Replacing missing teeth with implants is usually the ideal option. They function as individual teeth, and do not need to be supported by adjacent teeth. Basically what the procedure consists of is a screw surgically placed into your jaw bone, the bone is allowed to heal around the screw(s)- called osseointegration, and then a crown is attached to the screw.
REPLACING MISSING TEETH WITH FIXED PROSTHETICS:
Fixed Prosthetics are very good ways of replacing teeth, and include anything that is cemented in and is not intended to be removed. Like the dental crown procedure and tooth bridges.
Tooth bridges are multiple crowns fused together used for replacing missing teeth. For example, if you were missing one tooth, the teeth on either side of the space would be prepared for crowns, and 3 crowns fused together (the 2 anchor crowns plus the crown to fill the space) would be cemented into place.
*Picture courtesy of Stephen F. Gordon, 1993
They FUNCTION like normal teeth but you do need to FLOSS UNDER the tooth bridge to keep it clean.
The other drawback is that you are crowning teeth that may not necessarily need to be crowned.
WHAT ARE THE RISKS OF CROWNING TEETH THAT DO NOT NEED TO BE CROWNED:
If the teeth have fillings on them already, probably not too much. If the teeth are uncut, there is a risk of sensitivity to elements such as hot and cold, or in extreme cases could lead to needing a root canal.
The dental crown procedure is a bit invasive to the tooth, and while these symptoms are unlikely, they are still possible.
The two (or more) teeth on either side of the space that are crowned, are called, abutments. Because these teeth are going to be assuming a heavier load from the missing tooth or teeth, the abutment teeth need to be very strong, and in good condition. If they have periodontal disease for example, that is not an ideal situation.
The fake teeth that are going over the space where you are replacing missing teeth, are called pontics. In a tooth bridge, there is usually at least 2 abutments and 1 pontic, although in longer bridges there may be numerous abutments and pontics.
A bone graft is a surgical procedure where bone is added to an area to try and build up the ridge, in order to help support the teeth or provide better esthetics when replacing missing teeth.
When a tooth is removed, the gum and bone will normally shrink in that area. Sometimes a bone graftneeds to be done during the extraction in order to preserve the bone from shrinking too much. Bone grafts can also be done as a seperate procedure.
There are 4 different types of bone graft material:
This is a type of bridge that is usually only done in the front of the mouth., and to replace ONLY ONE tooth. Instead of putting full crowns on the two adjacent teeth, a false tooth is attached to two metal wings which are glued to the adjacent teeth. Because of the limited strength, they are not the best options for all patients. In those who grind or have inappropriate bites, MARYLAND BRIDGES will not be successful.
This dental crown procedure is much less invasive on the teeth, as only a thin layer of tooth is removed on the back of the two abutment teeth (teeth holding the fake tooth).
Picture courtesy of Stephen F. Gordon, 1993.
Cantilever bridges are fixed bridges that are not supported by teeth on both sides. They are attached to one or more teeth on one side, but are free standing on the other side.
This is sort of like holding a fishing pole over the water, in that you are holding the pole on one side but the tip/end of the pole is not supported by anything.
Because it is not supported on both sides, the tooth that is supporting it on the one side, is overloaded, andthis is not an ideal situation. On the other hand, there are some cases when this is acceptable.