There are many reasons why you might be missing a tooth — gum disease, tooth decay, injury or a genetic condition could all be culprits. No matter the reason, there are several different treatments available to both beautify and restore function to your mouth. We’ll take a look at the five different types of dental implants available, when and why they’re used and the pros and cons of each.
Typically made of titanium, endosteal implants are the most commonly used dental implant. They’re usually shaped like small screws and are placed in the jawbone. They protrude through the gum to hold the replacement teeth.
When To Use Endosteal Implants
Your dentist or oral surgeon will determine if endosteal implants are the best choice for you. Along with a missing tooth, or teeth, important criteria you should meet include having:
- Good general health
- Good oral health
- Healthy gum tissue (no periodontal disease)
- A jawbone that’s fully grown
- Enough bone in your jaw
- An inability or unwillingness to wear dentures
You should also not use tobacco products. It’s important to note that you must be ready to commit several weeks or months — much of that time for healing and waiting for new bone growth in your jaw — to complete the full procedure.
Pros and Cons of Endosteal Implants
One of the reasons endosteal implants are preferred is that they have a high success rate (above 97% for 10 years). They are also aesthetically pleasing — they look and act like natural teeth. Beyond regular brushing and oral hygiene, they don’t require special maintenance and patients can talk and chew normally without discomfort. While most patients are eligible for this type of implant, it requires a solid and healthy jawbone to fuse to.
There are disadvantages to endosteal implants, however. Patients simply may not meet the criteria listed above in order to obtain them. However, the most common barrier is cost.
Subperiosteal implants are dental implants made out of a metal framework. This metal frame is attached under your gum tissue but above your jawbone. Protruding from the metal frame of the subperiosteal implant are small metal posts. These are used as the anchors for the replacement teeth that your oral surgeon will attach to the implant.
When To Use Subperiosteal Implants
If you need dental implants but you don’t have enough healthy jawbone to support them, your dentist might recommend subperiosteal implants. These implants are placed on or above the jawbone and under the gum to protrude through the gum and hold the replacement teeth.
Pros and Cons of Subperiostal Implants
One of the reasons subperiosteal implants are preferred is that they create a natural look and feel with a shorter treatment time. The artificial crown on the implant is made to fit perfectly in your mouth, including a color match so that you don’t have one overly white tooth in your smile. The lack of jawbone support means you won’t need to wait for the bone to heal around the root — which is typically a lengthy process. Soft tissue heals over the subperiosteal implant much faster than bone heals. So, you will have a shorter treatment time than with a traditional dental implant.
The disadvantages of subperiosteal implants are that they are not as sturdy as traditional dental implants and there is no bone-health promotion. Traditional dental implants get their stability from the fact that the root is held into place by the jawbone. Subperiosteal implants don’t have that bone support and are therefore less stable. The lack of jawbone involvement also means that a subperiosteal implant doesn’t promote jawbone health to the same level. Natural teeth move slightly, and the friction helps promote jawbone health. Subperiosteal implants can provide some surface-level friction and promote the health of the soft tissue, but they don’t offer the same level of bone health benefits.
All-on-4 Dental Implants
All-on-4 dental implants are made of titanium and are screwed into the upper and lower jawbone, then fixed with a denture on top. They can allow for the replacement of a full arch of missing teeth with just four dental implants, but can still be a good option for you even if you still have some of your natural teeth.
When To Use All-on-4 Dental Implants
If you’re missing most of your natural teeth due to injury or disease, or your dentist has determined that your natural teeth cannot be restored, All-on-4 implants could work for you. Less costly than replacing individual teeth with individual implants, the All-on-4 procedure can also provide you with a new set of permanent replacement teeth in just one dental visit.
Pros and Cons of All-on-4 Dental Implants
Full-arch fixed implant bridges, or all-on-4, offer faster recovery times than traditional dentures. The implant screws begin to fuse to your jawbone almost immediately after they’re put in place. Once the implants are put in place, further bone loss in the jaw is often prevented. While traditional dentures slip and slide around inside the mouth, all-on-4 implants create an anchor that can attach to a custom-created implant and do not move around in the mouth, enhancing comfort.
The disadvantages of all-on-4 implants include difficulties in learning to speak with them in. It can improve with practice but is considered a downside. Tenderness and discomfort associated with drilling into the jawbone, potential rejection and an odd sensation when flossing teeth due to each implant being paired with multiple porcelain caps round out the cons associated with this type of implant.
Sometimes referred to as implant-supported dentures, overdentures are a more stable, modern version of regular dentures. While conventional dentures rest solely on the gum tissue and the underlying jawbone, overdentures remain anchored by dental implants. Such a feature makes them removable dentures instead of relying solely on suction or an additional adhesive and much less prone to sliding off when the patient speaks or laughs. Depending on retention needs, the denture can rest on two to eight implants per arch. Overdentures are still removable for easy cleaning.
When To Use Implant Overdentures
Patients who are missing most or all of their teeth are usually excellent candidates for overdentures. However, there is a certain amount of jawbone tissue required to support an overdenture. In order for a dental implant to be successful long term. The bone tissue must completely surround the anchor piece. Therefore, patients who have suffered extensive bone atrophy may not qualify for this type of teeth replacement option.
Pros and Cons of Implant Overdentures
Implant overdentures are a good solution for patients with soft and hard tissue defects in their mouths that cannot be addressed by a fixed implant prosthesis. They offer the missing retention and stability, along with easier oral hygiene access due to the removable nature of the restoration.
The drawbacks of overdentures are that they are more invasive as a surgical process, they may cost more (in the short term at least), and if not cleaned properly, they may be prone to infection and inflammation.
Implant Supported Bridges
As the name implies, implant-supported bridges use dental implants as opposed to crowns or frameworks. Typically, one implant is surgically placed for every missing tooth, and these implants hold the bridge in position. If one implant for each missing tooth isn’t possible, the bridge may have a pontic suspended between two implant-supported crowns.
When To Use Implant Supported Bridges
Considered the strongest and most stable system, an implant-supported bridge commonly requires two surgeries: one to embed the implants in the jawbone and a second surgery to place the bridge. If you have multiple missing teeth, implant-supported bridges can be used to replace them.
Pros and Cons of Implant Supported Bridges
Implant-supported bridges can provide you with a permanent, fixed and functional tooth replacement option. Due to the fact that the dental implants fuse with your natural jawbone, they can last a lifetime when properly cared for. Patients experience improved comfort because the bridge prosthesis feels just like natural teeth. It does not slip in your mouth or require bracing from other teeth, thereby restoring bite force and chewing power.
Disadvantages of implant-supported bridges include the number of months it can take for the procedure to be completely finished. They are often more expensive than traditional bridges and certain medical conditions, including substandard bone density in your jaw, can rule you out as a candidate for them.
Considering Dental Implants?
For more information on the best type of dental implant for you, contact West Coast Dental. We are pleased to accept most dental insurance plans. Give us a call at 888-329-8111 to make an appointment or book online.
Healthline – Endosteal Implants – Are They Right for You?
StatPearls Publishing – “Dental Implants”
MedicineNet – Disadvantages of Dental Implants
Washington State Prosthodontics and Dental Implant Center – What Are All-on-4 Restorations?
Foundation for Oral Rehabilitation (FOR) – Implant Overdentures, Introduction
Healthline – Dental Bridge