This post is intended toward dental implant crown and bridge restorations that stay in the mouth and are not removable. Denture implants called overdentures are not “fixed”, they must be removed daily. All materials have advantages and disadvantages. The following is a summary of the materials that can be used.
Dental Implant Restorations: Crowns and Bridges
There are basically four options that I use:
Full Cast Gold (High Noble Metal) Made of a gold alloy, full cast gold is the longest lasting of any of the laboratory-processed materials. The alloy consists of gold, silver, palladium, and sometimes zinc, copper, and platinum. Although it is a very strong material, the yellow color makes it not as esthetically pleasing as other options.
Full Cast Noble Metal Similar in properties and qualities to full cast gold, this material contains mostly palladium plus silver, gold, and other trace metals. Full cast noble material is more silver in color than a full noble metal.
PFM -Porcelain Fused to Gold (High Noble or Noble Alloy Metal) This material is very esthetic and can last 5 to 20 years. The gold substructure is covered with porcelain, which can wear opposing teeth or fracture under forceful biting or grinding. The porcelain can be applied to just the surface of the crown facing on cheek. The result will not be as esthetic, but will last longer. A night-guard may be recommended for protection.
All Ceramic or All Porcelain (Zirconia) This is the newest technology in laboratory-processed restorations and is considered very esthetic. They look very real. No metal is used in the process, and therefore no metal will ever be visible. It is excellent for restoration of front and back teeth. The same cautions exist as with any porcelain or ceramic material: it can wear opposing natural enamel, and a night – guard may be recommended for protection from bruxing or grinding. Some processes in fabrication of the all ceramic or porcelain crown are actually controlled by a computer!
All the above take at least two appointments to finish.
Abutment preparation, impressions, and temporary crown or bridge will be done at the first appointment. Your final cementation will take place during a second appointment. Because of the highly technical nature of the process and my exacting standards, I may need to take more than one impression. If I detect an irregularity with the returned laboratory restoration, I will take a new impression and redo the dental implant restoration.
I will recommend the best material to meet your specific needs and answer any questions you have.
Longevity of any of the restorations depends on the quality of the materials (and I only use the best), the technical skills in construction, and what you need to do with the restorations once they are in your mouth.
Clenching and grinding habits will significantly shorten the useful life of any restoration placed. What can break your natural tooth can break any man made restoration! Don't chew ice!
Your oral self-care will affect the length of service of the restoration. You will need regular dental examinations and cleanings at intervals determined by your particular needs and gum health.
A rule of thumb is that the more restorations you have in your mouth, the more care you will need. Any problem that begins can be discovered and corrected when it is small: with regular dental examinations, you can protect your dental implant investment.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry