Which is better - prosthetics or dental implants? Clasp prosthesis or implant which is better

Dental prosthetics is the final stage in the treatment with implants. Dental implants are implanted into the bone tissue, during the introduction of which the doctor establishes the basis. It will be used to fasten prostheses. Do you want to return to normal life and become the owner of a dazzling smile? In this case, you need orthopedic structures that solve not only functional, but also aesthetic issues. Find out what stages of prosthetics on implants exist, what you need to know before the procedure!

Dentures on implants are of 2 types:

• removable;
• fixed.

In most cases, patients choose a non-removable type of dentures on implants, which has managed to earn trust and become especially popular. Thanks to this treatment, it is possible to make a complete restoration of the lost chewing and aesthetic functions. In turn, removable prosthetics are distinguished by some inconveniences when using them.
Indications for fixed dentures on implants
In general, fixed prostheses on implants with a screw connection are appropriate in the absence of one or more teeth in a person.

The manufacture of such products for prosthetics can be carried out from various materials, among which are the popular zirconium dioxide, plastic, as well as a combination of metal and ceramics - cermets.

Cases of using fixed prosthetics

1. 1. Missing one or more teeth in a row

1. To support bridges (dental bridges), there is a strong grinding of the teeth located in the neighborhood. Implantation, on the other hand, keeps the adjacent teeth intact. There is no guarantee that the teeth under dental bridges will be suitable for the next prosthesis. The question of what is better prosthetics on implants or a bridge prosthesis disappears by itself.

1. It is considered appropriate to use a bridge prosthesis if the teeth located next to the missing one are 50% destroyed or they already have fillings.
   1. Unilateral or complete edentulous

Over time, teeth wear, enamel weakens, caries develops, and to this is added insufficient hygiene and the spread of harmful bacteria throughout the oral cavity.

Since the main load falls on the chewing teeth, because of the problems listed above, they usually suffer first, because of which the chewing function is disturbed, the bone areas atrophy in place of the missing teeth, and ultimately the entire bite as a whole suffers.

Severe periodontitis is one of the most common causes of loss of the entire row of teeth in one jaw or both at once.

There are three key methods of dental implantation:

• classical 2-stage implantation with delayed prosthetics;
• one-stage implantation with instant prosthetics.
• Mini-implantation of teeth: gives additional fixation to removable dentures.

Classic 2-stage implantation

Prosthetics on implants stages of classical implantation

Classical 2-stage dental implantation has forty years of experience. This method is the most common around the world. The method consists in the fact that the fusion of the implant with the jaw bone tissue must occur. And only after that is the load with a crown or prosthesis. Due to such implantation, various problems of the oral cavity can be resolved: the lack of one or more teeth in different places, or their complete absence. Implants, which are installed according to the traditional method, allow the installation of various types of prostheses, including conditionally removable ones.

The primary step in 2-stage implantation involves placing the implants in the bone tissue, after which the closure is performed with a special plug. The doctor determines whether dentures or crowns are required for a certain amount of time, and then the patient is allowed to go home for 4 to 6 months.

Before the procedure for installing the prosthesis, the plug is replaced with a gingival shaper. This stage is considered quite significant, since a bed is created for the upcoming crown with an abutment (adapter between the crown and the implant). After two to four weeks, the gum former is unscrewed, and the abutment is placed on top. This is followed by the standard work of an orthopedist: casts are taken, a crown is made in a special laboratory, after which it is fixed with cement or a screw.

With a 2-stage technique, the following stages and conditions are observed:

• bone tissue is built up in case of its shortage;
• if it is not possible to jointly build up bone tissue and install an implant, then it is necessary to pause for five to seven months;
• after the absolute integration of the implant into the bone tissue (a period of four to six months), prosthetics is performed;
• not in all cases, it is possible to install an implant in the hole of a freshly removed tooth. For this reason, after removal, a break is made for one and a half to two months.

Classical implants allow you to install any fixed prostheses, while achieving their maximum aesthetics.

Advantages of two-stage classical implantation:

1. prosthetics on a delayed-action implant minimizes the risk of artificial root rejection due to the absence of chewing load. This is both a positive and a negative fact, since the bone tissue regenerates faster as a result of pressure on it, but in some situations it is preferable to leave the implant at rest for the healing period;
2. a variety of implant systems allows you to choose the right products for a specific clinical case;
3. the possibility of choosing subsequent prosthetics on implants;
4. aesthetically better than other methods.

Disadvantages of this method

It is believed that the classic two-stage implantation will not give the patient an immediate effect, and as a result, due to significant costs for materials and additional operations, it turns out to be more expensive than one-stage implantation. But, even taking into account the above disadvantages, this method of implantation is considered the most significant from a functional and aesthetic point of view.

Implantation with instant prosthetics

Currently, a huge number of new methods of implantation are being practiced, which are different in the form of the selected implants and the methods of prosthetics. But at the same time, they all have the same essence - the installed implants must immediately be connected to each other into an integral structure by means of a prosthesis (temporary or immediately permanent). When using simultaneous single implantation, a crown is made that is removed from the bite and should not contain lateral contacts.

Stages of transgingival implantation

The key advantage of one-stage transgingival implantation is considered to be its instant implementation: the operation is carried out in only one doctor's appointment, and most importantly, after installation, you can immediately load the implants in the form of a prosthesis. In addition, the implant is implanted without cutting the gums. And on the same day or after a few crowns are installed on the implants.

