Fixed Dental Implant Bridge vs. Implant Denture – What is the REAL Difference?

There is a common mistake that I hear from patients on a regular basis.

Often times, I see patients for second opinions for dental implants to replace all of their teeth. They tell me they are having all their teeth removed and having a "bridge"

When I dig deeper or reference their paperwork, they are actually getting an overdenture!

Whoa! Yikes! Wait a second!

There is a HUGE difference between a "fixed bridge" and "overdenture" which some falsely call a "removable bridge"

Look at these pictures:

Upper denture

Note the size of the two.

An overdenture is just that…a denture that goes over implants and it is removable. It must be taken out at night and cleaned underneath.

Don't get me wrong, overdentures are fantastic for the right situation. Nine times out of ten, the right situation is a person that has had dentures for years and needs extra hold and security with their dentures. They can be made to look great.

IMG_8191

Fixed bridges are cemented or screwed to the implants and cannot be removed by you. Unlike dentures that have pink acrylic and plastic teeth, fixed bridges are porcelain fused to metal.

You will not have anything touching the roof of your mouth going over your gums with a fixed bridge. The teeth "emerge" from the gums and are not plastic like dentures.

Overdentures can be made with porcelain teeth, but that only makes the dentures look better.  It does not make them smaller or feel more natural.

Fixed bridges have a gold substructure underneath them. Hence the name "porcelain fused to metal." Because they have gold they are very strong compared to their overdenture counterpart.

If you are missing a little bit of gum, I usually make pink ceramic porcelain near your natural gum line. This will make it so the teeth don't look too long and square. Having that little triangle of gum between the teeth makes all the difference when you smile.

These are fixed porcelain bridges that I made for the whole upper jaw.  These patients lost all of their upper teeth:

IMG_4909

IMG_8193 

IMG_5456 

42

The cost of dental implants and a fixed bridge is more than an overdenture. A significant amount of gold is needed to make your implant bridge. Gold is about $1900 an ounce (in 2011) and it takes a several ounces to make a full upper or full lower bridge with 12 teeth. Of course, the fewer the teeth, the less the cost will be.

This is a picture of a patient of mine without his overdenture in place.  The implants are connected to a bar that the removable teeth snap onto.

IMG_4749 

The inside of the denture looks like this.  It has clips that attach to the bar and make it snap in.

IMG_4705

A fixed bridge requires much more precision to make than an overdenture and typically more appointments. The implants also need to be much more precisely placed, whereas an overdenture has some leeway.

What is right for you? It really depends on what you want, your budget, and how much bone you have.

The position of your lips and how much space you have between your top ad bottom teeth is CRITICAL. This is often overlooked by your average dentist. Your face and lips can end up looking too bulky or caved in Bone volume for samplesif this is not determined in the photographic assessment before anything is done.

 IMG_1731

You typically need more bone and more implants to make a solid fixed bridge than an overdenture. Depending on your situation, bone grafting may be necessary. These are things I can only determine by evaluating you in person.

If you are missing all of your teeth, a CT scan is almost always necessary to have a safe surgery.

The fixed bridge is the best long term solution and requires very little maintenance. An overdenture may be upgraded in the future to a fixed bridge.

Bottom line… A fixed bridge is the best and an overdenture is meant for people that already have dentures.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California
http://www.burbankdentalimplants.com

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44 Responses to Fixed Dental Implant Bridge vs. Implant Denture – What is the REAL Difference?

  1. shilpa says:

    Thanks for clarifying this. I wish I had you do my surgery. The doctor I saw is not considered to be an expert like you are. I may travel to come see you!

  2. Typhoon Forget says:

    I would like to know what is the different in cost (approximate) between the overdenture and the fix bridge. Are the number of implants the same for both procedures

  3. You will need more implants for a fixed bridge than an overdenture. Typically 6 -10 implants are ideal for a fixed bridge.
    The main cost difference is not the surgery, but rather the teeth. There is extensive lab expense involved.
    A fixed bridge can cost double the cost of an overdenture. A fixed bridge is the best of the best.

  4. mike wilson says:

    with a set of fixed bridge dentures, what should the cost difference be between acrylic and porcelain – I was told that fixed acrylic would run about 16000 vs 25000 for porcelain.
    Is this price spread accurate?

