Replacing Lost Teeth With Implants, Bridges, and Removable Dentures
The ‘Maryland Bridge’ (MB) is bonded or glued to the back of supporting teeth to hold the replacement tooth. Often the MB is unreliable.
A model of a permanent porcelain bridge. They are reliable (Cochrane Dental).
A ‘PFM’ is a metal crown coated in porcelain. It is esthetic and reliable. It is also used in bridges. (AMD Clinic)
Permanant versus removeable bridges The choice for replacing missing teeth is often based on budget, although there are other considerations.
Types of permanent tooth replacements
Zirconium bridges. Zirconia is a strong white crown. It is a ceramic material covered in porcelain. They have been found to be somewhat fragile.
Another type of bridge is made of metal crowns covered with white porcelain known as a ‘PFM’ (see picture). This type of bridge may prove longer lasting than zirconium. When there is one, or more, missing teeth, replacement by a permanent, cemented or ‘glued’ bridge is a good option. The teeth on both sides of the space are covered with a crown. Those crowns hold the tooth replacement for the space. (see image). These bridges are esthetic and long-lasting. A permanent bridge is a good choice particularly when nearby teeth are un-esthetic. The bridge will also improve the appearance of nearby teeth.
The ‘Maryland bridge’ (see picture) uses tiny metal ‘wings’ to hold the bridge in place. My experience is that they are not reliable and often come loose.
Implants are another method of replacing teeth by placing a post directly into bone (see image). The implant is a ‘post, or ‘thick pin’ set into the bone and made of titanium to which bone ‘bonds’ or ‘grips’.
Implants after extractions
Following an extraction, your dentist might chose to immediately place an implant (‘post’) into the bone. Studies suggest that immediate implants will cause receding gums and sometimes lead to esthetic problems. Studies tell us that following an extraction(s) approximately three months must be given for bone to heal before placing the post. After placement, the post should sit several months more before receiving the crown.
One final note. Following extractions, the bone in the tooth socket will slowly disappear. Implants will not grow significant amounts of bone. There are ways to preserve bone and even regrow bone, but implants alone will not do this. Check the link below to learn more about bone grafts.
Types of removable tooth replacements
There are three major types of cost-conscious removable dentures. The cast metal partial denture, the acrylic denture, and the flexible or ‘Flexi’ denture.
The cast metal partial makes a good fit but the metal clasps (hooks) are sometimes unsightly, and if a clasp breaks it is difficult or impossible to repair. A dental laboratory must be utilized for the repair, and this may take up to several days.
An acrylic denture often has either thin wire clasps, or acrylic clasps. This type of denture is bulky (thick) and often gives a poorer fit.
The Flexi denture has the best esthetics (often fabulous!) but may take several visits to properly fit. They may cost a bit more.
A last consideration is a removable denture that fits directly into a crown or over an implant. A denture placed over implants is called an overdenture. This type of denture usually has good retention and can be worn with confidence. Costs for overdentures are higher than for standard dentures that hook onto teeth.
Implant post in bone with crown. (Bunker Hill Dentistry)
The flexible (flexi) denture is extremely esthetic, well fitting and light (Denture Helper.com)
The acrylic denture is inexpensive but often fits loosely and the acrylic is thick and may interfere with speech.