Dental Implants vs Crowns or Bridges

Missing teeth can be replaced with a fixed dental bridge or dental implants. They can also be replaced with a denture or left as a space.  It is useful for you to know the benefits and disadvantages of each option, so that you can make an informed decision.

One of the biggest benefits of dental implants is that they protect the other teeth. In the case of a dental bridge, the natural teeth have to perform the function of support, whereas the implant is not putting any strain on other teeth.

Another great advantage of implants is that they can be used to replace more than one missing natural tooth. In the case of a bridge, you need healthy adjacent teeth for support. Various combinations are possible in the case of implants.

Implants require little maintenance, which is the biggest difference between dental bridges. The cleaning process is very simple and flossing between implants is possible. In addition, implants look more natural and facilitate chewing, since the dental bridge may slip. High quality implants can last a lifetime, whereas dental crowns and bridges are normally replaced every 10 to 15 years.

Dental bridges, on the other hand, also have a number of advantages. Firstly you only undergo a simple dental procedure that involves no surgery, whereas dental implants require surgical intervention. Secondly, it is easier and quicker to get dental bridges because the entire procedure can be carried out over two to three visits.

Normally, a dental bridge is recommended in the case of jawbone loss or significant damage, but it is important to know that the positioning of dental implants demands healthy bone. Once fixed, the bridge is very stable and comfortable, with patients adjusting quite quickly. Dental bridges are also a less expensive option than other dental methods for the replacement of missing teeth.

MORE ABOUT: Crowns, fixed bridges and dental implants

Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

How do crowns work?
A crown is used to entirely cover or cap a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function.  Porcelain or ceramic crowns can be matched to the colour of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

We may recommend a crown to:

  • Replace a large filling when there isn't enough tooth remaining

  • Protect a weak tooth from fracturing

  • Restore a fractured tooth

  • Attach a bridge

  • Cover a dental implant

  • Cover a discolored or poorly shaped tooth

  • Cover a tooth that has had root canal treatment

How do bridges work?
Bridges are commonly used to replace one or more missing teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth, can also lead to gum disease to and temporomandibular joint (TMJ) disorders.

Bridges span the space where the teeth are missing. They are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. We can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the colour of your natural teeth.

Different type of bridges:

  • Conventional bridges: A secure, long-lasting option. The bridge is anchored on neighbouring teeth or implants and cannot be removed

  • Resin bonded bridges or Maryland bonded bridges: Most suitable for a single missing tooth. This is essentially a sticky bridge which is bonded to the natural teeth and requires minimal tooth preparation.

  • Cantilever bridges: Ideal for single tooth replacement, fixed to one adjacent tooth.

  • Removable bridges: A hybrid denture bridge that stays in place with friction or precision attachment.

  • Implant-supported bridges: These bridges can be fixed to existing dental implants by being screwed or cemented in place. Once fitted, the implants provide the foundation for long-term support of bridges or dentures. If you are missing one or more teeth and wish to eat your favourite foods, increase your chewing ability, and improve your appearance, speech, and self-esteem.

How are crowns and bridges made?
Before either a crown or a bridge can be made, the tooth (or teeth) are reduced in size, so that the crown or bridge can fit over it properly. After reducing the tooth/teeth, we then take an impression to provide an exact mould for the crown or bridge. If porcelain is to be used, we can determine the correct shade for the crown or bridge to match the colour of your existing teeth.

Using this impression, a dental lab then makes your crown or bridge, in the material that we specify. A temporary crown or bridge is put into place to cover the prepared tooth, while the permanent crown or bridge is made. When it is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

How long do crowns and bridges last?
While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by brushing with fluoride toothpaste twice a day and flossing daily. It’s also important you have regularly dentist check-ups and professional hygienist cleanings.

How do dental implants work?

Dental implants replaces the root of a missing tooth and is made from surgical-grade titanium alloy (Ti 6Al-4V ELI) to exacting specifications. Initially, the implant is placed into the jawbone either immediately after the loss of a tooth, or after an extended period of time. If there is insufficient bone, various bone enhancing procedures can be performed prior to the implant placement. An abutment, which acts as a base for a prosthetic tooth replacement such as a crown, is inserted into the implant at the time of implant placement, or subsequently after a period of healing.

