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Implant supported prostheses

author icon By Dr. George Ghidrai

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


Dental crown

An implant supported crown is normally 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

The dental crowns can be made of porcelain fused to metal alloys (gold, titanium, base metals), zirconia or all ceramics. The time of execution is relatively short and the prognosis is very good.


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 that are supported by both natural teeth and dental implants (with some exceptions). This could lead to the loosening of the implants (because of natural teeth physiologic mobility) and failure.

implant supported bridge, chewing forced

The graphic above shows an implant in a bridge connection with a natural tooth. The movability of the tooth causes the chewing forces to act as a lever on the rigid implant situation.

It is also important to design enough implant units to adequately support the bridge. For example, if all teeth are missing and a fixed dental bridge is designed, at least 6 implants are required to support the bridgework.


Dentures

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


dental implant supported denture

Compared to a traditional denture (full denture) which rests exclusively on the gums, implant supported dentures allow chewing the food better, speak more clearly and is more stable.

Removable dentures are designed when a large number (most of the times, all) of teeth are missing. When a removable denture is worn, retainers to hold the denture in place are attached to the implants and the denture.

Special retainers

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


There are various types of adapters designed to hold overdentures in place : the ball-and-socket style retainer (image above) and the button-style adapter are just two examples.

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


Orthodontic anchors

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

Last review and update: February 2019



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