The versatility and almost universal scope of dental implantology has been stressed throughout this book. Although the average dentist is aware of conventional approaches to addressing the replacement of missing teeth, most may benefit from being apprised of the diversity of options that are now available and which are becoming commonplace in dental implant practices.
The Single Crown
The single implant‐retained crown replaces a missing tooth and can restore an unattractive or patient‐restricted smile, improve masticatory ability and slow down or retard bone loss. When that missing tooth is a central or lateral incisor, implant dentistry obviates previous restorative techniques such as the Maryland bridge and many other procedures. The latter include fixed partial dentures, removable partial dentures (RPDs) and “flippers.”
The other major advantage with the single dental implant is that it avoids the need for a three‐unit bridge, Fig. 7.3. Since preparing the abutment teeth for the bridge involves loss of sound enamel from the proposed abutment teeth, implant dentistry is clearly a remarkable advance in conserving otherwise sound teeth. This can be an important consideration when the abutment teeth may be compromised by dental caries or periodontal disease.
Another advantage of individually‐restored implants compared to bridges is that implants tend to retard continuing bone loss that often occurs at edentulous sites. They can also reduce the risk of dental caries and potential tooth loss because the single implant is considered to be more hygienic than a conventional bridge. However, the need for continued oral hygiene and periodontal maintenance of the implant site must be stressed to avoid the development of pocketing between the implant and its bony and soft‐tissue support. This topic is revisited in later chapters.
Implant‐Supported Bridgework vs the FPD/RPD
When several teeth are missing, both the dentist and the patient face the difficult task of choosing between a RPD, a fixed partial denture (FPD) or a multi‐unit implant bridge. The decision becomes even more difficult and/or problematic when the adjacent teeth are decayed or have periodontal involvement. A further factor in this decision process can be when financial considerations and the overall cost of treatment come into play (see Chapter 17).
As discussed in Chapter 1