Dental Implants vs. Crowns and Bridges

Eve a dental implant patient asks us:
I am 51, female, attractive and toothless. To date I have spent in excess of $7,000 for 2 lower dental implants and upper bone grafting.

That was over a year ago and I can’t seem to get the 2 separate doctors to agree on a plan. I simply cannot get the information I need to make an educated decision about what to do. My plan is to have 4 lower dental implants and 6 uppers and attach a denture to that. But is that the best way? Couldn’t one also have crowns put on and make bridges and then attach those to dental implants? What´s the real benefit of dental implants vs. crowns and bridges? Thanks for any help as to a basic treatment plan and an understanding of the issues here.

29 thoughts on “Dental Implants vs. Crowns and Bridges

  1. 4 mandibular implants and 6 maxillary should be enough to retain 2 dentures. Is it the best way? it depends on what your desires are and the specific of your case.
    If you are OK with a removable appliance that covers your palate and have adequate space in between the 2 arches, an implant supported dentures provide an easy solution to edentulness with great stability and very nice esthetics at a reasonable price.
    If it was my choice I would investigate the opportunity of having a fixed solution although it would require more implants (8-10 in the maxilla and 6 in the mandible)mandible) and would be definitely more costly from a restorative standpoint.
    Having said that not all options are feasible and it all depends from your specific situation.

    Fabrizio

  2. for edentulous maxilla,and mandible restorative options will be as follow(based on amount of bone and cost limitations): 1-fixed bridge needs 8 implants or more 2-fixed detachable dentures(hybrid restorations restoring missing teeth and bone +gum) 3-removable implant +tissue supported over dentures start by 2 implants . more implant used gives more support to the denture,also you can have ball and socket inplant +tissue supported or bar and clip overdenture.each implant case is diffrant. clinical evaluation is needed to select proper treatment planning.general guidlines for selecting fixed bridge over fixed detachable (hybrid)denture is the amount of remaining bone if you have recent extractions or having exo-done long time ago and denture used.you can dicuss all options with your dentist to pik up the right restorations, good luck .

  3. I’ve been undergoing implant surgery for over 20 years. I have been where you are and have tried many approaches. The most stable and comfortable, not to mention best looking is the fixed bridge. It’s more time and money and pain~the payoff in the end is well worth it! Good luck~a fellow toothless fifty year old.

  4. Another option is overdentures with Locator abutments-very retentive, very nice. A fixed bridge is of course the best option, as long as you don’t need to replace soft tissue (gums) for esthetic reasons. good luck.

  5. I currently have a fixed bridge on teeth 3,4,5,6 – tooth 5 is missing. Tooth 4 now needs to be removed. Tooth 6 has a root canal and tooth 3 has a root canal and apeco (not sure of spelling). I have been advised by one dentist to do get inplants on teeth 3 and 6 and then a fixed bridge over those teeth (with two fake inbetween the inplants. Another dentist advised to get inplants on 4 and 5 and leave 3 and 6 as is with crowns. Please give me your thoughts. thank you.

  6. To the patient with the 3-6 bridge. I would not do a 4 unit bridge over 2 implants. The best way to handle things is either with 4 implants, if 3 and 6 are not viable as single teeth, or 2 implants, and 4 individual crowns. The name of the game is one implant for each missing tooth. A comprimise would be 3 implants for 4 missing teeth. A waste of money would be just 2, especially in the area of 2 failed endodontically treated teeth. Apico is the proper slang abbreviation for the procedure called an apicoectomy.

  7. I am going to have tooth six removed and have an immediate implant procedure. Is that a problem? Also, do I need to take antibiotics either before or after this procedure? If yes, why?
    Thank you.

  8. I hv front upper 21 tooth missing,one thooth next to it have RTC been done,pls advise is it better to go for inplant or bridge? and what type full cermamic or any thing else?

