PROSTHODONTIC (TEETH / TOOTH REPLACEMENT)

IMPLANT SUPPORTED CROWNS

• A titanium support (implant) is surgically placed into the jawbone at the site of the missing tooth. The titanium implant will integrate with the bone in a period of 4-6months. After integration has been achieved, a crown and abutment can be attached to the implant. This crown will mimic the shape of the missing tooth.

Benefits:

• Fixed (non-removable) restoration that restores the form and function of a missing tooth.
• Excellent clinical durability – clinical studies indicating success rates of approximately 90% for 30years.
• No requirement to use adjacent teeth to support the replacement tooth – thus avoiding the need to reduce adjacent teeth, and allow for normal brushing and flossing techniques.
• Stimulates alveolar bone in the area of the missing tooth to maintain the thickness of the jaw bone.

Disadvantages:

• Cost is slightly more than a bridge.
• Insurance companies usually do not provide coverage for implant treatment (but this is slowly changing).
• Requires adequate bone support – bone grafting may be required prior to implant placement.
• Requires more time to complete (6 months) but in some cases, immediate placement and temporization may be possible.
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BRIDGES

• A missing tooth is replaced using the support of adjacent teeth. Crowns are fitted to the adjacent teeth. A false tooth is permanently attached to these crowns.

Benefits:

• Fixed (non-removable) restoration that restores the form and function of a missing tooth.
• Less costly than a implant supported crown.
• Usually completed in 2-3 appointments (1-3 weeks to complete).

Disadvantages:

• No stimulation of the jaw bone in the area of the missing tooth – usually resulting in slow resorption of the jaw bone.
• Requires cumbersome oral hygiene techniques to keep the bridge clean.
• Adjacent teeth, if not previously restored, are weakened for the placement of crowns.

PARTIAL DENTURES

• A missing tooth or multiple teeth in an arch are replaced with a removable prosthesis. The prosthesis is comprised of a base of plastic with or without a cast metal frame. The denture teeth are attached to this base. The base will have hooks and attachments fitted to some of the existing natural teeth to provide support and retention for the denture.

Benefits:

• Less expensive compared to dental implants or bridges.

Disadvantages:

• Relatively poor long-term stability (becomes loose over time). Poor esthetics due to presence of metal clasps (hooks).
• Variable comfort and function.
• Requires time for adjustment of having something large and foreign in the mouth.
• Natural teeth used as supports for the denture are at high risk of caries and occlusal trauma.
• No stimulation of the jaw bone in the area of the missing tooth – usually resulting in slow resorption of the jaw bone.

COMPLETE DENTURES

• Indicated if all teeth are missing in the dental arch. The prosthesis is comprised of a base of plastic with or without a cast metal frame. The denture teeth are attached to this base. Dental implants may be used to support the denture. A complete denture is usually removable but can be fixed to implants.

Benefits:

• Inexpensive.
• Able to achieve ideal smile esthetics in most cases.

Disadvantages:

• Relatively poor long-term stability (becomes loose over time) – especially with the lower arch.
• Variable comfort and function.
• Requires time for adjustment of having something large and foreign in the mouth.
• No stimulation of the jaw bone in the area of the missing tooth – usually resulting in slow resorption of the jaw bone.