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Treatment for Patients missing Multiple
Teeth
Replacing the Missing teeth and preserving remaining Teeth
People who have lost or are missing multiple teeth face several
dental issues. These issues include aesthetic difficulties if front
teeth are missing and chewing difficulty if back teeth are missing.
Neighboring teeth and teeth in the opposite jaw may drift in to the
space where the teeth are missing. These considerations lead to
further compromise in the remaining dentition and may also lead to
further tooth loss. Several options for treatment exist to replace
missing teeth. There are advantages and disadvantages to each
option.
1.Removable Partial Denture (Partial)
A removable partial denture is a prosthesis that replaces missing
gum tissue and teeth. It is made of metal and acrylic. Advantages
of this treatment include that the expense of treatment relatively
low. Teeth are stabilized from drift and movement. Treatment time
is relatively short.
Disadvantages include that the prosthesis may show in the smile.
There is a risk of tooth decay, gum tissue irritation and continued
bone resorption where the prosthesis rests.
2.Fixed Partial Denture (Bridge)
A fixed partial denture is also commonly referred to as a
bridge. The prosthesis is made of metal or metal and porcelain.
This procedure involves preparing or reshaping the teeth on either
side of the missing teeth. The prosthesis is then cemented over the
prepared teeth. An advantage of this technique is that it is
relatively expedient. The bridge will stabilize the bite and
prevent movement of the opposing teeth. A bridge is aesthetically
pleasing and functions well.
Disadvantages of this treatment are that there is a risk of nerve
damage and future decay to the neighbouring teeth. Porcelain
fracture may also occur on the prosthesis
3.Implant Supported Fixed Partial Denture (Implant
Bridge)
An implant supported bridge replaces missing teeth. It is held
in place by two or more implants that are anchored in the jawbone.
The advantage of this procedure is that no preparation or reshaping
of the remaining teeth is required. This reduces the risk of decay,
tooth nerve-damage and gum tissue irritation to the remaining
teeth.
Disadvantages of this procedure include the requirement of surgical
procedures and additional treatment time. Porcelain fracture may
occur on the prosthesis. The expense of this treatment may be
initially higher than other options.
Studies have shown that implants placed more than 25 years ago have
had a 90% success rate. Implants supporting multiple missing teeth
have shown similar success rates.
4.How Implant Treatment is Done
Treatment planning is required for treatment success. Planning
involves the restorative dentist in conjunction with the dentist
providing the surgical support. Diagnostic information required may
include conventional dental radiographs (X-rays), diagnostic casts
and a template to guide the surgery.
Following the surgery in which the implants are placed, care is
taken to allow soft-tissue healing. The bone around the implant
heals for 4 to 6 months. Following implant integration into bone, a
second surgery may be required to add a connector to the implants.
The connector becomes an extension of the implant through the gums.
A temporary bridge may be fabricated at this time. Three to six
weeks after the second surgery is required for soft tissue healing
before fabrication of the final crown.
After placement of the definitive prosthesis, the patient is
instructed in the required daily maintenance. As with natural
teeth, regular evaluation, maintenance and hygiene visits with the
restorative dentist and/or the surgical dentist are necessary to
maintain optimal dental health of the implants. | 