The presented method of implantation is being developed, which allows, in some cases, to perform implantation, in which there is no need to additionally build up bone tissue if there is a shortage. One-stage implants can be implanted at a certain angle to avoid the most difficult areas of bone tissue atrophy and to maintain parallel bite of the patient. In addition, on the day of the procedure, you can immediately carry out dentures.

Immediate implantation: in one session, implants are placed and dental prosthetics are performed

Currently, there is a trend towards the method of one-stage implantation with prosthetics in a few days. It is mainly applicable when a person is missing all teeth, the loss of only abutment teeth after dental bridges or periodontitis (chronic generalized).

The technique under consideration involves the use of different implants installed in different ways. In particular, screw implants are installed in the amount of four to eight pieces per jaw. It is essential that after the procedure, it is necessary to install implants by means of a prosthesis (temporary or permanent).

Based on the indications, with complex implantation during one operation, it is possible to remove the affected teeth when installing implants. However, with a strong loss of bone tissue, it will still not be possible to avoid building up. All on 4 are two-stage implants, after engraftment, a prosthesis is placed on them, which is fixed on the implants by screwing screws through 2 crowns and the inner part of the gum of the prosthesis.

Advantages of the method:

1. in one visit, it is possible to perform implantation of the entire jaw;
2. prosthetics is carried out within a few days;
3. there are options without bone augmentation;
4. since the patient starts chewing food immediately, the bone receives pressure and nutrition, therefore, the engraftment period is shorter than that of two-stage implants;
5. it is possible to remove the affected teeth with the direct installation of implants;
6. on the seventh day after the operation, chewing function is already restored;
7. compared with classical implantation, it is relatively small.

However, there are also disadvantages:

• while the implants take root (from 2 to 6 months), you must follow all the doctor's instructions and be a fairly responsible patient, gradually increase the load on them;
• this method is applicable for the rapid restoration of chewing ability, and only then for an aesthetic solution to the issue.

Mini dental implants

With such implantation, thin one-piece implants of small sizes are used, which are fixed in the bone tissue (minimal damage) due to tissue puncture. Healing is extremely fast, which means that the prostheses are installed immediately after the operation. Due to their thinness, mini-implants cannot withstand a lot of pressure, so only light removable dentures are fixed on them.

However, for complex edentulous, mini-implantation is not the best solution, although it has a low cost and an uncomplicated operation. The size of artificial roots is very small, as a result of which they cannot fully fulfill the functions assigned to them - bone atrophy still occurs. Mini-implants begin to become mobile, and dentures sag altogether. This option can be used to restore teeth up to ten years, but not forever.

Video review of the patient about the restoration of teeth using a fixed denture

Indications for a removable type of prosthesis on implants

This type of prosthetics is considered acceptable for significant jaw defects: most of the teeth are missing or they are completely absent. Fixation is performed reliably and quite firmly, but if there is a need to remove the prosthesis from the implant, this can be easily done.

Removable prosthesis: types

During dentures, implants act as a supporting surface, and removable dentures are fixed on them. Their advantage is that they are relatively cheap compared to fixed structures.

• beam construction;
• spherical fixation on implants MIS, Alpha Bio, as well as Nobel and others;
• screw mount, such as All-on-4.

Methods for attaching removable prosthetics based on implants are of three types:

• • Fixation on spherical locks. The top of these structures is a ball, which is the main attachment for new teeth. The second part of the castle is hidden in the artificial gum of the prosthesis. They can also be used to provide additional support for removable dentures.
  • Fastening on beams- the technology consists in the fact that several installed implants are combined with one metal beam. A similar design is installed on a removable prosthesis. The connection occurs due to snapping, after which the prosthesis is already firmly attached to the implants. Such fastening is acceptable if the entire jaw (upper or lower) is replaced with a removable prosthesis. Several implants are placed on the gum (one jaw has 4-6 implants).
  • screw fastening- a technology that allows you to restore the entire dentition without the mandatory installation of an implant for each tooth. 4 implants act as a support for the installation of a conditionally removable prosthesis. The considered fastening implies that the crown with the adapter will be connected outside the oral cavity. This is followed by screwing the structure to the implant by means of a screw. The screw passes through a through hole located in the chewing surface of the crown. Once the crown is fixed on the implant, the hole is closed with a composite made in the same color as the crown. Screw fixation has the following advantages: landing on the implant is carried out with maximum accuracy, a minimum of technological gaps, if necessary, it is possible to remove the prosthesis. Therefore, such prosthetics are advantageous, since there is a strong fixation.

Basal implantation of teeth in 3 days: an alternative to removable dentures! Video review of the patient about implantation for 3 days.

Contraindications

1. Increased risk of mandibular nerve injury during surgery.
2. With teeth grinding, implantation can only be carried out if mouthguards are put on the teeth at night.
3. With uncontrolled type 2 diabetes.
4. Cardiovascular diseases, smoking, exacerbation of HIV infection.

What are the complications?

• Implant rejection caused by the mistakes of the surgeon or the rejection of the body of a foreign object.
• In the first year after the procedure bone level atrophy in the area of ​​the implant more than 1 millimeter and from next year - the recession increases by 0.2 millimeters per year.
• Peri-implantitis. Inflammation of bone tissue and / or bone in the area of ​​the implant, which leads to loss of bone tissue in the area of ​​the implant or its rejection.

Surgery cost

Average prices for surgery for a classic two-stage implantation, while not taking into account the cost of the crown:

• one MIS implant - from 35 thousand to 50 thousand rubles.
• one Astra-Tech implant - from 40 thousand to 70 thousand rubles.
• one Alpha-Bio implant - from 12 thousand to 26 thousand rubles.
• one Nobel Biocare implant - from 24 thousand to 35 thousand rubles.

Dental implantation is a real revolution in dentistry. Mankind has been trying for many years to create an artificial model of a natural tooth. A huge step forward was prosthetics through bridges. Now implants are replacing bridges. The main difference between implants and bridges is that they look and feel like a natural tooth. This is exactly what patients want.

Choosing between classical methods of prosthetics and the installation of prostheses on implants, you need to focus on the individuality of each case, the availability of the product and the prospects for its use. A competent dentist will correctly assess all the pros and cons of the existing situation, and suggest the best option.

Permanent prosthetics

To understand the difference between prosthetics and implantation, you need to understand the features of each method for restoring teeth and eliminating adentia. The choice is influenced by the degree of damage to the crowns and roots, as well as the number of completely missing teeth and the condition of the remaining ones.

With the loss of the occlusal surface of molars and premolars in the amount of 30% to 50%, it is recommended to use inlays instead of filling or installing a crown. Their advantage lies in their individual production, due to which they adhere more effectively to the tooth, as well as in their increased resistance to stress and damage.

The result is achieved due to the material of the tab:

• metal alloys (gold, chromium-cobalt);
• all-ceramic (zirconium dioxide);
• composites.

In case of loss of a larger volume of hard tissue, it is necessary to place an artificial crown fixed on the remains of the tooth due to dental adhesive cement, which is additionally reinforced with pins. The preservation of the roots in the gum is mandatory, otherwise there will be nothing to attach the crown to, while it is recommended to use a stump tab instead of a pin. Like a regular tab, the stump one is cast according to an individual cast, but it does not serve as a full-fledged prosthesis, but as an additional support for the crown. It can be solid or collapsible if the prosthetic tooth has more than three roots, and consists of a base part and fixing pins. The whole system is much more reliable and durable due to the stump design, but at the same time increases the cost of prosthetics.

Important! The material for manufacturing the stump insert should not differ from the crown, so that antagonism does not arise between them: metal-ceramic cannot be combined with ceramics or composites, and vice versa.

The lack of roots suitable for the installation of a crown complicates the situation, since it involves fixing a bridge structure, and here the choice between implantation or prosthetics in favor of the second method becomes less obvious. The reason is the need to fasten a jumper overhanging an empty hole at the expense of neighboring abutment teeth, which requires them to be turned under crowns, and this is bad from the point of view of preparing completely healthy incisors, canines or molars. In addition to the fact that the entire system becomes noticeably more expensive, and the patient puts the teeth turned under the support at risk, the reliability of the bridge structure is not optimal, and the lower the larger area of ​​adentia has to be compensated.

The dental bridge has a number of disadvantages that do not allow it to be considered the optimal method of prosthetics:

• limited length;
• gradual loosening of supporting teeth under load;
• atrophy of the alveolar process under the coronal bridge.

Bridge to teeth

An alternative to mounting the product on abutment crowns are interlocks and adhesive mounts. The first allow for a more gentle preparation, the second prostheses do not require it at all, since they are not put on, but are glued to the back surface of the dentition using a composite. The disadvantage is the increased cost of dental work and the shorter life of the bridge, so these options are only considered as temporary.

Note! The positive difference between classical and full-fledged prosthetics is in a significantly lower price for materials and work, the rapid manufacture of the prosthesis and the simplicity of the entire process, which does not involve invasive intervention.

Removable prosthetics

It is impossible to understand what is the difference between prosthetics and implantation without analyzing removable dentures available on the dental services market. A common advantage of removable structures is the possibility of prosthetics for an almost or completely missing dentition. Such products do not cause discomfort to the patient during their manufacture or fitting, and care for them is even easier than for healthy teeth, since the false jaw is easy to remove and thoroughly clean. In addition, removable dentures can compensate for the absence of just one or more crowns, acting as a temporary replacement while waiting for permanent dentures.

There are three main types of removable structures that differ in the method of fixation:

• solid (acrylic);
• flexible (nylon);
• clasp.

The first type is the most affordable and popular among the population with an average or low income, and is an artificial plastic crown, fixed in an acrylic base that imitates the gingival row and palate. The whole system is quite rigid, which has a good effect on its behavior during chewing loads, but causes noticeable discomfort when worn. The size and hardness of the prosthesis lead to a long adaptation - up to several months, and this process does not always end successfully.

Nylon products have a smaller and more flexible base, which makes them easier to get used to and makes everyday use more comfortable. At the same time, the material itself looks more natural than acrylic, therefore it effectively masks the entire structure in the oral cavity. The disadvantage of nylon is not the most optimal distribution of the load on the gum and, in some cases, insufficient fixation on it. This leads to a change in the relief of the gums and "sagging" of the prosthesis due to its flexibility, which causes discomfort to the patient during chewing and articulation.

Additional Information. Nylon, compared to acrylic, cannot be adjusted or optimized in changing conditions, so the entire structure will have to be changed to a new one - just as expensive.

The clasp type, which is also arc, solves the problem of unreliable fixation, and at the same time does not cover the sky, which is achieved due to the metal arc, which serves as the basis for artificial crowns. Its fixation is achieved by clasps, which require a small turning of the supporting teeth, or attachments, which are more preferable from a visual point of view. The main disadvantage is the high cost and the presence of metal elements in the oral cavity, which leave a characteristic aftertaste and can irritate the mucous membrane.

