Restoring Missing Teeth
Fixed Bridges• A bridge replaces a missing tooth or teeth. It is called a fixed bridge because it is not removable.
A bridge is a structure, supported by teeth on either side of a space.
It spans the gap between teeth, just as a bridge spans a river.
How is a bridge made?• The first step is to prepare the supports for the bridge.
• Replacement crowns are placed over existing teeth as supports for a bridge.
o The dentist pares down the teeth on either side of the gap, and takes an impression of the prepared teeth.
o This is then sent to the dental technician where the bridge is made.
o The technician will make a replacement crown for each prepared tooth.
o These crowns are joined to an artificial tooth, which replaces the missing tooth.
o The dentist will then cement the completed bridge over the prepared teeth.
How will my pared down teeth be protected until I receive my bridge?• The dentist will make and install a temporary acrylic bridge that will protect the teeth and prevent sensitivity.
• You can eat normally with a temporary bridge. It will also look good.
What is the fixed bridge usually made of?• The base or framework is made of precious or non-precious metal to which tooth colored porcelain is fused.
• Since the development of new stronger ceramic materials, bridges can now be made entirely of porcelain.
Is the preparation of bridgework painful?• The procedure is not painful, because a local anaesthetic is used during the paring of the teeth, and the taking of the impression.
• It is seldom necessary to take an analgesic for pain relief after the treatment.
Will there be any sensitivity after the bridges are placed in the mouth?• Sensitivity to hot and cold sometimes occurs after the bridge has been cemented, but this is usually temporary.
Will a fixed bridge look good?• Fixed bridges can be made to look natural and to match the adjoining natural teeth.
A bridge in the front of the mouth will restore and even improve the smile.
How well will I be able to chew with a fixed bridge?• Eating with a fixed bridge should be as comfortable as with natural teeth.
How successful are fixed bridges?• Fixed bridges have been used successfully to replace one or more missing teeth.
They can last for many years.
Dental ImplantsDental implants are metal fixtures made out of titanium that are placed within the jawbone with great precision. Dental implants provide a highly biocompatible surface, which enables bone to completely fill in and provide long-term stability. When fully integrated with surrounding bone a dental implant serves as a root for a missing tooth. The dental implant also serves as the support for the final restoration, dental crown, bridge or denture.
Appointments From Start to Finish
First AppointmentThe first visit consists of a consultation. During the visit radiographs, "dental x-rays", are obtained and the area where implants will be placed is evaluated to make sure that the quality of the bone is good and quantity of the alveolar bone is sufficient to support a dental implant and any forces that will be exerted on it. A diagnostic impression is also obtained.
Second AppointmentThe implant is placed and in the jaw and allowed to heal and integrate with the surrounding bone. The time it takes for a dental implant to integrate with the surrounding jaw bone (alveolar bone) varies from patient to patient. Some of the main factors that can affect healing include the location of placement, health of the individual, quality of bone (good blood supply, soft malleable bone vs. poor blood supply, rigid bone), health of the surrounding area where implant is placed, type of dental implant used, and oral hygiene of the implant recipient. All these factors can determine how fast and how well the dental implants will integrate. After a dental implant is placed it can take anywhere from 3 to 6 months before the final restoration is completed. Healing time will vary from 3-4 months in the lower jaw to 4-6 months in the upper jaw. Implant placement surgery is completed with just local anesthesia and the whole procedure is performed under sterile conditions. Learn about immediate loading dental implants.
Third AppointmentImpression for a crown is obtained. The dentist will attach an impression piece to the implant and obtain a dental impression for the crown or a bridge. In case an overdenture or an implant supported denture, as it is commonly known, will be the final prosthesis the denture fabrication process begins with the final impression of the surrounding tissues and dental implants.
Fourth AppointmentCrown or dental bridge is tried in to confirm a perfect fit, good color match with surrounding teeth, and is cemented permanently.
An implant-supported denture with the teeth set in wax would be evaluated for esthetics, function, proper speech and stability. Adjustments are made in needed. Any changes to the position of teeth to improve esthetics, functionally, and speech should be made during this visit. Denture is sent to a dental laboratory for processing.
Fifth AppointmentImplant-supported denture is delivered. Movement of denture teeth cannot be completed because they are permanently set in hard acrylic. Special overdenture fixtures are attached to the dental implants and the denture is tried in. The implant-supported denture should have excellent stability. The dentist can modify the retention of the denture if necessary. Slight bite adjustment will be made to ensure an even bite.
Removable Bridges - Partial or Complete Dentures
DenturesA denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals.
Types of denturesComplete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position.
Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.
Complete or full dentures are made when all of your natural teeth are missing. You can have a full denture on your upper or lower jaw, or both.
Complete dentures are called "conventional" or "immediate" according to when they are made and when they are inserted into the mouth. Immediate dentures are inserted immediately after the removal of the remaining teeth. To make this possible, the dentist takes measurements and makes the models of the patient`s jaws during a preliminary visit.
An advantage of immediate dentures is that the wearer does not have to be without teeth during the healing period. However, bones and gums can shrink over time, especially during the period of healing in the first six months after the removal of teeth. When gums shrink, immediate dentures may require rebasing or relining to fit properly. A conventional denture can then be made once the tissues have healed. Healing may take at least 6-8 weeks.
An overdenture is a removable denture that fits over a small number of remaining natural teeth or implants. The natural teeth must be prepared to provide stability and support for the denture.
Partial dentures are often a solution when several teeth are missing.
Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps.