The three main ways to replace missing teeth include:
- Removable Partial Denture
- Fixed Bridge
- Implant Supported Crown or Implant Supported Fixed Bridge
Removable Partial Denture (RPD)
As the name implies, the method of tooth replacement is not cemented in place. It is made to be taken in and out daily. This RPD stays in place with a clasp that holds onto the surrounding teeth. A metal bar goes across the roof of the patient’s mouth along the upper arch or a metal bar in front of the tongue along the lower arch to help with stability during chewing. Care must be taken to avoid sticky foods, which can dislodge the RPD during chewing.
The RPD is the most economical way to replace teeth.
1. The RPD must be removed for cleaning and sleeping.
2. The RPD neither looks nor feels like your natural teeth.
3. The RPD can become dislodged when speaking or chewing.
The fixed bridge uses the teeth on either side of the missing tooth for support. It is cemented in and does not require removal by the patient. It looks and functions like natural teeth–except for flossing. Dental floss cannot be passed between the teeth on the bridge because they are splinted together; a floss threader is used to pass floss under the bridge.
1. The bridge does not require daily removal by the patient.
2. The bridge looks and functions like natural teeth.
1. The bridge “marries” three or more teeth together. A cavity on one tooth in the future can possibly require the replacement of the bridge if the decay gets under the margin on the bridge.
2. The teeth on each side of the space need to be altered. If there are existing crowns on either of these teeth, they will need to be removed and discarded.
Implant Supported Crown or Implant Supported Fixed Bridge
The implant-supported crown is the most natural feeling and functioning option. It does not rely on any other tooth to stay in the mouth. The implant is placed in the bone in the location of the missing tooth. After bone has integrated around the implant, a post and a crown are placed on the implant. The future of the crown/implant is not dependent on the surrounding teeth. The teeth on each side of the missing space do not need to be altered for support purposes. The implant/crown is not susceptible to decay and it can be flossed like a natural tooth.
1. Implant/crown is not susceptible to decay.
2. Implant/crown is minimally susceptible to periodontal disease.
3. Implant/crown does not rely on other teeth for support.
4. Decay on the surrounding teeth will not affect the implant/crown.
5. A more natural cleaning process for the patient occurs since typically implants are not connected to natural teeth.
6. The implant/crown increases strength of the quadrant where it is placed.
7. Bone stays with implant placement and atrophies (shrinks) with no implant.
1. Initially cost more than the RPD or Fixed Bridge- but a great value considering the disadvantages of the RPD and the Fixed Bridge.
2. Implants typically take more time; but with today’s techniques, the prosthetic (replacement) phase may begin at 2-3 months from implant placement.