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Replacing a Single Tooth: Comparing Single-unit Implants with Fixed Partial Dentures

No one wants to have a gap in their smile, this is why many patients seek treatment when they’ve lost a tooth. In the front area of the mouth, the loss of a single tooth is sometimes caused by trauma or congenital (birth defect) issues. For posterior teeth, a single missing tooth is usually a result of severe decay, an unsuccessful root canal procedure, or a birth defect. In any case, there are various options available for replacing a single missing tooth.

One option for replacing a single missing tooth is a removable partial denture. However, many patients find this choice unsatisfactory due to the noticeable metal and acrylic components. This may be coupled with the unattractive clasps required to secure the implant. Although a resin-bonded implant might seem like a potential solution, experience has indicated that these bonded pontics tend to have poor long-term outcomes. This is especially so if the adjacent teeth are not adequately prepared for mechanical retention.

Currently, the prevailing choices for replacing a single missing tooth are the fixed partial denture (a three-unit bridge) and the single-tooth implant. This article will explore the benefits of opting for a single tooth implant replacement instead of utilizing a fixed partial denture. Additionally, it will delve into the key factors to contemplate when planning treatment for the replacement of a single missing tooth.

A single-tooth implant typically comprises several distinct parts:

The implant – Made from titanium and designed to resemble a screw, it is firmly placed into the jawbone.

The abutment – Similarly composed of titanium, it is connected to the implant and serves as a link between the implant and the crown.

The crown – Made from porcelain, the crown is custom-made to match your current teeth. It gets affixed to the abutment once a healing period called osseointegration is complete.

Comparing Single-unit Implants with 3-Unit Bridges

Many people advocate for the use of 3-unit fixed partial dentures, However, it seems that in today’s context, single tooth implant replacements could be a more practical choice for patients. Some of the benefits include improved aesthetics, better accessibility for hygiene, preservation of bone structure, and reduced future maintenance—all at a similar cost.

  1. Aesthetics 

The visual advantage of a single tooth implant compared to a 3-unit bridge is very obvious. A pontic (the synthetic tooth that replaces the missing tooth) for a 3-unit bridge rests on top of the soft tissue. Conversely, a single-unit implant emerges from the soft tissue, providing a more natural-looking replacement for a single missing tooth.

  1. Ease

When it comes to replacing a single missing tooth within gaps or diastemas, making an optimal tooth replacement using a fixed partial denture can be a challenge. Most times, it’s not even feasible. On the other hand, achieving a satisfactory aesthetic outcome with a single-tooth implant is relatively straightforward.

  1. Oral Care

Comparing the two replacement options, hygiene accessibility becomes a significant concern. With a single-tooth dental implant restoration, patients can floss conventionally, just like they would with a natural tooth. However, in the case of a 3-unit fixed partial denture, patients will need to resort to proxy brushes, floss threaders, or superfloss. These will help them access beneath the solder joint area for proper oral hygiene maintenance.

  1. Cost

When comparing the costs of a single tooth implant and a 3-unit bridge, it’s important to note that the difference is minimal. Examination of fee schedules shows that the single-unit implant restoration is slightly pricier than the 3-unit bridge. However, if the patient needs any extra work done, the cost of the 3-unit bridge escalates significantly. Insurance company data indicates a limited long-term survival rate for 3-unit fixed partial dentures. This is evident in the fact that they cover the expense of a new fixed bridge every five years. If a patient requires new fixed bridges every five years their whole life, particularly someone younger, it will amount to a substantial financial commitment. Find out the cost of dental implants 

  1. Maintenance 

Also, there’s the consideration of future maintenance on the neighbouring teeth, which could involve costly periodontal, endodontic, or restorative treatments. These interventions might not have been necessary had the adjacent teeth not been prepared initially for a fixed partial denture. Notably, a single tooth implant restoration inherently reduces the likelihood of future maintenance procedures and simplifies the situation in case problems arise.

When a natural tooth is extracted and not replaced with an implant, it’s common to observe the development of an osseous (bone) defect. This defect frequently arises due to the collapse of the buccal plate following tooth loss and the loss of its functional stimulation. If an osseointegrated implant can be inserted on the same day as tooth extraction, the osseous contour can be preserved. This will result in a more pleasing aesthetic outcome. However, if the implant is placed at a later time, addressing the osseous defect may necessitate employing bone regenerative procedures. These procedures might be performed before, during, or after the surgical placement of the dental implant.

Although our success in addressing osseous defects through prosthetic means has been limited, achieving a satisfactory outcome is far more reliable through a surgical approach. Employing a surgical method for bone augmentation yields more predictable results. This augmentation can be performed alongside a fixed partial denture. 

While some might view dental implant placement as an assertive approach, it is actually the most conservative option from a biological perspective. Embedding a dental implant into bone offers a functional stimulus that helps preserve the remaining bone and hinders resorption. This is done while safeguarding the enamel and dentin of neighbouring teeth. Additionally, this approach is gentler on the pulp of the adjacent teeth.

To conclude, it is obvious that single-unit implants have the upper hand when it comes to replacing single missing teeth. This is because it offers enhanced aesthetics, improved hygiene accessibility, and reduced long-term expenses. When mapping out treatment for a single missing tooth, a single-tooth implant restoration should be taken into consideration as a viable option. If you think single-unit implants may be an ideal solution for you, don’t hesitate to reach out to us. Let’s help you get started!

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