Implant-supported prosthetics: crowns and screw-retained dentures

An implant replaces the root of a tooth, but it is the restoration on top that lets you chew and smile. How precisely it is made determines how natural the tooth looks, how the load is spread over the bone and how long the implant lasts. At UKRMED Dentistry, the implant supported prosthesis is the final stage of dental implant treatment, from a single crown to a whole jaw.

Photo: Coronation Dental Specialty Group, Wikimedia Commons, CC BY-SA 3.0

Types of restorations

A single implant crown replaces one tooth. Between the implant and the crown sits an abutment, a connecting part that emerges above the gum and holds the crown. The abutment is matched to the implant system.

An implant bridge restores several teeth in a row: two or three implants support a bridge with more teeth.

An implant supported full arch prosthesis is used when a jaw has no teeth. It is attached to several implants through multi-unit abutments, special connectors that correct the angle of the implants. For this restoration, a titanium bar (a metal bar connecting the implants) is milled and zirconia crowns are placed on it, or a screw-retained denture (one that only the dentist can remove) on a nylon base is made.

Fixed or removable

An implant supported fixed prosthesis means crowns and bridges that the patient does not take out. They are held by a screw or cement, and only the dentist can remove them, for example for a professional cleaning.

An implant-retained removable denture can be taken out by the patient for cleaning. It is held far more firmly than a conventional denture resting on the gums, does not slip while chewing and needs no adhesive.

A screw-retained denture is an in-between option: it is screwed to multi-unit abutments and stays in place day to day, but the dentist can remove it for check-ups and cleaning. The dentist chooses the option after assessing the number and position of your implants.

Crown materials

• Metal-ceramic - a metal framework covered with porcelain. A reliable and more affordable option, especially for back teeth.
• Metal-free ceramic and zirconia - no metal, so the gum does not show a grey shadow and the tooth looks natural. Ceramic crowns are a good choice in the smile zone.
• Temporary crown - acrylic, placed while the implant heals or the gum is shaped, so there is no visible gap.

How treatment works

1. Checking integration. After placement the implant needs time to fuse with the bone. Readiness is checked at a visit and, if needed, on a 3D scan.
2. Shaping the gum. A healing abutment (a small screw cap) is placed to form an even, natural gum contour around the future crown.
3. Impression or digital scan. An implant impression or a digital scan is taken; scanning records the implant positions more accurately and is more comfortable.
4. Making and trying in. The laboratory makes the restoration, and the dentist checks the fit and bite.
5. Fitting and care instructions.

Prosthetics on implants are planned before surgery: the prosthodontist and the surgeon decide together where the implants will go, so the future teeth have the right shape and load. If bone volume is insufficient, bone grafting may be needed before implant placement.

Who carries out the treatment

The prosthetic stage at UKRMED is led by dentist Mariia Sieraia, who specialises in aesthetic prosthetics and full bite rehabilitation (restoring all teeth and the way the jaws meet) with removable and fixed restorations on implants.

How reliable is it

A systematic review of clinical studies found that after 5 years, 96.8% of implants supporting single crowns and 94.5% of the crowns themselves were still in function. The most common complications are a loosened abutment screw and chipped veneering (the outer porcelain layer). Most can be fixed without replacing the restoration, which is why regular check-ups matter.

Caring for an implant restoration

• an implant supported fixed prosthesis needs thorough hygiene: brush twice a day and also use a water flosser or interdental brushes under bridges and bars;
• come for a check-up and professional cleaning every 6 months;
• if the gum around an implant bleeds, do not delay: inflammation around implants needs the same persistent care as gum disease;
• if you grind your teeth at night, ask your dentist about a protective night guard.

Implant prosthetics prices

The cost is calculated per tooth and includes the crown, abutment and impression. Implant prices are listed on the implant page.

Sources

1. Jung R. E., Pjetursson B. E., Glauser R. et al. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res, 2008. https://doi.org/10.1111/j.1600-0501.2007.01453.x
2. Pjetursson B. E., Thoma D., Jung R. et al. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res, 2012. https://doi.org/10.1111/j.1600-0501.2012.02546.x
3. American Dental Association (MouthHealthy). Dentures. https://www.mouthhealthy.org/all-topics-a-z/dentures