Dental implants versus dentures. Which one do I recommend

Many patients when they come to the clinic because they are missing a tooth or we are going to have to extract one for dental treatment, always ask us what is the best solution to replace the missing tooth or teeth, dental implant or dental prosthesis.

In this article I will explain, from the point of view of an implantologist, what are the benefits and drawbacks of each method and which one I personally choose. Let’s go there.

The dental implant

Dental implants are a very effective solution to solve tooth loss, restoring both functionality and esthetics to the smile. However, the cost of dental implants can vary significantly depending on several factors. In this guide, we will discuss the different types of dental implants, dentures and crowns, as well as the factors that affect the total price of treatment.

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What is a dental implant

A dental implant is a metallic element that is surgically placed in the maxillary bones, under the gums, when, due to an illness or trauma, it is necessary to remove a natural tooth and replace it with an artificial one. Once the dental implants are in place, crowns or bridges are placed on them, which are the elements that replace the teeth.

Dental crowns are used to replace the functionality and appearance of a tooth. In the case of the absence of several adjacent teeth, dental bridges with 2, 3 or 4 crowns are used.

The type of dental implant recommended may vary depending on the amount and quality of bone available, the location of the missing tooth and other factors.

In general, endosseous dental implants are the most common type and offer a high success rate.

At present, dental implants have proven to have a successful integration to the bone in more than 90% of the cases.

The cost of dental implants can vary significantly depending on several factors. Below, we will discuss the different types of dental implants, dentures and crowns, as well as the factors that affect the total price of treatment.

Dental prosthesis

The dental prosthesis is a structure that holds the dental piece or pieces to the adjacent teeth, it can be removable (removable) or fixed:Dental prosthesis

La prótesis removible una estructura protésica de acrílico con una base extensa de asentamiento (paladar) y una serie de ganchos metálicos que servirán para sujetarla a los dientes adyacentes. Su principal inconveniente es que con el paso del tiempo, entre cinco y siete años, se desajusta tanto a nivel de la encía como de los ganchos que retienen la prótesis.Dental prosthesis

In addition, chewing is that it can move and sway, as well as can penetrate food below the palate.

Nowadays it is hardly used unless there are health limitations that contraindicate implants, or economic ones.

The fixed prosthesis allows the replacement of missing teeth by means of a prosthetic structure that is attached to the adjacent teeth, which must be lowered to create the space to cement the structure and fix it. It is a type of design that has been in use for almost a century, and its chewing comfort is excellent.

Its main disadvantage is that healthy teeth must be sacrificed to fix the missing teeth.

It is not currently recommended if there is a possibility of placing dental implants.

Dentalbridges. Replace several teeth at the same time.

The dentalbridge is a structure composed of a set of crowns (usually two, three or even 4) that serves to simulate the shape of several teeth. The end caps are fixed to the teeth adjacent to dental implants, while the central one is designed to fill the gap left by a missing tooth.

This type of prosthesis can go on a screw or on the milled tooth itself. Many people think that a dental bridge is cheaper than an implant, but they do not take into account other factors.

Bridge on tooth: It is cheaper, since it does not require surgery for placement, but it is necessary to carve and perform a root canal on the adjacent teeth, where it will be attached. Normally, it is only performed when the patient already wore crowns previously or when these teeth are very deteriorated.
In case they are healthy, it is preferable to opt for another treatment to avoid reducing the volume of two teeth in good health.
Dental implant bridge: It is more expensive and requires the placement of two implants that serve as abutments. This treatment is chosen when the patient is missing three teeth in a row or if the two adjacent teeth have a poor prognosis and need to be extracted.
Bridges on implants are a more durable option in the long term, since the screw replaces the root of the missing tooth, preventing the resorption of the dental bone.

Example: a bridge of 2 pieces on teeth has an approximate cost of 1600 euros compared to 2000 euros for a bridge on implants. If we talk about 4 teeth the difference goes from 2600 for a bridge on teeth to 5000 for a bridge on implants.

