When teeth are lost due to extraction, trauma, or missing congenitally, the edentulous space(s) should be filled with prosthesis. Otherwise, teeth adjacent to the edentulous space will shift and tilt, leading to bite problems, jaw joint problems, and periodontal disease. In addition, in the absence of some teeth the bite load can be too much for the remaining teeth and they can crack and chip. Finally, restoration of edentulous spaces is important for chewing and esthetics.
Fixed prosthodontic restorations (i.e. those which are permanently present in your mouth) include bridges and implant-supported prostheses.
A fixed bridge is, in reality, just what it sounds like. A simple three-unit bridge consists of a filler tooth that is attached to two crowns, one on each side. These crowns fit over the existing teeth that flank the edentulous space, and hold the filler tooth in place. The bridge can be longer than three units and replace several missing teeth at once. Bridges are traditional fixed prostheses, with proven record and very good long-term prognosis.
Implant is a metal screw that is placed into the bone underlying edentulous site. Once the bone integrates with the implant, crown is placed on the implant with the help of intermediary part called abutment. In the simplest case implant supports one crown to fill a single edentulous space. However, implants can be also used to support fixed bridges and removable dentures. Accumulating evidence indicates that implants rival or even outperform bridges in longevity.
So, if you are missing a tooth, what should you get – bridge or implant? Each treatment has strengths and weaknesses. Bridge placement requires crown treatment of supporting teeth, which is beneficial if these teeth need crowns anyway, but may be not as desirable if they are in perfect condition. Placement of implants requires sufficient amount of bone in edentulous site, which may be problematic if tooth has been missing for a long time. These and other issues will be carefully considered when we give you recommendation which type of prostheses is best for you.
Removable dentures represent economical and stress-free alternative to fixed prostheses, especially when many teeth are missing. Partial dentures use existing teeth for support and retention, while complete dentures use adhesion to the gums or implant-borne retention mechanisms.