What is an implant bridge?

4-Tooth Bridge

An implant bridge is a one-piece set of teeth

• permanently connected to dental implants
• shaped to look like individual teeth
• does not move when you eat or speak 
• cleaned just like natural teeth.
• not taken out when you go to sleep
  

           

                                  

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What is an implant?

An implant is a titanium medical device shaped like a screw

• placed in the jawbone
• acts as an anchor / foundation to hold the implant bridge
• each implant has a small part called an abutment that connects
  the implant bridge to the implant

 

 

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An implant bridge has 3 parts:

Implants, abutments and the bridge                   

• implants are placed in the bone
• abutments are connected to the implants
• the bridge is connected to the abutments with small screws or cement

 

 

 

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What's involved in getting an implant bridge? 

 

 

What’s involved in getting an implant bridge?  

        There are three important things to know.

 

Implant bridge treatment is a process

• can take 7-18 months to complete
  
• the process involves an implant surgeon, your dentist, and a team of auxiliaries including dental laboratory and medical radiology personnel
  

 

The treatment process has three basic steps

• Step 1:  Remove the unhealthy teeth                          
                Place temporary teeth
  
  
• Step 2:  Place the implants
                Wait 3-6 months for the bone to grow around the implants
  
  
• Step 3:  Construct the permanent bridge
                Connect it to the implants

There are several types of treatment

• the type of treatment will determine the overall time and cost

How do I start the treatment process? 

How do I start the treatment process?

First, do you have enough bone for implants?

• to find out you will need to see an implant surgeon
  
  

• there are two kinds of implant surgeons:  
       -Periodontists
       -Oral Surgeons
  
  
• these dental specialists will determine if you have enough bone to place implants
  
  

What will they do?

• The surgeon will take an X-ray called a "Panorex"  ( a "Pan" )or a 3D "CAT scan" ( a "Cone-beam" scan )
  
  
• These X-rays will show the amount of bone in two critical areas:
       - the front of the mouth
       - the back of the mouth
  
  
• A successful bridge must have implants in both areas
  

 

What are the usual results for someone who is losing their teeth?

	Actual Panorex shows the upper & lower jawbone, and the remaining teeth.

• 80-85% of people have a common problem
  
       - they have enough bone in the front of the mouth​
  
       - there's not enough bone in the back of the mouth 
         
  

                                                         

If there's not enough bone, is an implant bridge still possible?

Diagram of upper jaw Panorex

• Yes!    An implant bridge is still possible
  
  
• Implant surgeons have several treatment options
  that can be used to overcome this problem

 

 

 

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What treatment options are available?

What treatment options are available? 

80-85% of people who are losing their teeth have a common problem

• they have enough bone in the front of the mouth to place implants
• there's not enough bone in the back of the mouth to place implants
  
  

A successful implant bridge must have implants in both areas

Four types of surgery can be used when there is not enough bone

• Grafted Surgery
• Standard Surgery
• Modified Surgery
• "Teeth in a Day"
  

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Compare Implant Surgery Options

What kind of temporary teeth will I wear until the

permanent bridge is ready?

Why do I need temporary teeth?

Before the implants can be placed, your unhealthy teeth must be removed

• temporary teeth will replace your unhealthy teeth
• these teeth will help you eat and speak normally until the permanent teeth are ready
• you wear these teeth for 7-18 months;  the time depends on the type of implant bridge treatment

 

Are the type of temporary teeth important?

Yes.  Temporary teeth will determine                  

• how you look and feel during the 7-18 months of implant bridge treatment
• the type of Implant Guide used by the surgeon to position the implants
  
  

There are 3 types of temporary teeth:

• Temporary denture  (removable teeth)

• Temporary bridge    (not removable)

• Immediate bridge    (not removable)
  
   

Learn more about temporary teeth

Back to The Overall Treatment Process

Treatment Summary: What is best for me?

The information below outlines the 4 most common ways that implant bridge treatment is currently completed.

