Types of dentures and bridges if there are no molars

If 3 teeth are missing, the patient can be helped with a removable denture, dental bridge or implantation. Implantation of implants is the preferred option: it provides high aesthetics, preservation of adjacent elements and bone tissue (bone atrophy is stopped), reliability and durability. The choice of implantation method depends on the location of the defect.

• When used:
  missing 3 teeth
• Type of anesthesia:
  local anesthesia
• Procedure time:
  from 45 minutes
• Treatment period:
  up to 4 months
• Healing period:
  up to 7 days
• Age restrictions:
  from 18 years old

What is better if 3 teeth are missing - dentures or implants?

Let's look at possible recovery methods:

• Bridge prosthesis
  A fixed structure consisting of several crowns is fixed to adjacent teeth with a special dental adhesive-cement. Before installing the prosthesis, the supporting units are depulped and ground. If there are no last teeth in the row, it will not be possible to install such a prosthesis, since there is no support.

• Removable denture
  A structure consisting of artificial gums with soldered crowns, fixed on the gums, held by hooks to adjacent teeth. Prosthetics do not require filing or removing the nerve of nearby supporting teeth. But such fastening is unreliable; food particles get under the prosthesis.

• Implantation
  In the absence of several elements, individual implants (titanium roots) are implanted into the “free” places, which are loaded with a fixed prosthesis on the 2-3rd day (with a one-stage protocol) or after the implants have healed (with classical implantation).

Implantation is the best way, as it provides:

• safety of neighboring teeth - they do not need to be depulped and ground down;
• aesthetic result - artificial teeth on implants are difficult to distinguish from natural ones;
• bone preservation - with an implant, the bone tissue experiences stress and does not decrease in size;
• reliability, durability - implants can withstand significant chewing loads and last 30 years or more with proper care.

Prosthetics of molars at the ILATAN clinic

Modern dentistry offers many durable solutions that provide maximum patient comfort while at the same time providing excellent aesthetic, functional and therapeutic results. When choosing a prosthetic restoration, we take into account the patient's existing conditions and expectations. By scheduling a free consultation with an orthopedist or implantologist at any of the ILATAN family dentistries by phone, you will find out which dental restoration option is right for you and can take advantage of high-quality dental services at affordable prices.

Implantation methods

• Classical
  operation is carried out in two stages. A two-part artificial root is implanted (the implant and abutment are separate elements) by detaching the gum flap and suturing it into the bone. After 2-6 months, the gums are opened, and abutments are fixed to the implants. The implants are loaded with metal-ceramic or zirconium crowns. Until the titanium roots engraft, the patient wears a temporary removable denture. In case of bone deficiency, implantation is preceded by bone grafting (bone augmentation surgery).

1

Implantation

Implantation of 3 implants

Installation of a butterfly prosthesis or temporary crown (if it is possible to remove the bite)

4-6 months

2

Prosthetics

Installation of abutment and permanent crown

• One-stage
  Monoblock implants are implanted (abutments and implants are inseparable) without detachment of the gingival flap - through a puncture in the gum. It is possible to install an implant in the socket of a newly removed unit. On days 2-3 after surgery, an adaptation prosthesis (with a titanium arch and plastic crowns) is fixed. After the artificial roots have engrafted, the temporary structures are replaced with permanent ones (with metal-ceramic or zirconium crowns). In a one-stage operation, implants are implanted into deep layers of bone that are not subject to resorption—bone grafting is not performed.

1

Implantation

Implantation of 3 implants

2 - 3 days

2

Prosthetics

Fixation of an adaptive prosthesis with a titanium arch and metal-plastic crowns

in a year

Permanent prosthetics

The choice of method for implanting three teeth in a row is determined after diagnosis and depends on the location of the defect (front or chewing teeth) and its extent.

Doctor's advice - crowns can be placed immediately

For this purpose, a one-stage implantation method is used, when an implant is placed and covered with a crown on top, without waiting for its engraftment. The method is used when there is a sufficient amount of bone tissue. Used for dental units that do not actively participate in chewing. The crown is placed temporary, made of plastic or metal-plastic, and removed from the bite (lower in height) to eliminate active loads. After engraftment, it changes to permanent.

Levin Dmitry Valerievich

Chief physician, Ph.D.

How many implants are needed?

