When replacing multiple teeth with dental implants, unlike a single tooth implant that is used to replace each single tooth, when a segment of teeth needs replacing, it is often not necessary to place an implant support under each tooth. Instead, two or more implants, can be used as anchors to replace a segment of three or four teeth, and when an entire arch needs replacing, full set of teeth can often be fitted to as little as four supports.

Why use bridges?

Replacing a segment of teeth with dental implants is often done as an alternative to dentures. Without teeth implants, other methods that involve a fixed bridge supported by each natural tooth on either side of the gap are often not possible when more than two teeth are missing.
Because of the long span, the prospects of success of a natural tooth bridge in the long term would be greatly diminished, and such a bridge would also compromise the supporting teeth over time. Whereas with dental implants the fixtures are strong and resilient, which makes them reliable anchors for a bridge.

As with any teeth implants treatment, sufficient bone density is required to house the dental implants. It is not advisable in most cases to place a fixture under each tooth for two main reasons:

1. When a segment of teeth implants is considered, there is a considerable biomechanical advantage to connecting the fixtures to each other via the bridge. As such, cleaning is not possible by flossing between each individual tooth. Thus, the more fixtures are used to support the missing segment of teeth, the more difficult it is to keep clean – this could lead to complications over time
2. When teeth implants are placed within a close vicinity to each other, studies have shown that they become susceptible to bone loss and recession of the gums.

By using a minimalistic approach as to the number of supports, which is guided by respecting what we know today of the biological limitations of dental implants, we can improve the long term outcome and at the same time facilitate hygiene with multiple teeth implants.

Optimising aesthetics

The other consideration with multiple teeth implants is the resorption of bone and recession of the gums that takes place when a number of adjacent teeth are lost. When planning to replace a gappy segment, it is particularly important for an aesthetic outcome to plan how to deal with deficiencies of the bone and gum tissues. We can deal with these in one of two ways:

• Attempt surgical resurrection of the gingival volume and choreography with bone grafting as well as gum grafting procedures. This can sometimes be done at the same time as when the fixtures are inserted. However, the most challenging part of the gum to re-build is the papillae, the triangular gum area that fills the spaces between each tooth, and as such a completely natural choreography of the gum shape cannot be guaranteed as it depends on complex healing processes
• As an alternative to grafting, we may consider aesthetic gum replacement with pink porcelain that integrates the gum component prosthetically to be part of the bridge. This is more predictable than surgical correction.

For more information on smile makeovers and the procedures performed at CAID, call (03) 8845 5400 or contact us online to arrange an appointment with one of our experienced, friendly dentists.