Types of Prosthesis (Your New Teeth)
An overdenture refers to a removable denture prosthesis, typically made out of denture acrylic that snaps onto and off of your implants. You remove it to clean the prosthesis and clean the top of the implant attachments. It usually sits on a metal bar with snaps, or locator attachments, that allow it to snap on and off.
Pros: A great advantage to an overdenture is the ability to put a large flange in the upper arch, extending under your lip to provide support for your lip muscles. This can dramatically improve the esthetics for someone that has worn a denture for a long time and lost much of the bone in the front of the upper jaw. With screw in fixed prosthetics, a flange cannot be placed because it would make it difficult to access under to clean between it and the gums on a daily basis.
Cons: The removable nature of the denture creates a lack of stability. People often like their teeth to be screwed in, permanently fixed, or only removable by the dentist for greater confidence and stability.
Crown & Bridge
A crown and bridge final prosthesis is a set of teeth that incorporates the bridges, screwed directly into the implants. The teeth butt up to the gums and the prosthesis typically consists of only white teeth — there is no pink gingiva (gums) or underlying metal support bar.
This is great option for individuals who have perfect gums. It can be done in young people with very regular gum lines or older individuals who do not show any gums when speaking or smiling. The teeth are typically made out of porcelain or zirconia.
This is the most common prosthesis when someone has all their teeth removed supported by implants. “Hybrid” refers to the prosthesis being made out of multiple types of materials — an underlying support bar for strength, the teeth themselves, and the materials used to replace the pink gingiva.
Hybrids can be made extremely esthetic and are used quite often, because most people who are in need of having all their teeth removed have had some sort of bone loss and have uneven gums. The dental implants are placed slightly deeper into the bone, allowing room for a strong support bar with the teeth sitting on top and the artificial gingiva.
Support framework options for hybrid:
- Titanium bar
- Pekkton bar
- Trilor resin bar
Material options for teeth:
- One unite milled nano-ceramic composite (crystal-ultra)
- Zirconia – cubic or monolithic
- Zirconia layered with porcelain veneers
- Lithium disilicate (Emax)
Material options for artificial gingiva (gums)
- Composite resin
Types of Final Prosthesis
- Monolithic zirconia: With this option, the supporting bar and teeth are all in one piece made out of monolithic zirconia. It utilizes composite resin to recreate the gingiva. This is a popular prosthesis falling in the mid to high price range. Zirconia is extremely strong and durable. However, it cannot be adjusted. For example, you cannot grind it to adjust the bite and it wears out the opposite arch of teeth.
- Titanium bar with acrylic denture teeth: This is a popular option due to its’ affordability. The titanium bar provides great strength to the structure, while the acrylic denture teeth provide acceptable esthetics. The downside to this option is the teeth occasionally chip off the prosthesis, requiring repair. They also wear with time. Another disadvantage is that the teeth and gums are made out of methyl methacrylate, which absorbs fluid and oral residue over time leading to “methyl methacrylate breath.”
- Trilor resin bar with nano-composite/ceramic teeth: This is becoming a very popular prosthesis because the resin bar provides a solid base for beautiful nano-composite teeth. Since both parts are milled as one piece, it is very cost efficient. It is slightly more expensive than the titanium bar with denture teeth explained above, yet equally esthetic without the fluid absorption so that you maintain fresh breath. The nano-ceramic composite material is easily bonded to and very practical for dentists to use.
- Titanium bar with zirconia or lithium disilicate teeth: This is a popular option because it provides strength with the titanium bar and the esthetics of zirconia bridges or teeth. It falls in the mid to high price range.
- Pekkton bar or framework with lithium disilicate teeth: This is the finest prosthesis option available. Pekkton is a material that has a similar flex to bone, making it shock absorbing to your jaw bone and opposite arch of teeth. Pekkton does not absorb materials or bacteria, so it stays fresh. All dental materials bond well to it, such as the composite gingiva and teeth thus requiring minimal maintenance. The downside comes in the flex of the bar — since the bar flexes, all the teeth must be manufactured (milled) as single crowns, which equates to more lab time. The teeth are made to be extremely esthetic from zirconia or lithium disilicate.
All teeth except denture teeth can be milled utilizing the smile of a “Smile Donator” — someone with beautiful natural teeth. The milled teeth will be shaped and formed to precisely replicate the donator’s smile in the prosthesis. This gives people a confident smile that does not look prosthetic.