The primary goal of implant treatment is to enhance the quality of life for individuals who have experienced tooth loss. This is achieved by restoring their ability to speak and smile confidently with aesthetically pleasing, functional, and natural-looking teeth. Prostheses supported by implants, applied through various techniques, are referred to as Implant-Supported Prostheses.
Implant-supported prostheses are generally categorized into two main types:
2)Fixed Implant-Supported Prostheses
These prostheses are permanently secured and cannot be removed by the patient. They are often the preferred choice for individuals missing one or more teeth and are also commonly used in cases of complete tooth loss. However, successful application requires favorable conditions, detailed planning, and the proper selection of materials and techniques.
Types of Fixed Implant-Supported Prostheses:
a) Cement-Retained Fixed Prostheses
These prostheses are bonded to abutments placed on implants, resembling traditional crowns or bridges. They are non-removable by the patient and typically require a dentist’s intervention—such as cutting or tapping—for removal. In cases of total tooth loss, at least six implants are usually needed. Materials commonly used for these prostheses include:
- Porcelain fused to metal
- Porcelain fused to zirconia
- Monolithic zirconia
- BioHPP composite frameworks
b) Screw-Retained Fixed Prostheses
These prostheses are attached to abutments using screws on the implants. They have become increasingly popular due to their convenience for both dentists and patients. While patients cannot remove them, dentists can easily unscrew and reattach them for maintenance or repairs, such as fixing fractures. In cases of complete edentulism, a minimum of four implants is typically required. Preferred materials for these prostheses include zirconia porcelain with a metal framework and softer materials like composites or enhanced acrylics.
2) Removable Implant-Supported Prostheses
Removable implant-supported prostheses are designed to be easily removed and reinserted by the patient. These rely on both implants and the gums for support and are often chosen in cases where bone quality is insufficient or implant support is limited. They are also a practical option when maintaining hygiene around the implants is challenging.
Different attachment systems are used for removable prostheses, such as:
- Bar-retained systems
- Locator attachments
- Ball attachments
- Telescopic attachments
The choice of attachment system and design is determined after a detailed evaluation of the patient’s bone structure, expectations, and preferences during the initial consultation. Even patients with sufficient bone but no natural teeth can benefit from removable implant-supported prostheses.
Bar-Retained Implant-Supported Prostheses
Bar-retained prostheses are one of the most widely used removable implant-supported prostheses in recent years. These prostheses provide support through one or more implants, where a metal bar is secured. The prosthesis is then stabilized on this bar, ensuring functionality and comfort.
Advantages of Bar-Retained Prostheses:
Enhanced Stability: The bar securely anchors the prosthesis, preventing it from shifting or slipping during use.
Fewer Implants Required: In some cases, fewer implants are needed, reducing treatment time and complexity.
Improved Fit and Comfort: The bar system ensures a proper fit and enhanced comfort for the user, making it a practical and effective solution.
While bar-retained prostheses offer excellent functional and aesthetic benefits, their success depends on careful planning and expertise. Each patient’s situation is unique, so an individualized approach is essential to achieve the best results.