  9. I am currently undergoing the same dilema. Finding it difficult to obtain a plans, options, prices from local specialists in SA. Also finding they are not communicating with each other or me for that matter to provide all my options. Frustraded and forced me to do my own research. I am now considering a cosmetic practitioner in NSW who is prepared to communicate and manage the procedures. He has taken the time sight unseen to communicate with me and discuss options. Alternatively I am seriously considering going overseas to a dental clinic that specialises in cosmetic dentisty.
    Happy to discuss with you if you wish to contact me.
    Mary

  10. I had a root canal gone bad. The drill bit broke off in the molar and there is infection under it. Now the took has to be extracted. I also had to have another molar (#19) extracted on the other side. The dentist sent me to an oral surgeon for that extraction, but is planning on extracting the molar with the drill bit in it. Is this normal or should I go to an oral surgeon for the additional extraction? Also not sure whether implants or bridges would be better. The dentist is planning on a bridge (at his cost) since it was his error. My fear is that one or both of the other molars will go bad and I am back at square one. Help anyone?

  11. dear maureen,

    As far as the fractured instrument goes, things like this happen sometimes, especially when root canals are very curved, which is common in molars. The question of what to do is one that depends entiely on the clinical situation. you have three basic options.
    1, seek an endodontic consultation. (this is a specialist in root canal work) to see if the instrument can be removed and another one done.
    2, have the tooth out and a bridge, this is good if you are older and the two teeth next door are heavily filled anyway.
    3, have the tooth out with minimal disturbance to the bone and plan for an implant later, you may need more bone put in, either when the tooth is taken out or at a later date. the implant treatment is the best in many situations but not all. there are definate cost and time implications in getting an infected site back with a tooth in it, it just depends on how much bone there is and what the teeth next door look like.

  12. Coming back to the question at the start of this thread, to go for an implant retained removable prosthesis, or a fixed bridge.

    It’s all about the lip and tissue support, if just ‘teeth’ on a bridge retained by implants can produce an acceptable appearance, then this is an option. If the teeth alone will do it, then subject to there being enough bone, and all the other variables, this may be an option.

    If there is insufficient lip and tissue support from teeth alone, ie the bone loss and atrophy from tooth loss that has not been corrected for many years, then the only simple option is an implant retained prosthesis which is removable, but which also replaces lost volume in addition to tooth loss.

    There are surgical techniques to rebuild bone when teeth have been lost for many years. My experience is that when the invasive nature of, and the risks, of this type of surgery are explored, there are few patients wanting to go down this route.

  13. Hi,
    Very confused about what is better inplant or bridge;
    1. About to do deep cleaning – told will need surgery to clear the stone away from the roots completely.

    2. Missing tooth 35 – Original Plan bridge between 34-36 (34 and 36 assumingly good teeth).

    3. Who would be best qualified to determine the feasablity of inplants – inplant Spec or Peridontist?

    Money not issue; what is the best course of action?

  14. I am in the process of receiving 2 implants for my molars 30 and 31. I have the option to have one joint crown that looks like 2 teeth or to have 2 separate crowns. What are the pros and cons of one choice over the other?

  15. I have been losing bone in my lower and upper teeth in the front(Most bone loss is in the two lower front teeth). There is a lot of spacing between lower front teeth. My dentist is saying that this is due to the gum disease and to treat it, the gum needs to be treated from inside as well as the deep scaling of the teeth. He says that will make the teeth moving more. He recommands to remove the lower front teeth and put the bridge. He says the teeth next to the badly effected lower teeth have thin roots. So he is actually recommanding me to remove them also and get the bridge of 6 lower front teeth. I am 36. I am having this bone loss for quite a long time and doesn’t bother me excecpt the appearance because of the spacing. My previous dentists have been recommanding me to just keep taking good care of the teeth. Please advise me should I go for the bridge now or may be wait? If I should go for the bridge, should I go for the 4-teeth or 6-teeth? (I will be paying $1100/tooth) How curable are the gum disease? Won’t I have any gum issue after I get the bridge? What are the chances needing the replacement of the bridge? Thanks much

  16. I have a 6-7-8-9-10 fixed bridge with some decay starting under a rest on an adjacent tooth (11). My dentist is recommending a 5-6-7-8-9-10-11 bridge. Is this an unrealistically long span for a fixed bridge?
    Thank you