3 factors to be considered when choosing the type of dental bridge

Aesthetics: Both treatments have an aesthetic functionality and are adjusted to the patient’s needs. Although it should be noted that the implant provides a more natural look to the smile due to advances made in recent years in both techniques and materials used.
Durability: The duration of the bridge and its stability depend mainly on the surrounding dental pieces. The bridge is supported on the patient ‘s natural teeth, so its useful life will be closely related to the useful life of the surrounding teeth and that the latter do not develop any problems such as caries.
Price:In the economic aspect, the dental bridge is cheaper than an implant.

Main characteristics of dental prostheses versus dental implants:

Prostheses are usually made of acrylic, resin and ceramic materials, so that they are lightweight and have the least possible effect on the natural teeth to which they are attached. Implants are usually made of titanium, a highly biocompatible material, resistant to chemical attack and lightweight. In addition, after a few months the titanium allows the bone to grow around it, which is called osseointegration.
At the esthetic level, both a fixed prosthesis and an implant respond very well to the esthetic requirements of the patient, but advances in implantology techniques and materials make the latter look and feel more like natural teeth.
At the functional level, implants respond much better than prostheses, since they do not move or run the risk of detachment, they are firmer and safer. In addition, with immediate loading implantology, the patient can eat, drink and lead a normal life in a single day.
In general, patients with dental prostheses need a longer adaptation time than those with implants. Implants feel and function like natural teeth, while prostheses are a foreign body that takes some getting used to. Although each case is different, as it will depend largely on the anatomical conditions of the bone and the person’s ability to adapt to the change.
The implants are placed directly on the bone, so they do not depend on the adjacent teeth, nor do they overload or affect them in any way. Dentures, on the other hand, are attached to adjacent teeth, thus limiting the number of teeth that can be replaced on the one hand, and requiring healthy, sound teeth on the other.
In the best conditions, a prosthesis lasts between eight and twelve years, while implants can last more than 25 years, if properly cared for.

Advantages of dental implants over dental prostheses

These are some of the advantages of dental implants over other treatments such as removable prostheses

They are more comfortable. As they are fixed, the implants do not need to be fixed with adhesive nor do they need to be removed for cleaning at night as it happens with removable prostheses.
Longer durability. With good care, dental implants last for many years.
Increased taste in food. Dental implants do not cover the palate, as is the case with some removable prostheses, thus increasing the sense of taste.
Better fixation. By fusing with the bone, dental implants are not at risk of moving, shifting or falling out during use so the patient can eat any food without fear of them falling out.

Disadvantages of dental implants:

Although, as we have seen, dental implants have many advantages for the patient over prostheses, they also have a series of disadvantages that you should evaluate:

When placing a dental implant, surgery is needed, which requires a period of healing time before placing the final crown, which can vary from 2 to 6 months, depending on each case.
To maintain the implant longer, proper daily cleaning and regular visits to the dentist for professional cleaning are necessary.
The price is usually higher initially than dentures.

Duration of dental implants

We can say that a dental implant usually lasts between ten and 15 years, but there are numerous scientific studies that show a duration of more than 25 years.

This period can vary considerably depending on the individual patient. Among other things, because the duration of the implants depends, to a great extent, on the patient ‘s habits (hygiene, diet, attendance to check-ups and professional dental cleanings, use of a mouthguard in cases of bruxism, smoking…).

So, although in some cases, a dental implant can last 25 years, in other cases it can last many fewer years if the patient does not maintain proper care recommended by the dentist.

Types of dental implantsBody

We will now discuss the different types of dental implants:

Osseointegratedimplants

They are the most commonly used dental implants. They are shaped like a small screw that is placed in the alveolar bone so that the osseointegration phase or union between the bone and the implants takes place, basic for the success of the implant treatment. Normally, they are made of titanium, a biomaterial that fuses perfectly with the patient ‘s bone, ensuring that the subsequent placement of the prosthesis has optimum support.

Immediate load implants

Immediate load implants or implants in one day, allow placing the implant and a fixed temporary prosthesis in a single intervention in less than 24 hours, so the patient recovers dental aesthetics and functionality of your smile in record time, thus improving their quality of life.

Immediate load implantology is a technique that can only be performed in certain cases.