  5. Hi Mike Wilson,
    Yes…that price range sounds fairly normal.
    Does this include standard or custom abutments? Does this include or exclude the implants, bone grafting, and extractions?
    Consider the long-term costs of definite repairs if you go with the acrylic style. Tooth fracture is very common if it fixed with plastic denture teeth.
    Does this help you?
    Dr. Ramsey Amin

  6. Bob says:

    Please provide a ball park estimate for making and installing an upper and a lower fixed bridge. 16 implants are already in place and ready to go. Thank you for your assistance.

  7. Hi Bob,
    A few question so I can answer you more accurately.
    1. Were the implants placed in such a way to accept a “screw-retained” bridge or a cemented bridge?
    2. Do you have enough lip support with your current temporary?
    3. Are the final abutments in place or do you just have healing abutments?
    4. Do you want acrylic teeth or porcelain?
    5. Would you be available to come in for me to look at you if you are local?
    Respectfully,
    Dr. Amin

  8. Bob says:

    In answer to your questions:
    1. Were the implants placed in such a way to accept a “screw-retained” bridge or a cemented bridge?
    They should have been done I believe for a “screw-retained” bridge but I am not sure.
    2. Do you have enough lip support with your current temporary?
    Do not have a current temporary.
    3. Are the final abutments in place or do you just have healing abutments?
    Healing abutments.
    4. Do you want acrylic teeth or porcelain?
    Porcelain
    5. Would you be available to come in for me to look at you if you are local?
    We are in San Gabriel. I am asking about
    my wife and will need to see if she approves.
    Thanks.

  9. Hi Bob,
    Since you live so close, why don’t you come in for free evaluation?
    I am here until Wednesday, then wont be back until 2011.
    Please bring a current panoramic x-ray or fmx AFTER all the implants have healed more than 4 months.
    If you do not have that x-ray, it can be taken for a nominal fee.
    It will also be helpful, to have the name and sizes of implants that you have.
    Please speak to Angie or Sophia when you call.
    Looking forward to meeting you!
    Dr. Ramsey Amin

  10. Bob says:

    Since we are not really local, I was hoping for a ball park figure to see if it is worth while coming in to see you.

  11. Hi Bob,
    I will send the info to your email. Please reply that you received it.
    Dr. Amin

  12. sara hunley says:

    What is the cost of a fixed bridge compared to teeth implants. I need only a small bridge about 3 missing teeth Approx. cost

  13. Hi Sara,
    In order to quote you accurately, I would need to see you.
    It will depend on your bone structure, and the area of the missing teeth. If I am able to use a one-piece implant, that can save you some money.
    Keep in mind that if you decide to do a regular bridge, you will be replacing it in 5-7 years. An implant bridge is usually done only once!
    Ramsey A. Amin, D.D.S.
    Diplomate of the American Board of Oral Implantology /Implant Dentistry
    Fellow of the American Academy of Implant Dentistry
    Burbank, California
    http://www.burbankdentalimplants.com

  14. Margaret Johnson says:

    I am a 59 yr. old female. In the last year, all of my teeth were pulled. I had a set of dentures made that cost more than a thousand dollars. My gums would not support them. Then I had surgery to have four implants in the top of my mouth and two in the bottom. Because a couple of the top ones did not graft due to my not having enough bone, they were redone using cadaver bone. Then I was referred to a dentist to have dentures made. He initially told me that my bottom dentures could be adjusted to fit over the implants, but that I would need “hybrid” dentures made for the top. A couple weeks later he sends me a copy of his “plan” for me. Now he says I need six abutments at the cost of $470.00 each, and new dentures upper and lower. He says that the estimated cost will be around $5,700.00. (I have already had to pay for than $11,000.00 for the extractions, dentures, and implants.) Why do I need implants and abutments? I am throughly confused and broke.