  17. Steve,

    I can relate, I have a 4-12 bridge from an accident 25 years ago, it did not start out with as many, but over the years, I have had to replace it every 8 yrs and added on. So I don’t think it’s a long span, even though it feels like it. I just found out that 3 root canals under my bridge are failing, so I have to address that and replace the bridge, they are suggestion extractions of some of the teeth under the crown where the failing root canals and implants to support the bridge and crowns… Cost… well upper 20′s…. I dont know what to do either. I dont have that kind of money, and I was told that if I keep doing bridges, they will need to be replaced every 8-10 yrs anyway at 10K a pop, so maybe, in your case too, you should ask about implants to support the bridge, its costly, but may save you having to redo the darn bridge every 10 years, if you can afford it. Im still tossing the idea and getting other opinions :o(

  18. Thanks to you both. I wonder how much unnecessary damage to my existing abutments I’ll sustain when this bridge gets pounded off. I wonder why a competent filling could not be placed under the funky old rest on my 11 tooth, instead of smashing the existing bridge off, and making a new bridge to include 11. I wonder if I’m getting sold a bill of goods.

  19. I’m missing a tooth and trying to decide wether to go for an implant or for a bridge. Money is not an issue, however my Dentist insists in going for a bridge even though the other 2 teeth are good. What would be my best option in the long run? Thank you.

  20. Hi All,
    I am happy to see it is not uncommon to have conflict or under-communication between the treatment team. I am struggling with a decision to remove all of my ailing teeth for implants, as they are dry due to salivary condition, but the gums/roots are fine, and going with crowns, root canals, etc. The difficulty with my teeth has been for 10+ years, and I am looking for a longer term fix, that will survive in my dry mouth. The periodontist would rather the crowns, etc, and the prosthodontist, and salivary specialist feel the implants are a better option. I am in my 40′s, and the perio feels “why mess with the good bone and roots. It’s a lot of money either way, so I am in a decision dilemma. Any thought to defend the crown route?
    Thank you!

  21. I just read this and have to respond. My treatment will be 2 years as of Oct 06! The cost is $50,000 + and will be ongoing even after the final prosthesis. It’s been explained that the implants can fail at any time etc. AND the superstructure I’m having made can break down as well. I’ve had several bone grafts, sinus lifts, failed implants, new ones put in, ones taken out and the list goes on and on. I’m scheduled for another procedure in a few weeks. Think it’s number 8 or 9. Mine was extreme in complications but now I seem to have developed periimplantitis……….like what would be periodontal disease! All this on the upper! Consider carefully the ongoing cost associated. Search under “pain after implants” in this site and you’ll be amazed and maybe make a decision with eyes wide open! Hope this helps…….

  22. Hi Karen,… It’s terrible that you have had so many problems with your implants. My mother, in her 80′s at the time, had lower implants to support her dentures due to bone erosion.
    She has had them now for about 10 years and aside from a fractured screw, has had NO problems. Of course, we are believers in natural and alternative healing methods and she takes large doses of Vitamin C (the sodium ascorbate powder form). Her dentist told her Vitamin C promotes healing and fights off infection. We take many other supplements as well as eating a good diet, too. So, perhaps your lifestyle is contributing to some of your problems. Or, maybe you need another dentist; they are not all good. Just
    some thoughts, trying to help….

  23. Thanks Jean for the Vit C suggestion! Due to abuse, my uppers were pulled at age 12 and that was 45 years ago. I have my lowers. So, I’ve had a lot of grafting and am just that person experiencing problems. I have 8 implants at the moment but 2 are questionable so the next procedure will be to uncover one of them and add a 9th just in case one fails. I do know that the mandible is way more successful (other than the risk of nerve damage) compared to the maxilla so I’m thrilled that your mother has a success story! It would be so encouraging to read other success stories……….. I do take lots of supplemnts and am in good health. Non smoker, drinker, etc. Mostly the problem has been that at age 12 the bone along the front had not even developed so I was really at a negative. Question though 1) how long has she had her implants 2) how many and 3) what kind of prosthesis did she get? And THANK YOU for your response as sometimes the responses from the doctors here feels like they aren’t listening, compassionate, or like yelling.