Implantation

There are no doubts about what is more effective - implantation or prosthetics - for qualified dentists, since with a complete loss of roots, the first option is optimal for the patient's health. The installation of implants is justified both when prosthetics of one tooth, and when compensating for the absence of a whole row in the lower or upper jaw. The essence of the process is the introduction of a titanium pin with a diameter of 3 to 5 mm and a length of 10 to 13 mm into the bone tissue, which is securely fixed there due to its adhesive surface. An abutment is installed on top of the implant - a special adapter necessary for the subsequent fastening of the prosthesis.

Implantation of several teeth

The stages of prosthetics on implants are as follows:

• the dentist examines the patient's oral cavity to make sure that there are no pathologies that are a contraindication for implantation, and also collects an anamnesis;
• the edentulous area is studied visually and with the help of computer scanning, the tactics of prosthetics is determined - the number and size of screws;
• under local anesthesia, the gum is dissected to access the bone, in which the dentist drills a canal with burs of ever larger diameter;
• the titanium pin is screwed in, the gum is tightly sutured;
• after a period of three to six months, when the osseointegration of the implant is completed, a gum shaper is attached to its top;
• after a few weeks, an abutment is screwed on instead of the shaper, after which the patient is ready to install the prosthesis.

Implants are fused with the bone like real dental roots, so they can serve a person for a lifetime, strengthening his jaw and preventing its atrophy and curvature. The main disadvantages of implantation relative to conventional prosthetics are the long waiting time from start to finish, surgical intervention in soft and hard tissues, as well as the highest possible price among all alternative options.

Collectively, teeth make up the dentition and are an important part of the jaw system built into the human body. The loss of a tooth, over time, leads to negative consequences. For example:

Malocclusion, crooked teeth.

• With the loss of one dental unit, there is a displacement of adjacent teeth towards the missing one, the antagonist tooth vertically extends towards the missing one. Therefore, if even one tooth is lost, it is necessary to restore the integrity of the dentition.

In the absence of a part of the teeth, the remaining teeth begin to shift in the anteroposterior and vertical directions, turn around their own axis. Gaps (three) appear between the teeth, which disrupt the proper closing of the teeth, which eventually leads to a disease of the mandibular joint and masticatory muscles.

The destruction of the remaining teeth.

• As a result of a violation of the integrity of the dentition, shifted and unfolded teeth are more susceptible to carious diseases, because food is retained in the gaps between the teeth, which creates conditions for the growth of pathogenic microbes.

Gum disease due to missing teeth.

• When teeth are removed, atrophy (resorption) of the bone tissue of the jaws occurs, it decreases, this leads to a change in the relief of the gums, the gums sag, which spoils the smile.

Chewing disorder.

• With a lack of teeth, the effectiveness of chewing during eating is impaired, which leads to faster swallowing of insufficiently processed food with saliva. Saliva contains alpha-amylase enzymes, which begin the processing of carbohydrates right in the mouth. If this process is disturbed, then the load on the pancreas and duodenum increases, which leads to diabetes mellitus and duodenal ulcer.

Change of speech, lisp.

• With the loss of teeth, especially the front teeth, there is a violation of the phonetics of human speech. A person begins to lisp and nasally when talking with others.

In the absence of teeth, the appearance of the face deteriorates.

• In the absence of many teeth, the height of the lower part of the face decreases, which leads to a deepening of the nasolabial folds, drooping of the corners of the mouth. The profile of the face becomes senile, the chin protrudes forward, the upper lip sinks, wrinkles around the mouth become aggravated.

Due to the absence of teeth, mental disorders occur.

• With a long absence of teeth, taking into account all of the above, a person's self-esteem changes, self-confidence falls, which leads to the emergence of complexes, limited communication, the development of mental illness, and a change in the social environment.

Of course, the processes described above develop slowly, over the years, but, unfortunately, inevitably.

Criteria for correct prosthetics

Proper prosthetics implies two prerequisites:

1. Restoration and normalization of the function of missing teeth
2. Creating natural aesthetics with artificial teeth.

So what is the difference between prosthetics and dental implants? How are dentistry and implant related to each other? Let's look at two dentures that express different philosophies in prosthetics: a bridge that rests on its own teeth and a crown that is fixed in a dental implant.

When using an implant, from a functional point of view, the masticatory load through the crown is transmitted along the intraosseous part of the implant into the bone tissue surrounding the implant, which maximally physiologically stimulates the metabolic processes in the bone and helps to preserve the volume of the bone from atrophy processes.

When using a traditional bridge denture, it is necessary to depulp and grind intact teeth and put on them the supporting crowns of the bridge, which in itself is not very good. When chewing, the load from the intermediate crowns of the bridge is transferred to the abutment teeth, which work for themselves and for "that guy who is not there", which sooner or later leads to overload and atrophy of the bone tissue in the area of ​​​​the abutment teeth.

From an aesthetic point of view, a ceramic crown on an implant forms a more natural and dense gingival contour around its neck than intermediate crowns of bridges. Of course, there are no bedsores in the area of ​​the crown on the implant, in contrast to the intermediate crowns of the bridge.

Thus, completing the answer to the question: "Implantation and dental prosthetics - what is the difference?", I would like to note that, other things being equal, dental implantation offers a more gentle and durable way of dental prosthetics compared to traditional prosthetics.

