Implants Vs. Tooth Crowns


 by Donna Pleis, RDH, BSBA

Dental implants and fixed bridge crowns are options to replace missing teeth. You and your dentist will need to discuss your individual case to find the option that’s right for you.

Dental implants and fixed bridge crowns are options to replace missing teeth. You and your dentist will need to discuss your individual case to find the option that's right for you. Dental implants involve attaching your new teeth to the jawbone itself, while bridges consist of crowns that use your natural teeth for support. If your dentist feels you are a good candidate for either procedure, the choice may come down to out-of-pocket expenses and personal preferences.

Crowns and Fixed Bridges

Crowns are porcelain or ceramic prosthetic teeth that fit over your existing teeth. Sometimes a crown is placed over a badly decayed tooth as part of the process to repair that tooth. When 1 or 2 teeth are missing, a fixed bridge can be used to fill the gap. To do this, your remaining good teeth on each side of the gap are ground down so that crowns can be placed over them. The 2 crowns form the opposite ends of the bridge, and the replacement tooth or teeth form the middle of the bridge. The entire bridge is permanently cemented onto the natural supporting teeth.

Advantages of Fixed Bridges

Fixed bridges have some of the same advantages as dental implants. They give more stability for chewing and speaking than removable partial dentures, and they look more like your own teeth. In addition, the permanent nature of this type of replacement prevents the other teeth from shifting out of position, which helps maintain proper tooth alignment and helps to preserve your bite. Cleaning is much the same as for your natural teeth, in that there are no dentures to soak. Fixed bridges tend to be less expensive than implants.

Dental Implants

A dental implant involves surgically placing a support -- a titanium cylinder, screw or blade, for instance -- into your jawbone. The term implant can refer to the procedure or this titanium support structure itself. The metals used in implants are compatible with the body and, over time, cells from your jawbone will attach directly to the metal in a process called osseointegration. After the implant is securely fused to bone, your dentist will attach a prosthetic tooth on top of the implant. The resulting connection between this tooth and your jawbone is thought to be more natural and beneficial for maintaining healthy bone.

Advantages of Dental Implants

Like bridges, implants don't shift or slip. They are as stable as natural teeth, allowing you to chew and speak easily. Unlike bridges, they don't rely on other teeth for support, so no tooth structure is lost or ground down from neighboring teeth. Implants maintain the contour of your face and preserve bone where a tooth has been pulled. They also prevent other nearby teeth from shifting. You can clean implants just as you do your natural teeth -- you do not take them out at night for soaking.

Other Considerations

Your dentist will consider your general health and your oral health. Not everyone can have implants, and not everyone can have elective oral surgery. Certain chronic illnesses like diabetes, for instance, can interfere with healing, as can smoking. According to an article in the June 2007 issue of the "Journal of Clinical Periodontology," smoking more than doubles the likelihood that an implant procedure will be unsuccessful. Healthy gums and strong jawbones are requirements for both implants and fixed bridges. Implants require a foundation of bone to work with to support the implant fixture. Out-of-pocket expenses may be greater with implants than bridges, but this can vary depending on your insurance.

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