The chart is based on the type of surgery used to place the implants since this will determine:

• the amount of surgery needed to place the implants

• if a surgical guide can be used to position the implants

• the type of temporary teeth
  

• the time needed to complete the overall treatment

• the number of teeth in the final bridge
• the overall cost of treatment
  

 

Common Implant Bridge Treatments (2015)                        Complete Treatment Summary
Surgery Type:	Standard	Grafted	Modified	Teeth in a Day
Implant Guide:	Any guide	Any guide	Any guide	Cannot use a guide
Temporary Teeth:	Denture	Denture	Temporary Bridge	Immediate Bridge
Treatment Time: (months)	8-11	17-20	8-11	5-8
# of New Teeth:	10	12	12	10-12
Cost:  (2015)	$26-30,000	$42-46,000	$30-34,000	$30-34,000

Cost figures cover the complete cost of treatment for either the upper or the lower jaw;  this includes the fees for the surgeon, the dentist and any additional fees for laboratory and radiology services.  It assumes that:

• treatments are provided to patients with similar dental conditions

• the patient has numerous unhealthy teeth that need to be removed 

• the patient lives in the greater metropolitan area of New York City

• all surgeries will be performed using local anesthetic (Novocaine) for pain control

If  IV sedation is required for implant surgery, a board-certified medical anesthesiologist will administer the appropriate medications during surgery:  fees for this type of service typically are $750 for the first hour and $450 for each additional hour (charged in 15 minutes increments).

 
Still have questions?  Need more information?  
Call our office to arrange a meeting to speak with Dr. Kobza

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Compare Implant Surgery Options:

Option 1:  Bone Graft Implant Surgery

Grafted surgery builds up bone in the back of the mouth using a bone substitute or a bone graft.  This requires a separate surgical procedure before the implants can be placed.

For the upper jaw:  Bone grafts are place in the sinuses.  This procedure is called a sinus lift or a sinus graft.  After the grafts have hardened (6 months), the back implants can be placed, along with additional implants to support the front of the bridge.

For the lower jaw:  The procedure is called a block bone graft.

Bone Graft Implant surgery  (sinus bone grafts in red)

Benefit:

• Final bridge has full 12 teeth

Downside: 

• Bone graft surgery needed​
  
   

 

Option 2:  Standard Implant Surgery 

Standard surgery eliminates the need for bone graft surgery by placing all of the implants toward the front of the mouth where there already is enough bone.  However, the final bridge will only have 10 teeth, not 12 teeth. This is because the back implants will be small or short and cannot support a full 12-tooth bridge. 

	Standard Implant Surgery

Benefit:

• No bone graft surgery
  

Downside: 

• Final bridge has only 10 teeth
  
  
  • back implants are small or short and cannot support a full 12-tooth bridge
    

Option 3:  Angled Implant Surgery

Modified surgery also eliminates the need for bone graft surgery by placing the back implants at a forward angle. in front of the sinus space.  These implant positions also allow the dentist to make a full 12-tooth bridge. Modified surgery is a recent surgical innovation and not every surgeon will have the specialized training to use this procedure.

Modified Implant Surgery

Benefit:  

• No bone graft surgery
  
  
• Final bridge has 12 teeth
  

Downside: 

• Limited availability
              
  

                

Option 4:  "Teeth in a Day"

"Teeth in a Day" is a procedure where all of your unhealthy teeth are removed, the implants are placed and a provisional (temporary) bridge is connected to the implants.....all in one day.  Once the implants are anchored in the bone, your dentist will make the bridge and connect it to the implants.

"Teeth in a Day"

Advantage:  

• Reduced treatment time
  
  
• No bone graft surgery
  
  
• Temporary teeth > Bridge

Disadvantage: 

• Higher risk of implant failure
  
  
• Final bridge has 10-12 teeth
  
  
• Cannot use an Implant Guide
              
  

                

 

 

Surgical Options Summary:

1.    80-85% of people losing their teeth do not have enough bone in the back of their mouth for implants.

2.    The surgeon has 4 ways to manage this problem.

3.    The treatment selected will determine:

               a.  the amount of implant surgery

               b.  the number of the teeth in the final bridge

Surgery Type	Benefit	Downside
Grafted	12 Tooth Bridge	Bone Graft Surgery
*Standard	No Bone Graft Surgery	10 Tooth Bridge
**Angled	12 Tooth Bridge No Bone Graft Surgery	**Limited     Availability
"Teeth in a Day"	Reduced Treatment Time No Bone Graft Surgery Temporary Teeth > Bridge	Higher Implant Failure  10-12 Tooth Bridge Cannot use an Implant Guide

 
 *Standard Surgery is the most common type of implant surgery.

**Angled Surgery is a recent surgical development; not every surgeon will have the specialized training needed
   to place the implants in this way.  Angled Surgery is also known as "tilted implant surgery" and is used for the
   "All on 4" Treatment. 

After the implants have been placed
what kind of temporary teeth will I wear?

