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Single Crowns or Bridges?

posted in Techniques and Procedures

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Dr. Stevens asks: There are two basic schools of thought in replacing teeth with dental implants
and crowns and bridges.   One approach is to replace each tooth with a dental
implant and a crown.  The other approach is to use pontics and cantilevers. 

What are the arguments both pro and con to each approach? Which one has worked well in your practice? In addition, I am now getting beyond replacing  single teeth and getting into fixed multiple unit restorations.  I really would  appreciate some advice here.  What approach should I take? Do I do single crowns or bridges? Thanks for comments.

4 Responses to “ Single Crowns or Bridges? ”

• satish joshi July 4th, 2006

  
  

  as far as long term predictability of implant success is concerned it is always more the merrier.
  But if you have optimum quality and quantity of osseous structure and there is abscence of parafunction and patient’s occlusion is favorable bridges are ok as long as implants are not over loaded.
  As far as ant. naxilla is concerned many well known clinicians like Dr.Tarnow,Dr. David Garber,Salam brothers and others advise to have pontics rather than replacing each tooth with implant due to difference in required distance between alveolar crest and contcat point.

• satish joshi July 4th, 2006

  
  

  what I mean is distance required to maintainor develope interdental pappilla.

• Robert J. Miller July 4th, 2006

  
  

  This is a classic paradigm issue. I prefer to have an implant per tooth in my cases. The periotest values in peer-reviewed literature indicates that they are higher in unsplinted vs. splinted cases. The only cases I do as splinted are full arch or where there are financial issues. In the edentulous quadrant, almost all of my cases are single tooth. Our ability to regrow papillae is significantly enhanced, hygiene compliance is high, and patients seem not to have the issue of food retention as in bridges. Last, if there is a problem of healing of an implant, better to treat a single tooth than lose a bridge while undergoing revision of the case.

• Alejandro Berg July 4th, 2006

  
  

  Dear Dr. Stevens:
  As most of us (implant guys)I started doing mainly bridges so i could distribute force and bla bla bla…. today Ive come to realize that unfortunatelly enough we depend on the patients wallet to plan a case(how politically incorrect was that?) ,but if my patient has the money i allways plan for free standing implants and for that I use specially designed implants (Endopore). The cosmetic result and the patient satisfaction level are higher.
  I wish this was in all the cases, but as Im sure your experience is, most of my patients cant afford that, so bridges.
  Today we still see the splinted vs non splinted battle, but this all developed from branemarks work with non surface treated and parallel wall implants that today most of us dont use.
  Still there are cases in wich I go directly to a bridge, allthough I never never use cantilevers and i really dont recomend them at all.
  best of luck to you

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