If a single tooth or few teeth are missing.....
This situation is most often seen in the younger population wherein a tooth may be lost due to trauma, may be congenitally missing or may have been extracted following severe decay and failed root canal therapy. The closest way there is in comparison to a natural tooth is an implant supported tooth. Needless to say , it is way safer and more effective compared to a bridge supported on the neighboring teeth.
Also to be considered is whether the missing tooth area is in the smile zone or in the rear area of the mouth. Accordingly, the choice of the material for the crown. If a tooth visible during smiling is involved, the crown of choice is a zirconia crown, the advantage being, it is completely metal-free, hence no unsightly grey gum margins involved in a metal crown. Additionally, it has sufficient strength to perform daily activities. Zirconia has about the same translucency as the natural tooth structure thereby proving to be an excellent aesthetic choice.
If the tooth is missing in the posterior area, aeshthetics is of little importance and function is a larger requisite. Hence strength an durability dictate the choice of a porcelain fused to a metal core crown.
Also to be considered is whether the missing tooth area is in the smile zone or in the rear area of the mouth. Accordingly, the choice of the material for the crown. If a tooth visible during smiling is involved, the crown of choice is a zirconia crown, the advantage being, it is completely metal-free, hence no unsightly grey gum margins involved in a metal crown. Additionally, it has sufficient strength to perform daily activities. Zirconia has about the same translucency as the natural tooth structure thereby proving to be an excellent aesthetic choice.
If the tooth is missing in the posterior area, aeshthetics is of little importance and function is a larger requisite. Hence strength an durability dictate the choice of a porcelain fused to a metal core crown.
if all teeth are missing in one or both arches....
This situation is most often seen in the elderly population wherein teeth are lost due to a combination of gum disease and decay.
Teeth could be completely missing in one or both arches.
The best choice would be to go for a complete fixed implant supported rehabilitation. The new set of teeth are sturdy , esthetic and have about the same feel as a natural dentition. Also, as the teeth are completely secured onto implants, there is no need for support in the form of a palate-covering plate. Hence, the tongue feels the natural palate and a gag-less comfort and better taste perception result.
In certain cases, the inavailability of bone volume or financial constraints with regards the number of implants, or special cases wherein manual dexterity to maintain good oral hygiene is lacking eg. Parkinson's disease, would necessitate going for a mid-ground solution. The fixed-removable option (denture snapped onto the implants and can be voluntarily removed by the patient) is of good use here. The denture remains quite steady as it is secured and supported onto the implants and gums. It snap-fits into place and counters the problem of loose dentures. The patient can additionally remove the denture at will to clean and maintain hygiene.
Teeth could be completely missing in one or both arches.
The best choice would be to go for a complete fixed implant supported rehabilitation. The new set of teeth are sturdy , esthetic and have about the same feel as a natural dentition. Also, as the teeth are completely secured onto implants, there is no need for support in the form of a palate-covering plate. Hence, the tongue feels the natural palate and a gag-less comfort and better taste perception result.
In certain cases, the inavailability of bone volume or financial constraints with regards the number of implants, or special cases wherein manual dexterity to maintain good oral hygiene is lacking eg. Parkinson's disease, would necessitate going for a mid-ground solution. The fixed-removable option (denture snapped onto the implants and can be voluntarily removed by the patient) is of good use here. The denture remains quite steady as it is secured and supported onto the implants and gums. It snap-fits into place and counters the problem of loose dentures. The patient can additionally remove the denture at will to clean and maintain hygiene.