    • Hi Margaret,

      The most important thing about your treatment is the plan that is developed before you ever start. A diagnosis is made, then the treatment is executed to follow the diagnosis. Sometimes, immediate dentures need to be replaced and can not be used for the final teeth. In my office, I control all these factors by doing the surgery and making the teeth myself in most cases. This controls cost and leads to great results. Have a discussion with your dentist about what your options are at this point.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      818-846-3203

  15. Kimberly says:

    Hello Dr. Ramsey, I am a 28 year old female, and my mouth needs a lot of work. I have been to several dentist for consultation, but was not satisfied, on what they told me. My front two teeth are discolored, and one has an infection, and is longer than the other. I also have some missing teeth on each side of my jaw. I have a build up of calcus as well. I was told that it would take 2 years to fix my teeth. Why so long? I am interested in a impant bridge. Do you think I will be paying a lot for an implant bridge for the top of my jaw. I do not want to spend a fortune, but I want something that will last and look natural.

    • Hi Kimberly,

      It sounds like you need a fairly substantial reconstruction of your mouth. Depending on the extent of bone grafting and making teeth, sometimes it can take 1-2 years to complete. Bone by nature heals slower than other parts of our body.

      As far as cost goes, dental reconstructions can vary depending on your needs. I have done rehabilitations from as little as $1500 to as much as $90,000. You really need to have a diagnosis and treatment plan that is well thought out and phased properly.

      I hope this helps.

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  16. ann says:

    hi dr. amin,
    i like your info but am based in east bay area, do you have a referral close to hayward?
    email annoneh@yahoo.com

  17. Bonnie Long says:

    Hello Dr. Amin!
    In the past 6-7 months, my remaining lower teeth have broken and 3 of the 7 teeth that I have are at varying heights of “nub.” I have gumline cavities to all 7 that remain. These are front teeth as I have lost back/jaw teeth at various times d/t extractions. I realize that you would need to see me for an accurate price on the removal of these and the cost of either a “fixed” or an “overdenture.” However, I am hoping you can give me a rough estimate on the cost of either procedure/appliance. I would definitely prefer the fixed but my finances are, of the course, the issue. I do not have insurance, so all costs are out of pocket. I am a nurse and my smile is very important to me as well as my patients. I feel as if I look like a “crackhead” or “meth user.” I would hate to have someone that looked like a drug user caring for me or my loved one! Therefore, I am not smiling like I used to! I know my teeth are visible when I speak, so I look down or away when conversing. I was very impressed when I saw that you answered people’s questions, so I am hoping you can answer mine & n afford someone with your expertise to make me smile again!!

  18. John Dunbar says:

    I am a 75 year old 10 years out from a heart transplant. I have a full upper denture and a bridge with only 6 teeth on the lower. i have had quite a bit of bone loss on the upper jaw but am considering implants. My dentist had CAT and MRIs done and determined I could support an upper full im plant devise with 4 posts if the outer two were installed radially. My question is should i consider a removable or fixed device? the difference in cost is $22000 vs $15000. Are the fixed devices really worth the difference in price? I do not like the full pallet dentures i now have.
    Thank you

    • Ramsey Amin DDS says:

      Hi John,

      Fixed implants are MUCH better than removable. Just make sure the bridge is porcelain not acrylic plastic.

      Four implants is too few for a fixed bridge. If one fails, there is no back up and you will lose everything.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  19. Catherine mccreadie says:

    High I’ve wore top denture from age 16 hate it so much lost my teeth thru bad asthma hw much would it cost me get fixed denture

  20. Michael says:

    Hello Doctor,
    I recently had oral surgery removing several bad teeth. 3 weeks later we were supposed to add Acrylic temps until I could decide whether to go with implants or bridges for the final solution. I paid $12,000.00 for the temporary work with temps not including the $5000.00 for the oral surgeon who removed the bad teeth and a metal l bracket from a 20 year old broken jaw injury which was causing an infection so 3200 was the actual price for the teeth removal. I have 8 teeth saved on top and 8 teeth saved on the bottom. When the Temps were put in they cracked twice in for days. When I went back for the second repair and started questioning the durability of the acrylic was when I was told by the dentist he never put in the acrylic and I had the resin based temps in and now he will be putting the acrylic teeth in this week. First of all he led me to believe that the acrylics were in already which now has taken the trust away I had in him. Was there a big difference in cost from the resin based temps and the Acrylic temps? For 12000 I assured I was getting great temps which would buy me 1 year to save for the permanent teeth. The permanent work he has estimated at $30,000. Which now Iam started to question also. Any advice would be greatly appreciated…

    • Ramsey Amin DDS says:

      Hi Michael,

      It sounds like there have been some
      miscommunications. Don’t let them get you down. You will be so happy that you had the implants when this is all done.