In the past, dentists would try to keep or replace teeth with treatments such as root canals, bridges, and fixed or removable dentures. Unfortunately, a significant number of root canal treated teeth fail, bridges require that healthy adjacent teeth be cut down and removable dentures can often be unstable and require the use of sticky adhesives. Dental implants are a solution to these problems, and many of the concerns associated with natural teeth are eliminated, including dental decay. Dental implants allow you to smile, speak, and eat with confidence and comfort.

What is the process?
The placement of a dental implant is typically completed in less than an hour, as a clinic procedure with only local anaesthesia. Post-operative discomfort is normally less than that of a tooth extraction. For aesthetic reasons, it is often possible to have a fixed transitional restoration immediately after implant placement so that you are never without a tooth. After a period of three to six months of healing, the temporary healing abutment is removed from the implant and a final abutment is inserted into the implant. A crown or removable denture is secured to this abutment as the final restoration.

Dental implant vs root canal treatment

Not all teeth are good candidates for root canal treatment. Root canal treated teeth are susceptible to decay and fracture, while implants are not susceptible to decay and almost never break. Implants are an excellent alternative. Often, the cost of saving a tooth with a variety of treatments can exceed that of the placement and restoration of an implant.

Can the implant, ever be rejected by the body?
The implant is machined from surgical-grade titanium alloy (Ti 6Al-4V ELI), which is a biocompatible material. However, there is a slight possibility that it might not integrate with bone. If this happens we replace the implant. It is highly unlikely that the second implant would not integrate.

Will I experience any pain? The pain experienced is usually minimal to none. While undergoing treatment, you receive a local anaesthestic, you may suffer mild post-surgical soreness for up to 72 hours. An over-the-counter pain reliever alleviates the discomfort for most patients.

What happens during treatment?
During treatment, we may be able to provide you with a transitional prosthesis that has the look and feel that you need during this period of healing. With the Bicon implant, it is often possible to have a fixed transitional tooth immediately after the placement of the implant.

How long is the procedure?
A single dental implant placement is usually completed in less than an hour in the clinic with local anaesthesia. The implant is then allowed to heal with the bone for a minimum of eight weeks. If you have poor quality bone and bone-grafting procedures are necessary, the overall process can take up to 12 months or more.

Why we use Ankylos and Branemark System dental implants

The Brånemark System is synonymous with the revolutionary concept of osseointegration (the firm anchoring of a surgical implant) which introduced safe and effective implant treatments to modern dentistry. These implants have been in clinical use for more than half a century and are the most scientifically documented implant system in the world. Developed in the early 1950s by Professor Per-Ingvar Branemark, the Branemark System is a patented method of tooth replacement. Hundreds of thousands of patients around the world have now been treated with these implants.

For more than twenty-five years, the Ankylos implant system has also been helping dentists around the world recreate beautifully natural smiles for their patients. The system enables us to replace missing teeth with long-lasting restorations that look and function just like the real thing.  The two-piece Ankylos design allows the implant to be located to provide the strongest possible foundation at the same time as achieving the optimum orientation for the restoration on top - crown, bridge or denture. However, it is essential that healthy supporting bone and gums around the implant give long-term stability.

How do I properly maintain the implant once treatment is completed? Ironically, dental implants require less maintenance than a natural tooth. Simply brush it as though it were a natural tooth.

What is a sinus floor bone augmentation?
When an upper posterior tooth is lost, the floor of the maxillary sinus drops down into the space formerly occupied by the root of the lost tooth. In order to place an implant, it is often necessary to put the sinus floor back up to where it originally was by adding a synthetic bone substitute. This procedure is called a sinus floor bone augmentation or a sinus lift.

What is a ridge split?
After the loss of a tooth, the bone formerly around the tooth is resorbed — often leaving a very narrow ridge of bone. In order to place an implant, the ridge of bone is split as though it were a piece of corrugated cardboard being expanded to provide a wider space between each side. For the upper jaw, this is accomplished at the same time that the implant is placed; the lower jaw requires a second surgical visit approximately three weeks later.

What is a bone graft?
A bone graft is a surgical procedure for adding height or width to a jawbone in order to increase its volume for the placement of an implant.