Compare Implant Surgery Options:

Option 1:  Bone Graft Implant Surgery

Grafted surgery builds up bone in the back of the mouth using a bone substitute or a bone graft.  This requires a separate surgical procedure before the implants can be placed.

For the upper jaw:  Bone grafts are place in the sinuses.  This procedure is called a sinus lift or a sinus graft.  After the grafts have hardened (6 months), the back implants can be placed, along with additional implants to support the front of the bridge.

For the lower jaw:  The procedure is called a block bone graft.

Bone Graft Implant surgery  (sinus bone grafts in red)

Benefit:

• Final bridge has full 12 teeth

Downside: 

• Bone graft surgery needed​
  
   

 

Option 2:  Standard Implant Surgery 

Standard surgery eliminates the need for bone graft surgery by placing all of the implants toward the front of the mouth where there already is enough bone.  However, the final bridge will only have 10 teeth, not 12 teeth. This is because the back implants will be small or short and cannot support a full 12-tooth bridge. 

	Standard Implant Surgery

Benefit:

• No bone graft surgery
  

Downside: 

• Final bridge has only 10 teeth
  
  
  • back implants are small or short and cannot support a full 12-tooth bridge
    

Option 3:  Angled Implant Surgery

Modified surgery also eliminates the need for bone graft surgery by placing the back implants at a forward angle. in front of the sinus space.  These implant positions also allow the dentist to make a full 12-tooth bridge. Modified surgery is a recent surgical innovation and not every surgeon will have the specialized training to use this procedure.

Modified Implant Surgery

Benefit:  

• No bone graft surgery
  
  
• Final bridge has 12 teeth
  

Downside: 

• Limited availability
              
  

                

Option 4:  "Teeth in a Day"

"Teeth in a Day" is a procedure where all of your unhealthy teeth are removed, the implants are placed and a provisional (temporary) bridge is connected to the implants.....all in one day.  Once the implants are anchored in the bone, your dentist will make the bridge and connect it to the implants.

"Teeth in a Day"

Advantage:  

• Reduced treatment time
  
  
• No bone graft surgery
  
  
• Temporary teeth > Bridge

Disadvantage: 

• Higher risk of implant failure
  
  
• Final bridge has 10-12 teeth
  
  
• Cannot use an Implant Guide
              
  

                

 

 

Surgical Options Summary:

1.    80-85% of people losing their teeth do not have enough bone in the back of their mouth for implants.

2.    The surgeon has 4 ways to manage this problem.

3.    The treatment selected will determine:

               a.  the amount of implant surgery

               b.  the number of the teeth in the final bridge

Surgery Type	Benefit	Downside
Grafted	12 Tooth Bridge	Bone Graft Surgery
*Standard	No Bone Graft Surgery	10 Tooth Bridge
**Angled	12 Tooth Bridge No Bone Graft Surgery	**Limited     Availability
"Teeth in a Day"	Reduced Treatment Time No Bone Graft Surgery Temporary Teeth > Bridge	Higher Implant Failure  10-12 Tooth Bridge Cannot use an Implant Guide

 
 *Standard Surgery is the most common type of implant surgery.

**Angled Surgery is a recent surgical development; not every surgeon will have the specialized training needed
   to place the implants in this way.  Angled Surgery is also known as "tilted implant surgery" and is used for the
   "All on 4" Treatment. 

After the implants have been placed
what kind of temporary teeth will I wear?

Permanent Implant Bridges:


A discussion about the types of implants bridges can become confusing.

Same word, different meaning

Same name, different types of bridge

So when you discuss the type of bridge, it's best to keep simple; focus on two things, and ask 2 questions:

-will I be able to remove these teeth from my mouth?

-what materials will be used to make the bridge?

There are three basic type of implant bridges.

There are three types of implant bridges.

• acrylic teeth connected to a metal frame
• porcelain teeth connected to a metal frame                      (Galatola bridge?)
  
• porcelain teeth connected to a zirconia frame

 

Learn More:  Implant Guides and Guided Surgery

 

What is an implant guide?

• a custom made appliance that shows the positions of your new teeth
  
  
• when placed in your mouth, the surgeon knows exactly where
  to place the implants

 

Why are implant guides so important?

• a successful bridge should look natural, feel comfortable and be easy to clean
  
  
• this result is only possible when the implants are placed in the correct positions
  
  
• allow for accurate implant placement, increase safety and predictability
  and reduce complications
  
  
  
  

How is it used?

