Short answer: An implant-supported prosthesis is an artificial tooth or set of teeth attached to implants placed in the jawbone. Fixed prostheses are secured to the implants either by cementing or with screws and can be removed only by the dentist. Removable prostheses (overdentures), on the other hand, sit on the implants with attachments and are put in and taken out by the patient. The choice depends on the number of implants, bone condition, esthetic expectations and care habits.
Although implant treatment is often thought of as a single step, it actually consists of two main parts: the implant placed in the jawbone and the prosthesis made on top of it. The part that is visible in the mouth and works in chewing and speaking is the prosthesis. Implant-supported prosthesis options vary according to the number of missing teeth, bone condition, esthetic expectations and the patient's care habits. In this article we explain what an implant-supported prosthesis is, the differences between fixed (cement-retained and screw-retained) and removable options, which prosthesis may suit whom and what you need to know about care and lifespan.
What is an implant-supported prosthesis?
An implant-supported prosthesis is an artificial tooth or set of teeth that replaces missing teeth and is attached to titanium or zirconia implants that have fused with the bone. The implant takes the place of the natural tooth's root; the prosthesis replaces the crown, the part of the tooth visible in the mouth. The connection between the two is provided by an intermediate piece called an "abutment."
Implant-supported prostheses can be grouped by scope as follows: an implant crown for a single missing tooth, a bridge attached to two or more implants when several neighboring teeth are missing, and full-arch prostheses for jaws with no teeth at all. By the way they are attached, they fall into two main groups: fixed and removable.
The prosthetic stage begins once the implants have finished integrating with the bone (osseointegration). This period usually ranges from 2 to 6 months depending on bone quality and where the implant is placed. In suitable cases a temporary prosthesis can be fitted on the day the implant is placed; however, this decision is made by the dentist based on the implant's initial stability.
Fixed implant-supported prostheses: what is the difference between cement-retained and screw-retained?
Fixed implant-supported prostheses stay in the mouth permanently and cannot be removed by the patient; they are attached to the implants either by cementing (cement-retained) or with a screw (screw-retained). Both methods have advantages and limitations.
Cement-retained prostheses
After the abutment is screwed into the implant, the crown or bridge is fixed onto the abutment with a special cement, much like crowns made for natural teeth. Since there is no screw access hole on the surface, this can be an esthetic advantage, especially in the front of the mouth. However, excess cement left under the gum during cementing can cause inflammation around the implant (peri-implantitis), so it requires careful application. Removing it when needed is more difficult than with screw-retained prostheses.
Screw-retained prostheses
The crown or bridge is attached directly to the implant or abutment with a screw that passes through the prosthesis. The screw access hole opens on the chewing surface or the inner surface of the tooth and is sealed with a tooth-colored filling material. Its main advantage is that the dentist can easily remove the prosthesis by unscrewing it when a check-up, cleaning or repair is needed. Since no cement is used, the risk of inflammation from cement residue is eliminated. Today it is frequently preferred for full-arch fixed prostheses and bridges involving several implants. In some cases minor mechanical problems such as screw loosening can occur; these are easily corrected at check-ups.
What are removable implant-supported prostheses (overdentures)?
A removable implant-supported prosthesis, or overdenture, is a prosthesis that sits on two or more implants via attachments in a jaw with no teeth and that the patient can put in and take out. It looks similar to a conventional denture; however, because it holds onto the implants, it stays much more stable.
Attachment systems vary: ball attachments, magnetic or locator-type cap systems and prostheses that sit on a bar connecting the implants are some of them. Because the retention of a conventional complete denture is limited, especially in the lower jaw, an overdenture on two implants can markedly reduce complaints such as the denture moving and food getting underneath it. In the upper jaw more implants are usually needed, and in suitable cases it may be possible to design the prosthesis so that it covers less of the palate.
The advantages of an overdenture are that it can be done with fewer implants, that it can provide lip and cheek support when there is significant bone loss, and that it is easy to clean. The chewing sensation is somewhat different from fixed prostheses, and the retentive elements in the attachments need to be replaced at certain intervals.