Implantation: pros and cons

In order to briefly describe all the advantages of implantation, it must be said that implantation is based on a new philosophy. It is as follows: "Restoring the integrity of the dentition, we save our remaining teeth, and we restore the extracted teeth with implants that are as similar as possible to missing teeth. Therefore, root-shaped implants installed in the alveolar process of the jaw are the most physiological in terms of transferring masticatory pressure to bone tissue of the jaw and the most aesthetic of all currently existing prosthetic structures.It is the high physiology of implants that ensures the greatest durability of the crowns installed on the implant.Accordingly, implantation is prosthetics using the most sparing methods.

The arguments against the installation of implants are as follows:

1. The terms of final prosthetics based on implants require from 4 to 7 months after the implantation operation. This is due to the fact that the process of osseointegration of implants in the jawbone takes from 3 to 6 months. This is longer than traditional dentures, which last from 10 to 60 days.
2. The cost of dental implants at first glance is more expensive than the cost of traditional prosthetics. But this is only at first glance. An explanation will be given below as to why this is the case.

Differences between traditional dentures and implants

The main differences between traditional dentures and implants are as follows:

1. With traditional prosthetics with bridges, it is necessary to grind the abutment teeth, which in most cases need to be depulped before that.
2. With traditional prosthetics, if there are not enough supporting teeth, then the patient is forced to make removable clasp dentures, or complete removable acrylic dentures. With implantation, almost always, you can make a fixed denture or conditionally fixed.
3. With traditional prosthetics with bridges, over time, an overload of the supporting teeth occurs, followed by atrophy of the bone tissue. This causes a loss of stability of the abutment teeth and requires a reworking of the bridge. During implantation, all your teeth are saved from turning, overloading, depulpation.

Of course, each clinical case is always evaluated individually, but now you know the main differences between traditional dental prosthetics and implantation.

Implant with a crown or dental bridge, photo

What lasts longer, an implant or traditional dentures?

Ceteris paribus, a dental implant, on which a metal-ceramic crown is fixed, lasts about 20-22 years, traditional removable dentures, such as a metal-ceramic bridge, clasp dentures, acrylic dentures or nylon dentures last on average from 1 to 10 years. It turns out that in the best case scenario for traditional dentures, the life of dental implants is twice as long as that of traditional dentures. In addition, the process of operation and subsequent maintenance of implants is much more convenient and hygienic than traditional dental prostheses.

Prosthetics and implantation of teeth, compare prices

Given the longer life of a dental implant compared to traditional dentures, the cost calculation should be carried out as follows:

The most classic option for comparison is a bridge of 3 crowns and one dental implant with a crown. The price of a bridge prosthesis of 3 ceramic-metal crowns, with the preparation of abutment teeth, costs from 30 to 40 thousand rubles. One dental implant with a ceramic-metal crown costs an average of 40-60 thousand rubles. In 10 years, with a probability of 90%, you will have to make a new bridge prosthesis, provided that the supporting teeth are preserved, which will require another 30-40 thousand rubles, and taking into account inflation over 10 years, most likely it will not be 40,000 rubles, but 70,000 - 80 0000 rubles. The total is 30,000 + 70,000 = 100,000 rubles, taking into account re-prosthetics after 10 years with a new bridge prosthesis based on one's own teeth, against 50,000 rubles for an implant, with a huge additional bonus in the form of preserving one's supporting teeth and bone tissue.

This is, as they say, a complete "Hamburg account". So what is more expensive? One implant with a crown or a traditional 3-crown metal-ceramic dental bridge?

If we consider only what we pay here and now, then the implant is more expensive, and if we take a time period of at least 8-10 years, then an implant with a crown is cheaper and more reliable than a traditional dental bridge. This is a weighty argument for the patient, and, unfortunately, not always for the dentist. Who knows if you will continue to be treated by him in 10 years?

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The loss of one, and even more so several, not to mention all teeth, leads to a number of functional and aesthetic disorders. First of all, in the place of the lost tooth, a decrease in the jaw bone tissue begins, the so-called resorption. The teeth adjacent to the defect begin to move, trying to occupy the vacant space, which leads to a displacement of the dentition, a violation of the closure of the teeth, and also a curvature of their position.

With all this, the temporomandibular joint suffers, which is fraught with jaw clicks, headaches, constant tension of the facial and lingual muscles, malocclusion and deterioration in the quality of chewing food. In the absence of front teeth, diction is seriously affected, saliva is sprayed when talking. With the loss of teeth in the lateral sections of the cheeks, they begin to sink, which not only makes the face look older, but also causes permanent microtraumas of the mucous membrane - simply “biting” the cheeks. By the way, negative changes in appearance, provoking, among other things, psychological problems are a separate important aspect of the consequences of partial and complete edentulous.

What are the hallmarks of proper dentures?

The main rule in the restoration of missing teeth is a harmonious and effective recreation of both aesthetics and functionality of the dentition. For 100%, only one modern technique can cope with this task, namely, dental implantation. Today it is the best option for dental prosthetics.

What is meant by restoration of function and aesthetics? From an aesthetic point of view, a denture should not differ externally from natural teeth: it should have the same color and transparency of the enamel as the neighboring ones; repeat the anatomical shape of the tooth (this point also applies to functionality, as it ensures the correct closure of the dentition), the soft tissues of the gums should fit snugly to it, the contour of which should be natural and neat (the so-called “pink” smile aesthetics).

