New Zealand Association of Prosthodontists and Restorative Dentists

Implant bridges

What are implant bridges?

Implant bridges are used when people have no teeth at all or when the number of missing teeth span too far to be replaced by a conventional, tooth-supported bridge. Implants have been around for many years and are a predictable method to replace missing teeth. They offer a way to have artificial teeth that look natural and feel secure. The implant itself is a titanium screw that is embedded into the jaw bone. Due to the biocompatible nature of titanium, bone heals very tightly against the implant making the implant fixed to your jaw.

The implant/s replace the root of the tooth to support the false teeth (bridge). Either a Periodontist or an Oral Surgeon, places the implants into holes made in the jawbone during surgery. Posts (abutments) can then be secured onto the top of the implants which help to hold the bridge in place. Sometimes the bridge is connected directly to the implants.

What are the advantages of an implant bridge?

After multiple teeth have been lost, implant fixed bridges are often the most reliable long-term method to restore normal appearances and/or function. Implants are fixed to your jaw bone and do not move. This provides a very stable platform to attach the implant bridge to replace multiple missing teeth. An implant bridge can provide a fixed solution when a partial denture is not satisfactory, or if you cannot manage with conventional dentures. A fixed implant bridge will improve your confidence when eating and speaking if you do not manage well with conventional complete or partial dentures.

A fixed implant bridge means you can enjoy a more natural experience when eating food compared with conventional dentures which cover your palate. Taste and thermal sensations when eating are not altered with implant bridges, which can occur with conventional dentures that cover your palate.

What are the disadvantages of an implant bridge?

A surgical procedure is required to place the implants into your jaw bone. This procedure may be uncomfortable but not painful. Local anaesthetic solution is administered to the operative site and this can be combined with oral or intravenous sedation depending on your needs. It is crucial that there is enough bone height and width to be able to place the implants with predictable results. Sometimes if there is insufficient bone height remaining, the final appearance of an implant bridge may not be perfect. You will be advised on whether an implant bridge is the most suitable option for you and what the expected result should be like.

Extra surgical procedures such as grafting may need to be required if there is insufficient bone to place the implants.

Implant bridges cost more than partial or complete dentures.

Treatment may take longer than conventional dentures or tooth-supported bridges. Total time of treatment will be discussed with you at the consultation.

Once the implant bridge is placed, how long will it last?

It is difficult to give you an accurate estimate of exactly how long the implant bridge will last, as this is dependent on many factors within and beyond our control. However what we do know is that most early complications with materials tend to occur within the first year of service and provided the implant bridge is maintained in a meticulous manner with routine checks, you should get many years of satisfactory service. It is important that you understand that implant restorations consist of two parts, the titanium implant and the superstructure that is placed on top of the implant head (abutment and implant crown). Research has demonstrated that dental implants may remain integrated with bone in excess of 25 years and many implants will remain integrated for life. The limiting factor for the survival of implant bridges is the porcelain, framework (metal substructure) or veneering acrylic.

Maintenance issues that may occur with the implant bridge include fracture of porcelain, acrylic or the framework, screw loosening, screw fracture and loss of the filling within the screw access hole. Usually problems involving the implant bridge can be repaired or replaced relatively easily, provided the implant remains integrated in bone. Acrylic will wear faster compared with porcelain however acrylic is significantly less costly and easier to repair. Often acrylic veneering will need to have some repairs or replacement as 8-10 years.

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