  24. Hi again, Karen… It’s been at least 10 years that my mother has had her implants. As I recall, she had 4 implants placed and they support a full lower denture. Email me if you like at:
    palacie@sbcglobal.net and I’ll tell you about the bone building supplements we both take. By the way, my mother turns 100 years old in December! Now that I think about it, she must have her implants at least 15 years….

  25. Coming back to Eve.
    Dear Eve,

    Dental implants can hold either dentures or crowns and bridges. In your case, it seems that the treatment plan is to place in the necessary dental implants to be followed by the dentures. The dentures will be attached to the implants but will be removable by yourself for cleaning purposes.

    Instead of dentures, you can have bridges fixed to the dental implants and these bridges will only be removable by your dentist. Bridges will be more firm than dentures and you will be able to eat much better than with dentures. This is because bridges are made of rigid and strong metal and porcelain. They are fixed firmly either with screws or by cementation. Dentures on the other hand are made usually of plastic and sometimes may have some metal. Dentures are more flexible and weaker than bridges and are removable at will by the patient.

    However in the case of bridges, you will have to place more dental implants than in the case of dentures. More dental implants mean more money. So you have to decide how much you want to spend. Get your dentists to give you quotations for the 2 alternatives: bridges or dentures. Also get them to explain the pros and cons of each choice. Finally, if you cannot get clear understandable answers, consider finding another dentist who would.

    Cheers.

  26. Dear Eve,

    The question to ask is not as the title of the discussion suggests: Dental Implants vs Crowns and Bridges. There is no conflict between dental implants and crowns and bridges. Dental implants are integrated seamlessly to crowns and bridges for both to work effectively to restore ones ablility to eat, speak and look good! If one is toothless, you must have dental implants placed before fixing crowns and bridges to them.

    The right question in your case seems to be: Should I have removable dentures fixed to my dental implants or non-removable bridges fixed to my dental implants?

  27. I had a consult at a local dental school and a perio student doctor told me it’s my decision

    – block graft, implants replace # 7, 8, 9, 10. separate crowns, easy flossing, more $$, more problems when implants are close together – resorption/recession, results may not be aesthetic if implant becomes exposed.

    or

    – 2 implants replace #7, 10, + 4 unit bridge 8/9 pontics. same or better results when 2 implants are farther apart, no block graft – less time to heal, less work for the student doctor.

    – immediate placement was suggested after extracting #7 and 10, but need to see CT scan to determine.

    we didn’t discuss occlusal and lateral forces. i think the student doctor wants an easy case, and i need permanent results. at first he suggested 4 implants would not be a problem and then almost started pushing toward 2 larger implants, no block graft, bridge.

    my concern is what would give me most stable, permanent results and 100% use of central and lateral incisors. 4 vs 2 implants, immediate placement vs 4-6 months socket healing time.

  28. can anyone tell me if mini implants are reliable. I went to a univ clinic – and they suggested – i dont have it in front of me – but i remember implants above and below for fixed dentures – originally they said i needed bone grafts on either side on the top and sinus membrane lifts otherwise my bone is in very good condition. I still have 5 teeth on top in the middle b(except one of the two front teeth – got hit by a coconut in costa rica – long story) i have kept these becuz when i originally went to the dental school about 5-7 years ago – they talked about how they needed to see where teeth went on top to do good job (students) and also becuz – and here the dr/prof at the dental school who i went to see again last fall said that it was surprising how my appearance doesnt show i have almost no teeth. I will get these out when i have something going in to take their place. i am a female 58 and do not smoke. I am eating organic and mostly non meat diet – just fish – whole grains etc.. no processed foods.
    they did not tell me that these would be long implants but i presume that is the case – becuz i read that the small ones are used to not have to do the sinus lifts and bone grafts. I have no idea .. am trying to get info .. Thank you very much

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