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Implant supported prostheses


Last Updated: 10.01.2024

Author: George Ghidrai, MD  

Dental implants can support a large variety of prosthetic devices. When planning for a type of implant-supported restoration, several factors are involved:


a. Dental crown

An implant-supported crown is typically indicated when a single tooth is missing. However, it is possible to design adjacent single-unit crowns when several teeth are missing.


dental implant-supported crown

Dental crowns can be made of porcelain fused to metal alloys (gold, titanium, base metals), zirconia, or all ceramics. Execution time is relatively short, and the success rate is excellent.


b. Dental bridge

Many patients prefer fixed implant-supported bridges because they do not have to be removed for cleaning. Bridges are permanently secured on the implants either with dental cement or with lag screws. Large dental bridges supported by many implants can be quite expensive.


dental implant-supported bridge

It is not advisable to design dental bridges supported by both natural teeth and dental implants, as this could lead to the loosening of the implants because of natural teeth' physiological mobility and failure.

What does natural teeth' physiological mobility mean?

  • Natural teeth are intended to have a little mobility. This is because the tooth is not fused to the bones of the jaws but is connected to the sockets by the flexible periodontal ligament.

    This ligament allows the tooth to move just slightly, but people should not actually be able to see or feel this movement.

Let's detail the above idea:

Contrary to natural teeth, dental implants fuse to the bone and, as a result, have no mobility at all. Consequently, the natural mobility of the tooth causes the chewing forces to act as a lever on the rigid implant fixture.

implant-supported bridge, chewing forced

this graphic shows an implant
in a bridge connection with a natural tooth


Moreover, designing enough implant units to adequately support the bridge is equally important. For example, if all teeth are missing and a fixed dental bridge is designed, at least six implants are required to support the bridgework.

Even in the case of All-on-4 dental implants, many practitioners prefer to place a few extra implants as an extra precaution.

What is an All-on-4 system?

  • The term All-on-4 refers to 'all' teeth being supported 'on four' dental implants, a prosthodontics procedure for total rehabilitation of a toothless dental arch.


Implant crown and bridge: Manufacturing materials

In the vast majority of cases, porcelain crowns and bridges are preferred when it comes to fixed implant restorations.

Porcelain is superior to any other aesthetic material used in dentistry because of the great aesthetic features that make porcelain restorations look almost like natural teeth.

porcelain crowns on the 2 central incisors

porcelain crowns on the two central incisors;
notice the outstanding aesthetics

Several kinds of ceramic restorations may be utilized. You can follow the links for extensive details:


c. Dentures

An implant-supported denture is a type of overdenture supported by and attached to implants. An implant-supported denture should be removed daily to clean the denture and gum area.


dental implant-supported denture

Compared to a traditional denture (complete denture), which rests exclusively on the gums, implant-supported dentures allow chewing the food better and speaking more clearly. Moreover, they have superior stability.

Removable dentures are generally designed when all teeth from a dental arch are missing.

Implant dentures consist of 3 parts:

  • the base
  • the artificial teeth
  • the special retainers

implant-supported denture, front view
implant-supported denture, front view


The base of the denture

The denture's base will cover your gum area and the soft tissue of your upper palate. The base will create a replica of your gums, eventually used to craft your custom denture.

Most often, the base of your denture is made of acrylic resin colored matched to your gingival tissue. Another variation is when the base is made of dental ceramics; however, this will entail a much higher cost.

When strength is an essential issue, the acrylic base can be metal-reinforced, or, in some cases, the base can be entirely made of metal (base metal, titanium, or even gold alloys).

When an upper restoration is designed, the base can cover the entire palate or only a part, depending on the clinical conditions.


The artificial teeth

The artificial teeth will replace your missing teeth. The artificial teeth are either stock teeth, delivered by manufacturing companies in various shapes, colors, and sizes, or custom-made teeth, individually fabricated at the dental lab.

Like the base, the artificial teeth can be acrylic (most often) or porcelain. Porcelain teeth will ensure a better aesthetic appearance but are more expensive.

Custom-made teeth can be constructed in any shape and size. When stock teeth are used, a set of artificial teeth is selected based on the clinical requirements. For example, women have smaller, more rounded teeth, while men have more prominent teeth.

set of stock teeth

set of stock teeth


Special retainers

When a removable denture is worn, retainers to hold the denture in place are attached to the implants and the denture.

Most often, the retainers are made of two components:

implant-supported dentures adapter or retainer
  • A male-adapter - attached to the implant

  • A female adapter - housed in the denture. This part will require periodic replacement.

special retainer abutments: male-adapters attached to the implants

the male-adapters
are attached to the implants

special retainer abutments: female-adapters are housed in the denture

the female-adapters
are housed in the denture


Various adapters are designed to hold overdentures in place, for example, the ball-and-socket style retainer (image above) or the button-style adapter.

Another variation is when a cast bar of metal is secured to the implants. The complete denture then attaches to the bar with attachments, allowing no movement of the denture (image below).


overdenture supported by dental implants


d. Orthodontic anchors

Dental implants can be used as orthodontic anchors to align teeth. Orthodontic implants differ from those used for prosthetics, as there is no osseointegration. Mini-implants provide absolute anchorage, and they have revolutionized the field of orthodontics.





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