An implant guide is placed in the mouth and is similar to the blueprint for a new house:  

• the blueprint shows the contractor where to put the foundation for the house
  
  • if the foundation is not correct, the contractor cannot build the planned house
    
    

• the surgical guide helps the surgeon place the implants in the correct position:            
  
  • if the implant positions are not correct, the dentist cannot make a successful implant bridge
    
    
    

There are 3 types of implant guides:

An accurate guide should:

• show the positions of the new teeth of the bridge
• not move during the implant surgery

Type 1:   Hand-held Guide
                                                           
Benefit:  

• Shows the new teeth
  
  
  •  implants are placed through the opening behind the teeth

Downside: 

• Low accuracy
  
  
  • this guide is difficult for the surgeon to hold steady
    when placing the implants
    
    
    
    
    

 

Type 2:  Anchored Guide 

Benefit:  

• Improved accuracy
  
  
  • guide is anchored with a metal pin
     

Downside: 

• Does not show new teeth
  
  
  • vertical lines help with correct implant spacing
    
    

Type 3:  Surgical Template
 
Benefit: 

• High accuracy
  
       * guide is anchored with multiple pins
  
  

• The guide is based on the positions of the new teeth
  
  
  • computer software and a virtual 3-D model of the new
    teeth are used to design and make the template
    

 

 

 

 

 

Downside:  

• New Procedure
  Recent surgical innovation / development
  
  
• not every surgeon will have the specialized training needed
  to design and use the template
  
  

  

Implant Guide Summary:  

1.  The appearance and comfort of your new teeth depends on correct implant positions.

2.  To achieve the best positions, the surgeon should use an implant guide.

3.  There are 3 types of implant guides. 
 

Type of Implant Guide	Advantage	Disadvantage
Hand-Held	Shows new teeth	Low accuracy
Anchored	Improved accuracy	Does not show new teeth
Template	High accuracy Shows new teeth	*New procedure

* The use of a template is a recent development in implant surgery; not every surgeon will have the specialized training needed
   to design and use the template.

What type of implant bridge will replace my teeth?

 

The following information will provide.....

Rehabilitation Concepts for Patients Losing their Teeth_USA.pdf

Full Arch Rehabilitation with the All-on-4 Concept_ 2010.1_70472G_GB.pdf

Quick Restorative Guide for Full Arch Implant Bridges_GMT39641.pdf

Guided Surgery Concept Manual 2016_79425A.pdf

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

Option 1:  Grafted Implant Surgery

This type of surgery builds up bone in the back of the mouth by placing bone graft material in the sinus spaces of the upper jaw.

Step 1: Sinus graft or Sinus lift surgery (grafts in red)               (Surgeon must wait 6 months for grafts to               harden before the implants can be placed)

Step 2: Grafted Implant surgery              (Dentist must wait an additional 6 months               before they can start treatment)

Procedure:     Grafted Implant Surgery

Benefit:

• Final bridge has full 12 teeth

Downside: 

• Bone graft surgery needed
  
  
  • Increases time by 9-12 months
  • Increases costs
  
  

• Treatment requires 2 surgeries:
  
  
  • Step 1: Sinus graft surgery
  • Step 2: Grafted implant surgery

 





        

 

Back to Compare Implant Surgery Options

Option 2: Standard Implant Surgery 


This type of surgery avoids bone graft surgery by placing all of the implants toward the front of the mouth where this is enough  bone.

	Standard Implant Surgery         (most common surgery when there is not enough          bone back of the mouth)

Procedure:     Standard Implant Surgery

Advantage:

• No bone graft surgery needed
  

Disadvantage: 

• Final bridge has only 10 teeth
  
  
  • back implants are small or short and cannot support a full 12-tooth bridge
    

Back to Compare Implant Surgery Options

Option 3:  Modified Implant Surgery


This type of surgery places the back implants at a forward angle to avoid the sinus space.  This eliminates the need for bone graft surgery.

	Modified Implant Surgery       (Implants placed at a forward angle to avoid the sinus)
	Additional implants support the front of the bridge

Procedure:     Modified Implant Surgery

Advantage:  

• Final bridge has 12 teeth
  
  
• No bone graft surgery needed
        to place the implants
  

Disadvantage: 

• New procedure
  
  
  • not every surgeon will have the specialized training to use this procedure            

               

Back to Compare Implant Surgery Options

 

 

"Teeth in a Day"

This information for this page is being developed and should be available soon.

 

Back to Compare Implant Surgery Options