      In complex situations like you have, I prefer to control all the dentistry from start to finish. This means that one implant dentist is responsible for the surgery and making the teeth. This also helps reduce cost.

      Temporaries do break. Materials are one factor but your bite design and your compliance is usually more important than the material. You should only be chewing very soft foods like pasta until the real teeth are put on.

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  21. pkleghaei says:

    Thanks for explaining, Really nice info sharing…..

  22. katrice says:

    Hi Dr.Ramsey
    Im a 34 year old woman that needs major help……I have missing teeth, a few cavities and 5 days ago my gold crown fell out along with my tooth…im afraid of dentist due to the fact that was hurt very badly while getting a tooth pulled….I really want implants but I cant afford it…any suggestions?? is there any insurance that would cover implants??

    • Ramsey Amin DDS says:

      Hi Katrice,

      I understand your fear of dentistry and dental implants. You can sleep through most of it using IV sedation. This way you can get the dental work that you need done in a comfortable manner. It is really awesome. I use IV sedation 1-3 times daily.

      Here is a link;

      http://www.burbankdentalimplants.com/details-of-sedation/

      All procedures can be done safely while you are sedated.

      Respectfully,

      Dr. Amin.

  23. Paula Green says:

    Dr Amin, how nice of you to answer all these questions. I am in WV and have had dental problems as long as I can remember. While in grade school, one of my front teeth was partially broken off and became abcessed(sp?) The dentist said that because my front teeth weren’t straight he had to pull all four front permanent teeth to place a partial. The wires on the partial ruined the rest of my top teeth and I had a full upper denture in high school. Fourteen years ago at the age of 43 yrs., I had five dental implants with an over denture. One year ago, one of the implants broke between the bone and the gum(I think). The surgeon removed the implant and placed cadaver bone around the remaining four implants. A few days ago, I removed the denture and felt pain and noticed the abuttment was loose. I panicked and inserted the denture. When I tried to remove it, it felt like the implant was pulling out. I called my dentist, who is on vacation, and was told to not remove the denture and just clean it as well as possible since he can’t see me for ten more days. My dentist had advised against the permanent bridge, saying my teeth would look very long. I noticed you use pink gum and wonder if my dentist could possibly do this since I will probably, once again, need another surgery.

    • Ramsey Amin DDS says:

      Hi Paula,

      I’m sorry to hear about your dental situation. Some overdentures cause more stress on implants than fixed bridges.

      Most of my patients that I treat elect to have fixed upper porcelain dental implant bridges instead of snap on dentures. You are likely to be missing bone, so pink porcelain will be needed and is recommended. You will likely need at least 6 implants. Your four sound a bit too weak for this.

      Look at this page for some examples;

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      • Paula Green says:

        Thank you for your prompt reply, Dr Amin. I will try to find a surgeon in WV that can do this for me. Hopefully, I will finally have no dental worries.

        Paula

  24. Silver T says:

    Hi Dr. Amin,
    I’m 66, female, have 5 implants to bottom jaw. I am going to get a removable snap-on denture, but would like to have fixed denture that only can be removed by a dentist. Is 5 implants enough for the fixed denture and how much more to get fixed over snap-on denture?

    • Ramsey Amin DDS says:

      Hi Silver,

      Yes, five implants are enough…if they are in the right spot.

      I use five lower implants routinely to support full fixed porcelain bridges for the last fourteen years.

      I would suggest porcelain instead such as the prettau fixed dental implant bridge. It is super strong and looks great and has low to no maintenance. Fixed hybrid dentures break all the time and start looking bad after only 1-2 years because they are plastic dentures.

      I have many samples in this link;

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  25. RJ Anderson says:

    Q1: Sir…you state that a fixed bridge is the best option. Do you mean it’s the best option between the two methods discussed here (overdenture vs fixed bridge) or best option compared to any restoration? I’m thinking of having my awful and too far gone upper teeth removed and a implant and crown placed for each individual tooth. Is that the best option short of having own natural teeth? Or would you still recommend fixed bridge?

