Tooth Replacement

Tooth replacement or restoration, as it is often referred to, can take one of three forms: implant-supported crowns to replace individual teeth; bridges to substitute for multiple adjacent teeth; and dentures for cases when bridges are not possible. Crowns and bridges are cemented to existing teeth or bolted onto implants.Thus, crowns and bridges are non-removable or fixed solutions. In contrast, dentures are designed to clasp onto to adjacent teeth or dental implants, thus making them removable solutions. Crowns and bridges tend to have a higher investment value than dentures; however, they are more stable, durable, and comfortable to wear. Below is a general guide of tooth restorations.

	Missing One Tooth	Missing Several Adjacent Teeth	Missing Many Adjacent Teeth	Missing All Upper/Lower Teeth
Option #1	Implant-supported Crown	Implant-supported Crowns for each missing tooth	Implant-supported Crowns for each missing tooth	Implant-supported bridges. Requires placement of several implants per arch
Option #2	Conventional Bridge secured to adjacent natural teeth	Conventional Bridge. Need at least two anchor teeth from both sides of the bridge	Implant Bridge. Requires at least two implants	Full Implant-supported Denture. Needs placement of several implants per arch
Option #3		Implant Bridge. If conventional bridge is not possible. Needs at least two implants	Conventional Partial Denture	Conventional Full Denture
Option #4		Conventional Partial Denture

Implant-supported Crown
Traditionally, crowns are attached to the existing tooth root. However, if no tooth structure exists, a surgeon can place an implant to serve as anchor and then attach a crown to it. Dental implants are small, sturdy, titanium “roots” or “anchors” that serve as a foundation for crowns, bridges, and dentures, as the root structure would serve for a natural tooth. Implants are placed into the jaw bone in a way that allows bone tissue to grow around them. Please click here to learn more about implants.

Conventional Bridge
Just like conventional crowns, conventional bridges are attached to the existing healthy teeth. However, unlike crowns, bridges usually restore more teeth than there are root structures to support. For instance, a crown can replace only one tooth while a 3-unit bridge can replace three teeth and be supported on two “anchor” teeth. Similarly, 5-unit bridge can replace five teeth and be supported on three “anchor” teeth. There have to be least two anchor teeth: one from each side of the bridge.
Bridges are cemented to anchor teeth, thus making them non-removable or fixed solutions. Fixed prosthesis should be placed or removed only by a dental professional.

Implant-supported Bridges
As we have stated earlier, conventional bridges required at least two healthy anchor teeth. If none of the adjacent teeth can qualify as anchors, a surgeon must place two or more implant to serve as anchors and then attach a bridge to them. At least two implants are necessary because bridges must be attached to the anchors of similar origin: either natural teeth or implants. A combination of natural teeth and implants will weaken the bridge and it is likely to fail within a short period.

Conventional Partial Dentures
Conventional partial dentures are removable solutions designed to clasp onto the adjacent teeth. Removable partial dentures are for patients who are missing some of their teeth on a particular arch (upper or lower jaw). This type of prosthesis is referred to as a removable partial denture because patients can remove and reinsert them when required without professional help.

Conventional Full Dentures
Complete or full dentures are worn by patients who are missing their entire upper or bottom teeth. Because there are no anchor teeth for dentures to clasp onto, this type of prosthesis is designed to “hug” or wrap around the gums. For better fit and stronger hold, patients can use special temporary adhesives that are applied between the gums and full dentures.

Implant-Supported Dentures
Some of the problems associated with removable dentures include increased salivation, sore spots on soft tissues, gagging, accumulation of dental plaque, and loss of taste. Luckily, implant technology can vastly improve the denture-wearing experience by increasing stability and retention factors. In addition, implant supported dentures allow for less gum irritation, reduce the risk of dentures slipping of patient’ smouths, and improves appearance due to less plastic required for retention purposes.
Finally, patients with implant supported dentures have increased chewing efficacy and
can speak more clearly.