As for the function, here we are talking about the full participation in chewing and speech, as well as the correct distribution of the load. When prosthetics rely on neighboring teeth, the entire load falls on them, which leads to their destruction and bone resorption under the prosthesis, the formation of “pressure sores” on the oral mucosa and poor hygiene. When restoring teeth by implantation methods, an artificial tooth completely takes on all the functions of a natural one and does not differ in appearance from the adjacent natural teeth of the patient.

What are the pros and cons of dental implants?

Unlike traditional prostheses based on adjacent teeth, the implant does not interact with them in any way, contributing to the correct distribution of the masticatory load. One hundred percent efficiency in restoring functions and aesthetics is the main and indisputable plus of implantation. In addition, the conditions of our clinic and the qualifications of doctors make it possible to reduce the treatment time using a sparing implantation technique (minimally invasive) without additional bone growth, by installing implants immediately after tooth extraction. At the same time, chewing efficiency and aesthetics are not lost, since temporary crowns are made for the patient during the engraftment of implants. Among the minuses, a higher price compared to traditional prosthetics is usually called, however, in terms of a long term, implantation is not only not expensive, but even a much more economical measure. The fact is that, unlike classical prostheses, a dental implant serves its owner throughout life.

How exactly is traditional prosthetics different from implantation?

Prosthetics differs from implantation in the way the prosthesis is installed, all other differences are the result of this. Firstly, both removable and non-removable dentures (with the exception of the false teeth, which we will discuss separately) are installed based on adjacent teeth. To do this, in most cases, these supporting, initially healthy teeth are depulped, that is, they lose the nerve. A tooth devoid of a nerve is a dead tooth, it is not difficult to guess that it will soon begin to collapse, and in a few years a new prosthesis will be required, replacing, among other things, the once perfectly healthy abutment teeth. Thus, the answer to the question: "Which is better - prosthetics or implantation?" becomes more and more obvious.

Secondly, between the gum and a removable, as well as a fixed prosthesis, in most cases there is a gap in which plaque, bacteria and food debris accumulate, which negatively affects the gum under the prosthesis.

Thirdly, as already mentioned, the load during chewing in the case of traditional prosthetics is unevenly distributed, which leads to accelerated destruction of the supporting teeth and irreversible changes in the structure of the jawbone, in other words, to its loss. By the way, the only way to restore a resorbed bone is through surgery.

As for a complete removable denture, here the loss of bone tissue becomes catastrophic, and reliance on the gum mucosa (due to the absence of supporting teeth) leads to constant chafing and chronic diseases of the oral cavity. And if bridges and clasp prostheses simply cause inconvenience, both aesthetic and functional, then the false jaw is a real disaster: it constantly moves inside the oral cavity, falls out, rubs, interferes with speaking, does not allow you to fully chew food.

Is implantation always possible and are there indications for traditional prosthetics?

A few years ago, there were strict contraindications for implantation, but with the improvement of techniques and the development of medicine, these contraindications have practically disappeared. As for such systemic diseases, diabetes, coagulation disorders (blood clotting) and some others used to mean one thing: only traditional prosthetics, no implantation. Taking into account that, today, the implantation of dental implants is also possible in these cases, the only difference is that the doctor performing the operation must have the knowledge and skills appropriate to the situation, and the patient must undergo thorough preparation for implantation and strictly follow the recommendations and listen to his own body during the recovery period.

We compare service life: what is more durable - prosthetics or implantation?

As mentioned above, a titanium root implanted in the jaw during implantation serves its owner throughout life due to the phenomenon of osseointegration - the ability of bone tissue to grow together with the implant body. A crown placed on an implant lasts from 10 to 15 years, depending on whether it is a posterior or anterior tooth. As for bridges or clasp prostheses, they require a complete replacement on average every 5-7 years, and the abutment teeth underneath, which are prone to destruction, increase the length of the required prosthesis over time. Removable dentures require regular relining and periodic complete replacement.

Dental prosthetics and implantation - which prices are higher?

As mentioned above, in terms of the long term, implantation is no more expensive, and even more economical than installing a traditional prosthesis. This is due to the fact that the implant is paid for by the patient only once, and the crowns on it need to be replaced very rarely, while the usual removable or fixed dentures, each of which is cheaper than the implant itself, must be completely renewed much more often, which ultimately rises to more than a large amount.

Reflecting on what is better - prosthetics or implantation, let's compare conventional prosthetics. A reliable implant together with a ceramic or ceramic-metal crown, indistinguishable from a natural tooth, will cost an average of 50,000 rubles and will last the rest of your life. A bridge that replaces just one missing tooth costs about 30,000 rubles. Further - simple mathematics: the next installation of the bridge, which will be required in 5-7 years and will restore not one, but most likely two or as many as three teeth, will reduce all the "savings" to nothing.

Which is better - prosthetics or dental implants?

Before you finally decide on the choice in favor of prosthetics or implantation, we would like to draw your attention to one important point that is of paramount importance in any treatment. This is the presence of specific indications and contraindications for prosthetics or implantation in your case. And to form a clear idea of ​​the advantages and disadvantages of these procedures, we suggest that you familiarize yourself with the table below.

• High price.
• Long terms of engraftment of implants.

Summing up, we can say that the most effective method of restoring lost teeth is implantation. Traditional prosthetics are slowly but surely becoming a thing of the past. Conscientious specialists prefer not to turn to him even in case of complete adentia: a modern solution to this problem is the installation of a full prosthesis on 2, 4 or 6 implants or mini-implants. However, implantation has its pros and cons, which the doctor must take into account when choosing one or another treatment method.

