Restoration of the dental arch, regardless of the cause of tooth loss, should begin as early as possible. Statistics are relentless: significant changes in the bone tissue and the position of adjacent teeth begin in the oral cavity after just 6 months without teeth, although most of these can be corrected by modern methods and are not completely “inevitable.”
First, the remaining teeth begin to shift, filling the vacated space. Then the bite changes, and ultimately, the ability to successfully place a prosthesis may be compromised. In the best-case scenario, to place a dental bridge or crown, the adjacent tooth will need to be prepared (ground down). In the worst-case scenario, bone augmentation (grafting) will be unavoidable.
Usually, patients start wondering what is better – dental implantation or prosthetics – right at the stage of tooth loss. Although a final conclusion can only be reached after consulting a dentist, we will briefly try to understand the advantages and disadvantages of each of the popular methods for restoring the dental arch.
Dental Crown (On a Natural Tooth)
This is a type of fixed dental prosthesis that remains permanently in the oral cavity. Placement is possible if at least part of the tooth remains, preferably half. In this case, the tooth is prepared (ground down) for the crown. In this case, the tooth is ground down for a crown. Today, pulp removal is only performed when necessary, rather than “by default,” and instead of metal posts, modern clinics use fibreglass inlays, after which the crown is fixed in place.
The material can be any: ceramic, metal-ceramic (porcelain-fused-to-metal), or zirconia.
Dental Bridge
This is a method for the complete replacement of one or more missing teeth. Essentially, it is an orthopedic (prosthetic) construction that relies on adjacent healthy teeth for support.
It must be understood that placing a dental bridge requires grinding down the abutment teeth (sometimes vital, completely healthy ones). The “weak” point of the bridge is its junction with the gum, which is often noticeable to the naked eye, as well as the increased load on the supporting teeth, which can shorten their lifespan.
Implantation
This is the most modern and effective technology for restoring a lost tooth. First, a titanium post (the implant) is surgically placed into the bone tissue, where it acts as the root and the abutment. Then, after the implant is fully integrated and the tissues have healed, a crown made of the chosen material is placed.
A dental implant replaces the lost tooth without affecting the adjacent ones. This is the most aesthetic option, and after the procedure, distinguishing a natural tooth from an implant is virtually impossible. However, it is the most expensive method in terms of cost.
How is Implantation Performed?
The placement of a dental implant is performed under anesthesia. Depending on the clinical picture, local anesthesia, sedation, or a combination of these methods is chosen; general anesthesia is rarely used and mainly for extensive surgery.
For instance, during implantation immediately after tooth extraction, a simple local anesthetic may suffice; placing multiple titanium posts or performing additional bone grafting may require sedation or combined pain relief.
The decision of whether to place a dental crown, bridge, or implant should always start with a dental consultation and diagnostic examination. Restoring the dental arch is possible today regardless of the number of missing teeth—either by the “individual implant for every tooth” technology or using the All-on-4 / All-on-6 implantation method (although this method is not suitable for everyone and is primarily used for complete loss of all teeth in the upper or lower jaw).