Possible options:

• 2 classic (two-piece) implants are implanted along the edges of the defect, after healing they are loaded with a permanent prosthesis of 3 connected crowns (2 “sit” on the implants at the edges, 1 in the middle fills the void);
• 3 classic (two-piece) implants replace missing teeth with individual implants and load them with separate crowns after implantation of artificial roots;
• 3-4 monoblock (one-stage) implants on titanium roots immediately fix an adaptive prosthesis with a titanium arch and three welded crowns.

The choice of the number of implants depends on the location of the defect.

Guarantees

Our Center uses implants with a lifetime guarantee - Nobel Biocare. We provide guarantees:

• 2 years for treatment;
• 1 year for prosthetics;
• lifetime for implantology.

Warranty obligations apply provided that the patient follows the doctor’s recommendations, rules of care and regularly visits the dentist. The warranty program includes a complex: for an implant, surgery, bone reconstruction and prosthetics.

Features and options depending on the location of the defect

Upper jaw

The jaw bone on top has a loose structure - more implants are required, and they take 1-2 months longer to take root than in the lower jaw. The bone tissue on top is smaller in height; after the loss of an element, it quickly atrophies. In addition, the maxillary sinuses are located close to the upper jaw, so implantation should be carried out with extreme caution.

When choosing a classic protocol for bone deficiency, bone grafting (sinus lift) and installation of 2-3 classical implants are required. As part of a one-stage protocol, 3-4 one-piece implants are implanted, eliminating bone grafting and shortening the treatment period.

Lower jaw

The bone tissue of the lower jaw has a less loose structure; implants take root here faster. The bone is not as susceptible to atrophy as the upper one, but with a long absence of teeth, the likelihood of active tissue destruction is high. In addition, surgery on the lower jaw is complicated by the proximity of the mandibular nerve, which is taken into account after a CT scan.

Installing three implants using a one-stage protocol is the best option for the lower jaw. Instant installation of an orthopedic structure allows you to speed up the healing of implants and reduce the number of dietary restrictions.

Front teeth

If three or more teeth are lost in the frontal area, 3 classic implants are installed, after which they are healed, single crowns are placed. The method helps to achieve a highly aesthetic result (artificial units look natural, an even gum contour is formed). In case of bone deficiency, bone grafting is performed.

It is not always possible to implant 3 monoblock implants within the framework of a one-stage protocol on the front teeth: an extended defect is needed to fix the products, and the frontal units are usually small in size. The fact is that titanium roots are installed at an angle (to avoid bone tissue buildup) - the roots of neighboring elements can be touched.

Chewing teeth

It is preferable to install monoblock implants (3-4 pieces) in place of 3 missing chewing teeth. Titanium roots are implanted at an angle into areas of “quality” bone, bypassing the roots of neighboring units. The implants are immediately loaded with a prosthesis consisting of 3 crowns.

You can install 3 classic implants, but the teeth in the chewing area are most subject to stress, and the likelihood of bone atrophy is high. When choosing a classical technique, bone tissue will need to be augmented before implantation.

Orthopedic treatment of complete edentia

In case of complete edentia, the doctor can offer two main correction options: implantation followed by prosthetics or wearing a complete removable denture.

Removable dentures were very popular before the advent of implant prosthetics, accessible to a wide range of people. Now removable dentures are used, but are not considered the optimal solution to the problem. In modern dentistry, several types of removable dentures are used:

✔

acrylic;

✔

nylon.

Acrylic removable dentures consist of a solid base and attached artificial teeth. The lack of flexibility gives these prostheses several special qualities, which are both the main advantage and the main disadvantage. On the one hand, a solid base contributes to an even, healthy load on the entire jaw when chewing food. However, this same property makes the prosthesis more fragile and less comfortable to wear compared to more elastic structures. Acrylic dentures have a porous structure on which bacteria and plaque accumulate; the monomer in their composition can cause an allergic reaction. When choosing this design, we recommend paying attention to Acry Free prostheses, made from the latest type of plastic without toxic substances. They are more modern, durable and flexible, but their cost is higher than other acrylic prostheses.

Nylon prostheses are more flexible and aesthetic. They are made from hypoallergenic materials. However, they have insufficient rigidity, which affects the quality of chewing food and contributes to rapid atrophy of bone tissue. Because of this, nylon dentures made of polyurethane and other materials are not recommended for use in completely toothless jaws.

