Dental Implants Versus Fixed Bridges: The Right Choice ?
Tooth loss is a common problem seen in elderly population. It can be due to dental caries, gum disease, trauma or other pathological reasons. While procedures like Root Canal Treatment (also known as RCT) can help in saving badly decayed tooth, however in certain situations, the decayed tooth has to be removed. Even after tooth extraction, there is often a dilemma to choose between dental implants or fixed bridge for missing tooth replacement. In this article, we will be addressing specific indications and treatment considerations for both the procedures, dental implants versus fixed bridge treatment.
Dental implants for teeth replacement is a popular procedure. It is advanced, predictable with excellent results. Dental implants are metallic screws made up of titanium. Since Titanium is a biocompatible material, it forms a strong union with the surrounding bone. The process of bony union of implant is called Osseointegration. In nearly 3- 4 months after surgical placement of implant, it forms a firm foundation for receiving the visible portion in mouth called as crown. Various components of dental implant unit are:
- Implant: These are conical screw-like structures made of titanium metal or sometimes ceramic material called as zirconia which are placed surgically inside the bone.
- Abutment: A small connector placed on top of the implant, usually made of titanium, zirconia, or stainless steel. It supports and secures the replacement tooth.
- Crown: The visible portion of overlying prosthesis inside mouth is called as crown. It is often tooth coloured, made of ceramic like zirconia, or metal or both.
Dental Implants: Treatment Considerations and Indications
Dental Implant is considered as treatment of choice in patients with single or multiple missing teeth. The chief advantage of dental implant is only area with missing tooth is treated and any reduction of neighbouring teeth is completely avoided.
Procedure of Dental Implant Treatment: It involves two phases- surgical phase and prosthetic phase.
Surgical Phase- After thorough clinical and radiological examination, a treatment plan is formed about the exact size and position of dental implant. Since the implants are placed surgically in the mouth, the bone quality and quantity assessment need to be carried out using radiographs and cone-beam CT scans. Under the local anesthesia, dental implants are placed surgically at the missing tooth site with or without artificial bone grafts. The implant remains undisturbed inside the bone for minimum 3 months for complete integration with the surrounding bone.
Prosthetic Phase- After 3 to 4 months, implant site is assessed clinically and radiologically for placement of overlying abutment and crown. The underlying implant head is uncovered and subsequent gum modulation and digital impressions are carried out for crown fabrication. The new crown is checked thoroughly for its fit and shade and is then cemented in its final position.
Fixed Bridge Treatment for tooth replacement
Unlike dental implants which gained popularity in last two decades, the fixed bridge is a conventional procedure for replacing missing teeth. The basic philosophy is to use teeth adjacent to the site of missing tooth as pillars or support to place an artificial tooth or crown in missing tooth region. Hence, it is called a bridge.
Fixed Bridge: Treatment Considerations and Indications
The choice of fixed bridge over implant depends upon clinical situation, medical history and socio-economical status of patient. For patients with history of tooth extraction over a prolonged period of time, often fixed bridge is a treatment of choice due to drifting of neighbouring teeth in extraction space. Sometimes, medical conditions like uncontrolled diabetes, severe hypertension, patients with cardiovascular abnormalities, patients taking medications involving blood thinners etc. often are considered as good candidate for fixed bridge to evade the surgical procedure involving active bleeding. The dental implants are modern and technologically crafted specialised mini-screws made of titanium metal which are placed surgically, hence, the treatment involving dental implants is relatively more expensive than the fixed bridges.
Procedure of fixed bridge treatment: The clinical examination for planning a fixed bridge involves assessment of neighbouring teeth for caries or gum disease. It is important for the adjacent teeth to have sound tooth structure and healthy gums. The adjacent teeth are then prepared to receive the terminal crowns. These terminal crowns serve as anchor to join with the crown in missing tooth region. All the crowns are joined with each other by connector region. Sometimes, due to caries or high sensitivity, root canal treatment is done in adjacent teeth to prevent any sensitivity or pain in future. The prepared bridge is then fixed on the teeth with the help of a permanent cement and the missing tooth region is completely replaced by artificial tooth.
The final choice?
Whether to go for fixed bridge or implant depends upon clinical considerations, other medical ailments, status of other teeth and own financial constraints. The level of maintenance of oral hygiene by patient also determines the long term success of both the procedures. However, a specialized Prosthodontist is the best person to guide the patient about the right treatment choice.
As the best dental implant clinic in Gurgaon, our prosthodontist Dr. Neelu Arora Gupta, President of India Gold medal awardee has a rich experience of over 15 years in treating specialised cases in need of Dental Implants or Fixed Bridge.