Bone-freeimplants

Bone limitation when placing dental implants is a relatively frequent situation, but there are treatments that allow us to solve this type of cases: from bone grafts to maxillary sinus elevation.

There are different bone regenerationtechniques that allow us to recover the density, quality and/or quantity of lost bone. The choice will depend on the particular diagnosis.

These procedures will influence the final price of the implants as we will see below.

Zygomaticimplants

For people who have a great deficit of bone, zygomatic dental implants can be the solution. These implants are placed in the zygomatic bone or cheekbone, which is a bone that never resorbs, which allows us to face the treatment successfully. It is a much more complex surgical procedure than conventional implants and its placement is performed under general anesthesia.

Microimplants

They are implants with a smallersize than conventional implants that can be placed in patients with poor bone quality. To determine if it is the best option, it is essential to establish an accurate diagnosis.

Screwless dental implants

Screwless dental implants or subperiosteal implants are an option for people with limited jawbone structure, periodontal disease or for patients who suffer from atrophy of the upper jawbone. These implants are placed under the periosteal membrane, which is a layer of tissue that covers the bone, are usually made of titanium and have a grid or mesh shape that conforms to the contour of the underlying bone and are fixed with a special adhesive for the oral cavity, reducing the need for intervention in the bone. Once in place, the implants integrate with the bone and provide a solid foundation for the placement of dental prostheses.

Surgery for the placement of screwless dental implants can be less painful than conventional implants because there is less need to drill into the bone, resulting in a shorter recovery time than conventional implants.

Types of dental prostheses on implants.

We can distinguish two types of dental prostheses, the pieces that imitate the teeth they replace, to be placed on dental implants:

Removable prosthesis on implant or mucosa-supported prosthesis. The patient can remove them for cleaning and sanitation. They are usually placed in totally edentulous patients.
Fixed prostheses on implants.They are placed directly on the implants and cannot be removed without a visit to the dentist.

Types of dental crowns on implants, according to their composition:

There are two types of implant crowns depending on the material of which they are composed:

Metal-porcelain crown. Its interior is made of metal, covered with porcelain in order to imitate the natural tooth. These crowns are more economical, but are recommended for teeth located in the back of the mouth, because if there are retractions in the gum, a small metal arch can be seen on the edge. Their price is approximately 360€.
Zirconium crown. Made entirely of zirconium. It offers a more esthetic result, since they are translucent like natural teeth. They are the most common for implants in frontal positions of the mouth. Its price ranges between 350 and 500 € approximately.
Porcelain crown. Porcelain allows to obtain the best combination of natural colors, on the other hand they are more fragile than metal-porcelain or zirconium. Porcelain crowns are used to restorethe esthetics of anterior teeth. However, they are more fragile than metal-porcelain or zirconium crowns. Their price ranges from 400€ to approximately 850€ .
Resin crowns . They are usually used provisionally while the definitive crowns are being fabricated. In the case of bridges on teeth, they are ideal for protecting the ground teeth in the period between the measurements and the cementation of the dental crown. Their price is around 40 €.

Types of dental crowns on implants, according to their fixation:

Dental crowns can be attached to the implant in two ways:

Bolted crown . The crown is fixed to the implant through a screw. It is the most used at present. The advantage is that it is very easy to disassemble by the dentist for the maintenance and cleaning of the implant and its connection. In this way we avoid that bacteria are introduced into the implant itself generating peri-implant diseases such as mucositis or peri-implantitis.
The crown is fixed to the implant by means of a biocompatible cement. Its advantage is that it is a simple clinical procedure as well as its manufacture by the laboratory since it is the same process as cementing a crown on a natural tooth.

As you can see, for me as a dental implantologist, there is no doubt. I would always opt for the dental implant, for all its advantages and that although in principle, may represent a greater investment in the medium and long term, it is much better for you.

It is best to go to a trusted dental clinic that has experts in dental implantology and analyze your case, prepare a personalized implant budget to propose the best option in the long term. If you have any questions about dental implants in Barcelona, you can call 669 154 020 and we will advise you without obligation.

Dental implants versus dentures. Which one do we recommend