Operation stages

1. Consultation

The doctor listens to the patient, determines the condition of the teeth, gums and the advisability of implantation, and answers the patient’s questions.

2. Diagnostics

The patient is sent for an x-ray. A 3D computed tomography (CT) scan is performed. Helps to exclude contraindications and assess the volume and condition of bone tissue.

3. Preparation

They organize treatment of dental pathologies (if they are diagnosed), and carry out professional cleaning of the oral cavity.

4. Installation of implants

After anesthesia, the implants are implanted using the method of detaching the gum flap, followed by suturing the gums (with a two-stage protocol) or fixed through a puncture (with a one-stage implantation).

5. Prosthetics

If the operation is organized in 2 stages, 2-6 months after the implantation of titanium roots, the patient is fitted with permanent dentures with crowns made of zirconium dioxide or metal ceramics. While the bone is fused with the implants, the patient wears a temporary removable denture. In a one-stage protocol, the installed artificial roots are loaded with an adaptive prosthesis 2-3 days after surgery. Re-prosthetics with permanent structures are organized after a year.

Price

The clinic uses a case payment system. The cases are designed for installation of 1 implant. Accordingly, if two teeth are missing, the package cost will double.

The cost of the surgical stage includes:

• anesthesia;
• implant;
• plug, abutment, former;
• complex of reconstruction and basic bone augmentation;
• repeat CT.

The price of implants varies depending on the type of bone. Nobel Biocare PMC (cheaper) is intended for weak bones, and Nobel Biocare Conical Parallel CC (more expensive) is for dense bone tissue.

The cost of prosthetics includes:

• making a crown;
• taking impressions;
• installation.

Paid separately:

• tooth extraction with one-stage implantation - the price depends on the complexity (simple is cheaper, complex is more expensive);
• bone grafting or sinus lifting if necessary - the price depends on the amount of bone material and the method of osteoplasty.

Bite with complete absence of teeth

With complete edentia, the jaw looks unaesthetic, and the shape of the patient’s face changes significantly. In this situation, specialists need to recreate the correct bite so that the prosthesis does not protrude or sink.

In order for the prosthesis to fit correctly, correcting aesthetic and functional problems caused by edentia, it is necessary:

• calculate the occlusal height of the upper jaw;
• form a prosthetic plane;
• determine the height of the lower facial region;
• determine the central relationship of the jaws and fix it with notches.

To determine central occlusion, the doctor holds the corners of the patient's mouth. After the patient swallows saliva, the jaws close correctly.

Causes

The main and only cause of adentia is the absence or death of tooth buds. Primary pathology can be caused by heredity or provoked by various harmful factors acting during the formation of the fetal dental plate.

Complete congenital edentia is an extremely rare phenomenon. Formed due to ectodermal dysplasia. In this case, along with the absence of teeth, patients experience underdevelopment of hair, skin, nails, as well as sebaceous and sweat glands, eye lenses, and nerves.

Other common causes of pathology include the following:

• disturbance of mineral metabolism during the period of intrauterine development of the fetus against the background of diseases of the mother during pregnancy;
• illnesses in early childhood;
• heredity;
• disruption of the endocrine system;
• disruptions in the development of ectoderm - the outer germ layer of the embryo;
• treatment of concomitant diseases, including malignant neoplasms;
• chemotherapy, treatment with ionizing radiation;
• osteomyelitis and other purulent inflammations of the jaws.

The causes of secondary tooth loss in the process of life can be untreated caries, pulpitis, periodontitis, dental trauma, phlegmon, abscesses, illiterate provision of dental or orthopedic care, as well as other pathologies of the teeth and gums.

Indications and contraindications for production

A butterfly denture is made in the following clinical situations:

• Loss of 1-3 teeth in the front or side of the jaw;
• The need for prosthetics for 2-3 teeth;
• Partial edentia;
• Absence of a tooth by nature;
• Temporary replacement of a defect during the manufacture of a permanent structure;
• Inability to perform prosthetics using other prostheses;
• Presence of contraindications to implantation;
• Patient's wishes.

Contraindications to prosthetics are:

• Absence of more than 3 teeth in a row;
• Severe tissue atrophy;
• Periodontal diseases of adjacent teeth;
• Stomatitis, acute inflammatory processes in the oral cavity;
• Allergy to manufacturing materials (plastic, nylon);
• Deformation or defect of the alveolar process;
• Removal of the last molars, since their replacement is impractical.