics, a report of a technique to upright a mesially tilted molar using an implant-supported device co-authored by ACP members Steven E. Handel, DMD and Andrew S. Ryser, DDS, MS.

When a tooth has been removed, teeth distal to the edentulous area tend to tip or incline in a mesial direction. If uncorrected, there is a restorative dilemma due to the altered space available. Many techniques have been described for uprighting of mesially inclined second molars.

This article introduces an osseointegrated implant-supported device called the Implant Supported Distalising Piston (ISDP). This customized, implant-supported restoration can provide consistent distal directional force to a mesially tipped tooth for uprighting while minimizing undesirable movement.

Two patients described in this report presented to a prosthodontics practice with implants placed several years before seeking prosthodontics treatment. The mandibular second molars were mildly mesially tilted and encroached on the space needed to design implant-supported crowns with ideal contours. CAD/CAM technology was used to design implant-supported zirconia crowns with a distalising piston placed into the distal of the crown to upright a mesially titled molar. The ISDP successfully corrected two mesially titled molars to allow for a more ideal implant restoration.

This method is minimally invasive, requires minimal chair time, and is cost-effective. Restoring implants with ideal restorations will afford the patient the opportunity for better hygiene and better long-term success of the restoration.

Talbot BA, Handel SE, Ryser AS, Sabol JV, Jackson S. Implant facilitated molar uprighting using CAD-CAM technology. J Prosthodont. 2025; 1–5. https://doi.org/10.1111/jopr.14053

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