Prosthetics on Implants

Dental prosthetics on implants is a method for restoring one or more missing teeth. Treatment involves several steps, from implant placement to installing dental prostheses.

Installing a prosthesis on an implant helps:

• restore the sensation of a healthy tooth;
• maintain the integrity of the jawbone (and even stimulate its growth);
• ensure the stability and reliability of the prosthesis during chewing.

How It Works

The essence of implant-based prosthetics:

• The dentist surgically places a dental implant. This titanium root serves as the foundation for the future prosthesis.
• An abutment (connecting element) is attached after the implant fully integrates.
• An individual prosthesis is fabricated and fixed. Depending on the clinical case, this could be a crown, bridge, or complete overdenture.

Full list of services for implant-based prosthetics:

• Dentist consultation
• Temporary crown on an implant
• Permanent crown on an implant
• All-ceramic (zirconium) crown with screw fixation on an implant
• 3-unit bridge on 2 implants, metal-ceramics (excluding implantation costs)
• 3-unit bridge on 2 implants, E-max ceramics and zirconium dioxide (excluding implantation costs)

Indications

• One or more teeth are missing.
• Toothless areas are located between healthy teeth (the patient wishes to avoid preparation of healthy teeth).
• Terminal defects in the dental arch (missing last teeth in the row).
• Completely edentulous jaw.
• Contraindications to wearing removable dentures.

Contraindications

• Absolute: blood clotting disorders, immunodeficiencies, oncology, severe neurological disorders.
• Relative and temporary: poor oral hygiene, pregnancy and breastfeeding, periodontal diseases, significant bone tissue deficiency.

Crowns

Crowns on implants are placed after the artificial roots have fully integrated with the bone (3–6 months). They are fixed with a screw on the connecting element (abutment). A temporary acrylic crown is installed immediately after implantation or on the 3rd–4th day.

The cost of a crown on an implant depends on:

• the type of structure (temporary or permanent),
• the material (ceramics and zirconium dioxide are more expensive than metal-ceramic crowns),
• the implant brand (abutments from premium brands are more expensive).

Bridges

A dental bridge on implants can replace up to 5 consecutive missing teeth. The side crowns of the bridge are fixed on supporting implants, while intermediate units cover gaps in the dental arch. Bridges made of solid ceramics and zirconium dioxide are typically placed in the anterior jaw, while metal-ceramic bridges are more suitable for restoring molars.

The cost of a bridge supported by implants is higher than that of a traditional bridge on natural teeth due to the added expense of screw-retained fixation.

Overdentures

A full fixed prosthesis on implants restores the entire dental arch. It consists of an acrylic base that forms an aesthetic gum contour. Crowns perform the function of teeth. Overdentures can be full or segmental (restoring specific sections of the dental arch).

The cost of an overdenture depends on the base material (acrylic, nylon, or Acry-Free), fixation type (screw or bar), and artificial tooth material.

Crowns and Bridges Are Made From:

• Metal-ceramics — an optimal material in terms of price and quality. Ideal for restoring molar areas. However, it appears less aesthetic on front teeth due to the metallic core, which may show under light.
• Solid ceramics (E-max) and zirconium dioxide — strong, reliable, and aesthetic materials suitable for restoring all tooth groups. Ceramic or zirconium abutments may need to be custom-ordered for prosthetics with these materials.

Overdentures Are Made From:

• Acrylic — affordable prostheses, though they may cause allergies in some patients.
• Nylon — made from polyamide, flexible, comfortable, and hypoallergenic.
• Acry-Free — made from non-acrylic plastic, hypoallergenic, comfortable, and durable.

Types of prostheses and prices

Immediate Implantation

The dental implant is placed immediately after tooth extraction into the socket left by the removed tooth. If the situation permits, a temporary plastic crown is placed immediately.

This method is used for restoring front teeth.

One-Stage Implantation with Immediate Load

Prosthetics via the one-stage protocol (Immediate Load Implantation) occurs simultaneously with the dental implant placement. Temporary prostheses are placed on implants on the day of surgery or 7–10 days after soft tissue healing and suture removal.