For many people, the loss of several teeth seriously impairs their quality of life. At the same time, the patient is often at a loss before choosing which type of prosthetics to prefer and what is better for him: a bridge or an implant? We propose to weigh all the possible "pluses" and "minuses" of both methods of prosthetics, answering all the possible most important questions.

In the people, bridges are called the short word "bridge". They received such a name in dentistry due to the features of fixation. This type is represented by crowns, which are held on adjacent "supporting" teeth and replace the functions of their missing "brothers". Thanks to the paired support fastening system, such a prosthesis is called a bridge.

The bridge is a one-piece structure that replaces one or two missing teeth in a row and is installed on the abutment teeth.

Modern bridge devices have a frame made of medical or precious alloys, which are coated with a ceramic composition. Various non-metal materials, cermets, zirconia or dental resins can also be used.

Care should be taken when a dentist proposes to install a bridge with a large number of missing teeth. This can overload the jaws, involve too many abutment teeth, and lead to the fragility of these structures.

Bridge indications

• missing teeth (one or more);
• financial difficulties that prevent the patient from using;
• chronic diseases or conditions in which implantation is contraindicated (degeneration of the jaw bone, pathology of the oral mucosa, general chronic diseases, etc.).

The main advantage of replacing missing teeth with bridges is their low cost and availability to people of low income. However, due to the mass of shortcomings, bridges are gradually giving way to more progressive types of prosthetics.

Disadvantages of bridges

The term "put a bridge" is known to most people of the older generation and has not ceased to be a common method of prosthetics so far. However, bridges seriously lose out to more modern types of dentures. Do not forget that bridges have such significant disadvantages as:

• Long-term and multi-stage prosthetics. First, the neighboring “supporting teeth” are treated, which will have to withstand a tremendous load. Then the roots and diseased teeth that cannot be restored are removed. And only in a month - one and a half, when the damaged gums heal, the installation of bridges will begin. This stage will also take up to a month.
• The need to grind the abutment teeth. This is important for the installation of crowns on them, on which the prosthesis will be fixed. Turning seriously damages the tooth, which over time will begin to collapse, bearing the maximum chewing load. Without grinding, teeth could remain healthy for a long time and serve for many more years.
• It is difficult to notice the destruction of teeth covered with a bridge prosthesis in time. Bridges usually last no longer than 6-10 years.
• The destruction of the prepared abutment teeth is also facilitated by the loosening of the crowns planted on the cement. Food inevitably gets into the gaps formed, which will contribute to carious lesions of the supporting teeth. After the loss of abutment teeth, these teeth also have to be replaced.
• Uneven stress on the jaw bones results in poor blood circulation in the underloaded segment of the bone causing it to atrophy. The bone with excessive load gradually becomes thinner and sags, which can interfere with further prosthetics.
• Promote resorption (or resorption) of the jaw bones in the segments of missing teeth. This pathological process can lead to gradual serious complications for the patient - for example, to form an "senile" mouth, visually narrow the lips or reduce the size of the lower part of the face.
• Due to the gradual destruction of bone tissue, it is often impossible to install an implant in place of the bridge. Sometimes this requires a preliminary expensive and traumatic operation to restore the structure of the jaw bones.
• Difficulty getting used to. Wearing a bridge often causes discomfort in patients: often constructions lead to pain in the abutment teeth.

Naturally, all of the above disadvantages make this type of fixed prosthesis not the most favorite among dentists and their patients.

Complications after the installation of bridges

If the patient nevertheless decided to install bridge structures for himself, it is important for him to know about such possible consequences of this method of prosthetics:

1. Often, after prosthetics, patients begin to experience discomfort due to the adaptation of taste buds to the voids in the mouth. This may take several days.
2. Unpleasant sensation from getting food under the prosthesis. This is natural, since always after prosthetics there is a gap between the gum and the mote, the so-called "flushing space". If you install the prosthesis tightly against the gums, this will lead to the formation of bedsores. It is necessary to see a dentist if the flushing space is excessively large or at some point the prosthesis touches the gums. Most often, the constant ingestion of food under the prosthesis causes the destruction of the filling of the adjacent tooth or a new crown.
3. To remove food residues, the patient needs to accustom himself to use a toothbrush, irrigator or superflos.
4. Unpleasant feeling of excessive convexity of the bridge at some points. It seems to the patient that in some places something interferes with the movement of the jaws. Such a nuisance can provoke a split in the prosthesis or soreness in the area of ​​\u200b\u200bthe supporting teeth. Therefore, in such cases, it is necessary to correct the protruding places of structures at the dentist.
5. Exposure of the neck of the tooth some time after the installation of bridges. This phenomenon can be considered a natural process due to the "retreat" of the gums. This unpleasant process can develop rapidly with pathological processes of the gums or improper turning of the teeth (without the formation of a special ledge). To slow down the exposure of the gums, the production of crowns from biocompatible materials with all-metal edges is used.
6. Frequent falling off of crowns occurs in patients suffering from bruxism. With this disease, many types of prosthetics are contraindicated, since crowns and veneers can peel off.

bridge unstuck

Sometimes patients may complain about the bridge coming off quickly after installation. This may be due to improper fixation of the prosthesis or saliva ingress. In this case, it is necessary to contact the dentist and re-glue the prosthesis.

