Implants and bridges close unsightly gaps between teeth when a tooth has had to be extracted. But when is which solution better? Which lasts longer: bridge or implant? What are the advantages and disadvantages of both methods? And what do they cost? Our expert Dr. Dr. Manfred Nilius provides answers to these questions in an interview.
Implant: artificial tooth root
Dental implants are based on artificial tooth roots that are surgically fixed in the jawbone so that a dental prosthesis can be attached to them, such as a crown, bridge or removable denture. Whereas the jawbone of wearers of partial and full dentures often recedes due to incorrect loading, resulting in instability, dental implants are firmly anchored in the bone like a tooth of their own. The small artificial roots made of titanium or zirconium oxide provide a secure hold for the crowns or bridges attached to them, giving patients a perfect bite. “No method replaces missing teeth so naturally and inconspicuously,” emphasizes maxillofacial surgeon Dr. Dr. Manfred Nilius. Using state-of-the-art computer technology, the implantologist calculates the position, angle and size of the optimal implant down to the millimeter and then plants it exactly where the root of the lost tooth was originally located.
Bridge: Bridging gaps between teeth
To close gaps between teeth, the fixed bridge is a proven method, and there are different types of bridges. Dental bridges are usually made of metal veneered with tooth-colored ceramic. Smaller versions are often made entirely of high-performance ceramics, which can withstand high chewing forces in the area of the posterior teeth. The bridge takes its name from the fact that it bridges a gap between teeth by being attached to the adjacent teeth. In addition to a pontic that spans the gap, two anchor crowns are required, which are placed on the teeth to the left and right of the gap. Before this, however, the teeth have to be ground down, just as with a normal crown. Thanks to stable metal frameworks, several missing teeth can also be bridged. Bridges of the new generation are made of bioceramics and can be computer-assisted milled. Often both variants, bridge and implant, are combined, so that entire rows of teeth of up to twelve can be replaced on just four or six implants.
Implant or bridge? Interview with expert Dr. Dr. Nilius
Find out what you always wanted to know about bridges and implants and what else you should know below. Expert Dr. Dr. Manfred Nilius answers the most frequently asked questions on the subject.
When is an implant particularly useful?
With the help of an implant, a firm anchorage is also possible where no natural one is available. The advantage: grinding down healthy teeth is unnecessary, as the implants are fixed directly in the jaw and not to the tooth walls as with a bridge.
In which cases is a bridge still the better solution?
A bridge is the first choice when both adjacent teeth are also affected. This is because in this case, they are optically provided for without additional costs.
When should an implant be avoided on principle?
Implants are only recommended to a limited extent in the case of diabetes, leukemia, heart disease or severe disorders of the immune system. The same applies to certain medications or drug addiction. In these cases, a discussion with the family doctor is absolutely necessary beforehand.
What are the specific disadvantages of both methods?
Implants: As a rule, the costs are higher than for conventional bridges. In addition, drilling into the jawbone is required, albeit minimally invasive. In the upper jaw, attention must be paid to the sinus. In the lateral mandibular region, it is important to spare the sensory nerves. Bridges: These are often perceived by patients as more of a foreign body. They can slip and wobble and do not provide as firm a fit as implants firmly anchored in the bone. Often, a lot of tooth substance has to be sacrificed in order to be able to fabricate a beautiful new crown. In addition, with bridges with metal frameworks, the dark crown margin often shimmers through the mucosa.
Are there any risks?
Implants: Wound healing problems may occur. In smokers, the success rate of currently about 98.8 percent is significantly reduced. Serious risks are not known. Bridge: Tooth nerve damage with subsequent nerve removal and tooth discoloration may occur.Loss of the tooth and thus the loss of the entire bridge is possible. In addition, hygiene problems may occur under the pontics, as cleaning is difficult.
Can implants cause allergies?
Instead of conventional materials such as gold and steel, “gentler” materials such as “zirconia” ceramics are now increasingly being used for implant abutments. This takes the problem of metal intolerance, which is not uncommon, off the table. And there is also something to be said for implants as an alternative in terms of appearance: the gray shimmer that used to be common with implants is guaranteed to be no longer an issue.
How long do modern implants and bridges last?
Implants: With proper care, they last a lifetime. Bridges: 15 years and longer.
How are dentures “anchored”?
Implants: A scalpel is unnecessary with modern methods. Instead of cutting open the mucous membranes, implantologists punch holes. Quite new is the “corkscrew method.” Special laser technology and a corkscrew-like thread make it possible to anchor the implant with a single hole that is only two millimeters tiny. The advantage for the patient: The wound heals faster, swelling and pain are significantly reduced. Bridges: In addition to a pontic that spans the gap, two anchor crowns are placed on the teeth to the left and right of the gap as a retainer.
Is an implant possible even with little bone substance?
Usually, the jawbone of a tooth gap provides sufficient substance for an implant with ceramic abutment. If this is not the case, the missing bone can be built up with artificial replacement materials and/or the patient’s own body tissue.
How much do dentures cost?
Implants: 1,500 to 2,500 euros costs the implant, plus abutment and dental crown. Bridges: from 1,500 euros.
Does the health insurance fund pay part of the cost?
Yes, for the bridge, the costs are covered by the health insurance. For implants, the statutory health insurance does not usually cover the costs. However, the insurance companies often pay a fixed subsidy in the amount of the standard treatment. Talk to your dentist in advance about the costs and the treatment and cost plan.
What should I look for when choosing a doctor?
If you decide to have an implant, the oral surgeon or dentist should have advanced training as an implantologist.