    Q2: re: fixed bridges….what is your opinion on a fixed bridge that is in two or four segments? I know one dentist that likes to use a PFM bridge in two pieces, one left and one right side of upper on 8 implants. Another dentist suggested 8 implants supporting 4 segments of a bridge. I guess the advantage of this is not having to remove/repair/replace the whole full arch if something goes wrong but is there also maybe an advantage as far as bite force being spread out over the bridge differently?

    Q3: Is PFM being dropped by a lot of dentist in favor of other options in order to metal free? Like using zirconia instead or e.max? Or is PFM still a great choice?

    Q4: I have been researching hours upon hours, days upon days trying to find out what the best option is for my case. In your opinion can you list what the absolute best 3 or 4 options (in order of bestness*) are for someone who needs to have all uppers extracted?

    *I like to make up my own words ;)

    • Ramsey Amin DDS says:

      Hi Rod,

      thank you for your organized questions!

      q1: The ‘best option’ is different for each person. Just like a minivan maybe a better option than a Ferrari. Your unique situation, desires and anatomy will determine this if money is no object. There are many times when I do replace every single tooth with an implant. Often times, every back tooth is a single tooth implant while the front benefits from some spacing between implants and skipping sites for cosmetic reasons.

      q2: Segmented bridges are great when using traditional technique materials such as PFM. CAD/CAM technology reduces some of the fit problems that leads implant dentists to break up into segments.

      q3: Yes to zirconia –
      Emax is great for esthetics too. PFM’s are good but they do chip!

      q4: Very difficult to answer without seeing you. Fixed, cemented or screw retained CAD/CAM bridges or single unit implants are the best **IF** your bone, bite and facial esthetics will allow. An overdenture or traditional non-implant upper denture would be the less optimal choice.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  26. lisa says:

    An overdenture helps fill in the bone loss on the upper teeth. The pink acrylic can be used to add bulk. If I choose a fixed full upper implant supported bridge is there any way they can still add to the gumline for bulk and to restore lip fullness? I have to make a decision thanks

    • Ramsey Amin DDS says:

      Hi Lisa,

      A fixed implant solution can still support your lips. Your bone loss and skeletal relationship has to be pretty severe under my care to have an overdenture due this reason. Most of the time that choice is made to save money.

      It is very routine in my Burbank office to create full lip support using non-removable dental implant teeth.

      There are VERY special contours that need to be built into the teeth to support your lips the right way.

      I suggest you seek out an ABOI credentialed dentist in your area.

      Good luck!

      Dr. Amin.

  27. Maria Kandetzki says:

    Hi,
    I have a dental implant that I have done a 5 months ago. It was done in my country.
    My dentist there advise me that because the time I spend there was too short. It could become loose, and I should go to a dentist here to tight it up. Could you please do this?

    Thanks,
    Maria

    • Ramsey Amin DDS says:

      Hi Maria,

      I don’t really understand your question. Your implant is unlikely to become loose!
      I can help if you need!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  28. radhika says:

    Hello sir,
    i am 18 year old
    i chipped my front right tooth when i was 16 and at first it was operated upon and fixed with dental cement as the chip was really minor, later my dentist suggested capping and i went for it, but it is opaque ( i think because of metal acrylic) and does not look natural, over time has even moved upwards making gap between my teeth, i want to replace it as it looks really bad.
    please suggest what material will be the best and most natural looking but not very very expensive!?

    • Ramsey Amin DDS says:

      Hi Radhika,

      Your teeth are priceless! A month after having a great result, you will be happy that you spent the money to do it right!

      Each situation is different but you can use E.Max Press, Lava or felspathic

      good luck!

      Dr. Amin

  29. Annie says:

    I have had implants and am ready for my fixed denture. However, one of the screws came out of my implant, is this normal and should I be concerned. My biggest fear is that my temperature denture, which cost over $1600 has fitted so poorly and will not stay in and it makes me look 10 years older. Should I be concerned that my permanent denture/implant will not look any better. How can I make sure my permanent implant fits and looks more natural. I have all my savings riding on this and can not afford to have it redone.

    I live on the east coast. Thanks for your time in answering my questions.

  30. Louis says:

    Great post! We will be linking to this particularly great article on our website.
    Keep up the great writing.

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