If you delay the visit to the doctor, this can provoke a displacement of the supporting teeth and the need for a new alteration of the bridge.

It happens that the unsticking of the bridge occurs after a long time after its installation. In this case, it is also necessary to contact the dentist as soon as possible. Otherwise, food getting under the bridge will lead to a bacterial infection and damage to the supporting teeth. The reeling or “suction” of the bridge will also lead to this.

The doctor must definitely find out the reason for the detachment of the bridge structure. Often, it is still possible to save the abutment teeth and get by with a slight alteration of prostheses.

When installing a bridge, the qualification of a doctor is especially important. Poor tightness of the design leads to loosening of the prosthesis and its rapid failure. With a timely visit to the doctor, it is usually necessary to re-install the bridge and grind the adjacent teeth.

Unlike an implant, it is impossible to reinstall a dental bridge many times, due to the destruction of the supporting teeth.

What are implants

Implants are considered the most modern and reliable way to replace missing teeth. Although this method is not cheap, thanks to it you can forget about problems with your teeth for a couple of decades.

The implant itself consists of three main parts: a crown (fixed on), an abutment (the junction of the upper part of the prosthesis and the root) and an artificial root (usually made of titanium alloys).

Usually, patients resort to the installation of implants in the following cases:

• in the absence of contraindications;
• if you do not want to install removable dentures;
• wanting to do without turning the abutment teeth.

Most often, modern orthodontists advise their patients to install screw implants. This model is a type of screw that is screwed into the jawbone as a basis for attaching the crown.

Most often, the patient receives as many implants as he has missing teeth. When using implants, bridges are very rarely used as the basis for crowns. This is because a normal tooth is attached in the hole with the help of ligaments that provide it with the necessary mobility. The artificial implant is fixed firmly and does not have natural mobility. Therefore, each such fixed structure is attached to its own hole, helping to properly distribute the food load and without injuring the jawbone.

Benefits of implants

In modern European countries, it is implant systems that are considered a priority type of prosthetics. This type of treatment is used even with a large or complete absence of teeth.

In developed European countries, a doctor does not have the right to offer a patient the installation of a bridge where it is possible to install an implant. Otherwise, he will be deprived of his license to practice privately.

Unlike bridge structures, implant systems completely restore the function of missing teeth (anterior and chewing) and meet the high aesthetic requirements of patients.

Also, the advantages of installing implants include:

1. the possibility of their long-term use (often a lifetime warranty) due to the presence of strong artificial roots made of titanium alloy.
2. fast prosthetics - most often the whole process takes up to 2 months, and sometimes modern implants are installed in one step immediately after tooth extraction;
3. the ability to do without turning and depulpation, keeping the abutment teeth intact;
4. ideal distribution of food load on the gingival bone, comparable to natural and the ability to protect the gums and jaws from atrophic changes;
5. the possibility of selecting a crown with a full selection of shade for the natural color of the patient's tooth enamel;
6. excellent survival of structures (96-98%) due to the use of hypoallergenic materials;
7. the possibility of using implants as a support for fastening for bridges and removable structures.

It is important to install an implant as soon as possible after losing a tooth. This helps to keep the dentures from sagging and forget about the issues associated with repeated prosthetics for a long time.

Contraindications for implantation

Since implantation is still an operation, there are quite a few contraindications to it. Contraindications are general, in which no operation can be performed. This includes serious illnesses of the patient and some conditions (pregnancy, drug addiction, diseases of the blood, nervous system, immune or malignant diseases, severe diabetes mellitus, tuberculosis, bruxism, post-irradiation, etc.)

Local contraindications for implantation are:

• insufficient observance of oral hygiene;
• pathology of the bone tissue of the jaw;
• disproportions in the distances between the sizes of the maxillary sinuses.

Some of the patient's diseases are temporary contraindications, since after their cure, implantation becomes possible.

Such contraindications include: the presence of carious teeth, inflammation of the gums of any nature, periodontitis, inflammation of the jaw, etc.

Disadvantages of implants

As with any treatment method, even the most modern and popular, the implantation method also has disadvantages. These include:

• a large number of different contraindications;
• high cost and inaccessibility for patients with low incomes;
• long stages of implantation, lasting up to a year.

It requires access to qualified and skilled specialists. In this case, the dentist must thoroughly examine the patient and think over a plan for his treatment.

Successful engraftment of the structure requires the patient to strictly follow all the instructions and prescriptions of the specialist doctor. This will avoid dangerous postoperative complications.

Complications after implant placement

Unfortunately, occasionally (in 5% of cases) implantation can cause various complications. They can occur during the implantation operation, immediately after it, and after some time.

Most often, patients may experience the following types of postoperative complications:

• bleeding (with low blood clotting);
• pain:
• divergence of seams;
• perforation in the maxillary sinus (usually as a result of insufficient examination before implantation in the upper jaw);
• paralysis of masticatory muscles after damage to the mandibular nerve;
• inflammation at the incision site;
• peri-implantitis (severe complication in the form of inflammation around the implant and it).

In case of any troubles (pain, divergence of sutures, inflammation or bleeding), it is important for the patient to immediately call his doctor.

The prescribed hygiene and proper treatment of the postoperative wound is also important.

Peri-implantitis is more often observed in the first months after surgery. Occasionally, this extremely unpleasant consequence occurs much later for various reasons (prosthetic errors, burns during surgery or postoperative inflammation, bone pathology or patient diseases).