The Perfect Smile
Multiple missing teeth may be replaced using several techniques. As far back as the Egyptian civilisation, dentures and bridges were used to fill the space of missing teeth. A piece of animal bone would be carved and used to fit in the gap where the missing teeth once stood. Gold wire used in traditional jewellery would be used to tie the mobile or extracted teeth to the adjacent good teeth and hold them in place. The materials used in both dentures and bridges have changed considerably but the concepts haven’t! Dentures are now made of acrylic resin and false acrylic or porcelain teeth are bonded onto them. Together with their design removable dentures are held in place with the help of clasps engaged around the adjacent natural teeth. Bridges too require adjacent teeth for support. Utilising this method the adjacent teeth are filed down to short stubs and crowned to form part of the bridge fixing it into place.
Implants discovered by a Swedish orthopaedic surgeon made all the difference. In this scenario the implants engage in the patients bone and are independent of teeth, whether present or not!
Dis-advantages
Dentures | Bridges |
Removable | Dependent on teeth; tooth loss= bridge loss |
Move on eating, talking | Continual loss of bone and gingiva |
Reduce taste |
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Psycologically demeaning |
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Food entrapment |
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Advantages of Implant supported teeth
- Prosthetic teeth are independent of patients natural teeth
- Retention of natural bone and gingival tissue
- Stability and security at all times
Implants are inserted in the patients’ natural bone and within 3-4months of healing the surrounding bone grows and bonds onto the implant surface. As a result, the rigidity of the implant fixture is extremely high and can support very large loads. Typically two implants may support 2-4 teeth, 3implants 3-6teeth and 4-6implants up to 14teeth. This means that with multiple implants one may completely eliminate the need for dentures.
Causes of multiple tooth loss:
- Gum disease
- Failed tooth-supported bridges
- Trauma road/traffic accidents
- Multiple genetically missing adult teeth
- Poor oral hygiene leading to severely broken down teeth needing removal
Most of the bone and gingival tissue surrounding a tooth is lost when the tooth is extracted. This is even more evident with multiple tooth loss. In certain case scenarios the volume of bone present is not enough for implantation and so bone grafting is required. Bone grafting is also essential in obtaining a good aesthetic result with good gingival architecture. This is especially important in the anterior aesthetic zone. The posterior areas are also important as they support facial tissue such as the cheeks and lips retaining the patient’s facial features and hence reducing the effects of ageing! Implants carry a hefty price-tag and require a series of appointments but ultimately its quality of life that commands!
