Missing teeth can be replaced by a denture or a conventional bridge, an adhesive bridge or an implant retained crown or bridge. The majority of people would prefer to have a replacement tooth that is permanent rather than a removable denture. An adhesive bridge, also known as a Maryland Bridge, is simple, economical and requires minimal preparation of the supporting teeth.
The disadvantage is that the type of case in which this type of restoration is restricted and there is always the risk that the bridge may become decemented. If adjacent teeth are heavily filled a conventional bridge with one or two crowns supporting an artificial tooth may be the treatment of choice.
Obviously if the adjacent teeth are healthy the bridge preparation would be destructive and this would weaken the tooth. Also if anything should happen to a supporting tooth the whole bridge may be lost. An implant retained crown has the advantage of being a predictable treatment modality that is independent of the adjacent teeth. The disadvantage is that the treatment is more expensive and takes longer. Our aim, though, is to provide a means of supporting a crown for the rest of a patients life.
To support a crown a special abutment is connected to the implant fixture and used to support a crown. Sometimes we use a manufactured precision abutment which requires special techniques. On other occasions our laboratory will fabricate an abutment the looks like a normal prepared tooth so that a dentist can use routine crown impression techniques. The latter procedure is utilized when crowns are being placed on adjacent teeth.
Often we will invite patients to visit our laboratory so that the technician can personally match the colour and characteristics of a tooth.