This protocol is used for restoring single defects of anterior incisors and premolars on the upper jaw and in full-arch rehabilitation protocols like All-on-4 or All-on-6.

Two-Stage Implantation with Delayed Load

The classic protocol for tooth restoration — implants are placed first, followed by a waiting period for them to integrate with the bone fully. Prosthetics are carried out 3–6 months later (second stage).

This method is recommended for all tooth groups, especially when there is a higher risk of implant rejection.

Removable

A full removable prosthesis with artificial teeth is fixed on 2–6 implants using snap-on locks. Patients can remove the prosthetic structure at home for cleaning and maintenance.

Removable prosthetics on implants are often used when fixed prosthetics are not an option or when there are contraindications to non-removable constructions.

Installation: Ball-shaped abutments (attachments) are placed on the implants. The prosthesis itself contains round slots for attachment.

Advantages:

• an affordable option for prosthetic construction.

Disadvantages:

• ball attachments unevenly distribute the load on the jawbone and require periodic replacement.

Lifespan: Suitable for patients on a limited budget. The service life depends on the condition of the implants and matrices in the abutments.

Semi-Removable

Semi-removable prostheses use a bar system for retention. This system consists of a steel bar and a hollow arc in the base, connecting several implants. The bar snaps into place like a lock, securely holding the prosthesis on the implants.

Semi-removable constructions are used in cases of complete edentulism of the jaw.

Advantages:

• the bar enhances the stability of the structure, provides even load distribution on the jawbone, and allows immediate loading of implants.

Disadvantages:

• high production cost.

Lifespan: Lasts longer than removable prostheses on attachments.

Fixed

Fixed prostheses cannot be removed at home. This category includes temporary and permanent overdentures with screw retention, single crowns, and bridges. These are attached to the implants directly or via a steel bar that distributes pressure evenly on the jawbone. Fixed constructions are the gold standard in implant-based prosthetics.

Application area: Any dental arch defects (single, multiple, or full tooth loss).

Installation features:

• Screw retention: Holes are drilled into the crowns through which the prosthetic device is screwed to the abutments using special screws. After installation, the holes are sealed with composite material. Used for both temporary and permanent prosthetics.
• Cement retention: Special abutments shaped like prepared teeth are attached to the implants. Dental cement is applied to them, and then the crown or bridge prosthesis is pressed onto the abutments.

Advantages:

• the structure is securely fixed in the oral cavity and provides even load distribution on the gums.

Disadvantages:

• high cost.

Lifespan: With proper care, they last from 10 to 20 years.

All-on-4

This technique from Nobel Biocare involves placing a full fixed prosthesis of 12 teeth on 4 dental implants (two in the anterior and one in each posterior region of the jaw). The method is also known as Teeth-in-a-Day since the temporary fixed prosthesis is installed immediately after surgery.

A unique feature of the All-on-4 system is the angled placement of titanium roots, enabling implantation even with insufficient bone tissue.

All-on-6

This technique differs from All-on-4 by providing more support points for securing the fixed prosthesis. For full prosthetics using the All-on-6 method, four implants are placed in the anterior region with denser bone, while two additional implants are placed in the posterior (distal) sections of the jaw. Depending on the bone condition, implants may be angled.

The All-on-6 concept is preferred when higher prosthesis stability is required. This protocol is ideal for upper jaw rehabilitation and for taller patients with a more developed jaw.

• Which is better: a partial denture or an implant?

  We recommend installing a fixed prosthesis on implants. A partial denture system attaches to healthy teeth with metal clasps after preparation, reducing the lifespan of those teeth. Implants are unequivocally superior as they do not damage adjacent teeth and prevent bone atrophy.

• How often are dental implants rejected?

  Dental implant rejection is extremely rare. Depending on the brand, the rejection rate within the first year after placement is 0.5–1% of all cases.

  Rejection of the titanium root may result from poor oral hygiene and failure to follow the dentist's recommendations.

• How to care for prosthetic structures on dental implants to extend their lifespan?
  • Brush teeth and interdental spaces at least twice a day using a medium-bristle toothbrush and dental floss.
  • Undergo professional oral hygiene (ultrasound + Air-flow) twice a year.
  • Have a check-up with your implantologist every six months.