Which implant-supported prosthesis suits whom?
Which prosthesis is suitable is determined by considering together the number of missing teeth, the amount and quality of bone, the number of implants that can be placed, the smile line, general health and the patient's expectations. As a general framework:
- A single missing tooth: Usually a screw-retained or cement-retained crown on a single implant.
- Several neighboring missing teeth: Instead of a separate implant for each missing tooth, a bridge attached to two or three implants may be planned.
- Jaws with no teeth and enough bone: A fixed full-arch prosthesis on four to six or more implants may be an option.
- People with advanced bone loss or who prefer fewer implants: An overdenture can be a good alternative; the acrylic part of the prosthesis provides lip support.
- People with limited manual dexterity: For ease of cleaning, removable prostheses or fixed prostheses designed to be easy to clean may stand out.
If neighboring teeth have tilted or shifted because of missing teeth, creating suitable space with orthodontic treatment before the implant may also come into consideration. At our clinic, orthodontic and prosthetic planning are done together in such cases.
How does the treatment process work?
The implant-supported prosthesis process starts with an examination and planning and is usually completed in several stages:
- Examination and imaging: Bone volume and anatomical structures are assessed with a panoramic X-ray and, when needed, a three-dimensional CT scan.
- Planning: The number of implants, their positions and the type of prosthesis are determined; fee information is provided in writing after the examination and planning.
- Implant surgery: The implants are placed in the bone under local anesthesia.
- Healing period: Time is allowed for integration with the bone; a temporary prosthesis can be used during this period.
- Impression and try-in: The model of the prosthesis is prepared from a digital scan or impression, and color and fit try-ins are done.
- Delivery: The prosthesis is fitted, the bite is checked and care instructions are given.
How should implant-supported prostheses be cared for, and how long do they last?
Using implant-supported prostheses without problems for many years depends largely on daily care and regular check-ups. Implants do not decay, but the gum and bone around them can become inflamed; if this is not treated, it can lead to implant loss.
- The underside of fixed prostheses and the areas around the implants should be cleaned every day with interdental brushes, a water flosser or special floss.
- Removable prostheses should be taken out and brushed every day, and the areas around the attachments should also be cleaned.
- If you clench or grind your teeth, a night guard may be recommended to protect the prosthesis.
- Since smoking increases the risk of inflammation around implants, quitting is recommended.
- Check-ups and professional cleaning should generally be done every 6-12 months.
With regular care, implants can function for many years; the prostheses on them, however, may need renewal or repair over time due to wear, chipped porcelain or worn retentive parts. For other topics you may be wondering about, take a look at our frequently asked questions page.
When should you get an assessment in Ankara for an implant-supported prosthesis?
If you have trouble chewing because of missing teeth, if your current denture moves, or if you have noticed movement, breakage or gum complaints with the prosthesis on your implants, an assessment is recommended. At our clinic in Park Oran Ofis, next to Panora Mall, your bone condition and expectations are evaluated together and the implant-supported prosthesis options that suit you are explained in detail.
Frequently asked questions
Which is better, a screw-retained or a cement-retained prosthesis?
Both methods have their own advantages, and the choice is made case by case. Screw-retained prostheses can be removed easily when needed and carry no risk of cement residue. Cement-retained prostheses may be preferred for esthetic reasons in some front-tooth cases.
Should a removable implant-supported prosthesis be taken out at night?
It is generally recommended to take out and clean removable implant-supported prostheses at night. This lets the gum tissues rest and keeps the area around the implants clean. Exact instructions for use are given by your dentist according to the type of prosthesis you have.
How many implants are needed for a full-jaw prosthesis?
In the lower jaw, a removable prosthesis can be made on two implants; fixed full-arch prostheses usually require four to six or more implants. In the upper jaw, more implants are usually planned because of the bone structure. The exact number is determined by the condition of the bone.
How long does an implant-supported prosthesis last?
Its lifespan depends on oral hygiene, chewing forces, clenching habits and regular check-ups. With good care, prostheses can be used for many years, but repair or renewal may be needed over time. Rather than giving a specific number of years, regular follow-up is recommended.
