The best dental implant teeth crowns can be made in a variety of ways. The teeth can be made separately, like natural teeth or connected as bridges. This post refers to having more than one implant next to another.
In my Burbank dental implant practice, I restore the crowns or bridges for dental implants in a variety of ways depending on your unique situation.
Everyone usually wants separate individual teeth because that seems to make most sense. This thinking is flawed because dental implants are not natural teeth…their biology is very different
Separate dental implant crowns allow you to floss normally between your teeth. Another advantage is that if the porcelain crown breaks or is damaged, it is easily repaired or replaced as one isolated tooth rather than having to replace two or more.
There are some disadvantages to individual implant teeth. If your teeth are long due to vertical bone loss, you may get **more** food stuck between two implants right next to each other. It sounds strange to get more food stuck if they are disconnected but it happens because implants don’t have a periodontal ligament which acts a shock absorber. When your dentist adjusts the space between the implants which is necessary to install the crowns, a good or bad space can be created. Lastly, single unit implant teeth crowns are more likely to break porcelain than connected ones.
The above x-ray shows the best of both worlds. In this patient from Burbank, some of the implants are connected and some are individual.
Connected implant crowns are referred to as “splinted.” Splinted implants have the huge disadvantage that they are connected but that is also their advantage in some ways. Splinted implants are most commonly used in areas where the bone is soft and the bite forces are strong. That area is notoriously the upper molars. If your bone is soft and/or had to be bone grafted back, splinted implants distribute forces better to the bone. This is especially important in sinus bone grafts. That will prevent bone loss over time that can happen around dental implants that get overloaded with bite forces such as clenching and grinding.
All zygomatic dental implants that I placed are mandatory to splint/connect.
You can’t floss normally around connected dental implants but that is ok. There is actually evidence that flossing may harm dental implants but NOT natural teeth. Micro-fibers of floss gets stuck in the threads of the implant and cause bone loss. This happens especially on patients that floss overzealously.
in general, connected dental implants are better if there is any question about bone stability whether that be on the upper or lower teeth.
So what is the best? Each situation is very unique. I recommend different ways for different patients and in different areas of the mouth. This post is focused on back teeth. Front teeth dental implants have many other concerns from the cosmetic standpoint far beyond this post.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry