Implant Supported Prostheses
Modern dentistry exhibits a holistic approach in compensating for tooth loss, aiming not only for aesthetic appearance but also for chewing function and the preservation of the jawbone. In traditional methods (bridges or complete dentures), while eliminating tooth deficiency, it may sometimes be necessary to cut healthy teeth, or bone resorption cannot be prevented. However, the development of dental implantology has completely changed the concept of prosthetics.
Restorations built upon titanium screws (artificial roots) placed in the jawbone, namely Implant Supported Prostheses, offer patients comfort and biomechanical balance closest to their natural teeth. Providing oral and dental health services in the Thrace region, Kırklareli Dental Clinic Atlas Sea Dental performs these advanced prosthetic applications in light of current literature and under sterile clinical conditions.
What is an Implant-Supported Prosthesis and How is it Classified?
Dental implants are structures that mimic the lost tooth root. However, the implant itself does not chew; the part that performs the chewing function and provides aesthetics is the prosthesis placed on the implant. Implant-Supported Prostheses are superstructures applied after the biological fusion (osseointegration) between the implant and the bone is completed. These prostheses are examined in two main categories based on the patient’s edentulism status, bone volume, and aesthetic expectations: Fixed and Removable.
- Fixed Implant Supported Prostheses These are prostheses that the patient cannot remove from their mouth, fixed by screwing or cementing to the implants. It is the option closest to the natural tooth sensation.
- Single Crowns: In a single tooth deficiency, it is a porcelain crown made on a single implant without touching the neighboring teeth.
- Implant-Supported Bridges: In multiple tooth deficiencies, it is a system applied by making a bridge body between implants placed at the beginning and end of the gap. For example, a 3-unit prosthesis can be made on 2 implants for a 3-tooth deficiency.
- Hybrid Prostheses (All-on-4 / All-on-6): In cases of total edentulism, these are screwed systems fixed on 4 or 6 implants placed at strategic angles in the jawbone, usually including gingival aesthetics. Kırklareli Dental Clinic Atlas Sea Dental physicians frequently evaluate these methods to provide fixed comfort in fully edentulous patients.
- Removable Implant Supported Prostheses (Overdenture) Preferred in fully edentulous patients where the bone structure is not suitable for making a fixed prosthesis or where more economical solutions are sought. The prosthesis can be removed and cleaned by the patient, but it does not move while in the mouth because it is supported by implants.
- Ball Attachment: The ball-shaped parts at the tip of the implants fit into the sockets inside the prosthesis with a “snap” logic.
- Bar Attachment: It is a denture that sits on a metal bar connecting the implants. Its retention and stability are very high.
Screw-Retained Systems or Cemented Systems?
The way Implant-Supported Prostheses are connected to the implant is a technical detail that affects the long-term success of the treatment.
- Cemented Prostheses: Like natural tooth veneers, they are fixed to the abutment attached to the implant with special adhesives. It is advantageous because the screw hole is not visible aesthetically, but excess adhesive residue can lead to gum inflammation (peri-implantitis).
- Screw-Retained Prostheses: The prosthesis is fixed with a screw that goes into the implant. There is a small screw hole on the chewing surface of the prosthesis, and this hole is closed with composite filling. The biggest advantage is that in case of any problem (porcelain fracture, screw loosening, etc.), the physician can open the filling, remove the screw, and easily remove the prosthesis. Today, screw-retained Implant-Supported Prostheses have become more popular because they are “retrievable”.
Materials Used and Technological Infrastructure
Materials used in implant-supported restorations require higher durability than traditional prostheses. This is because while the periodontal ligament (elastic fibers) around natural teeth absorbs chewing force, implants are directly connected to the bone and have no margin for stretching. Therefore, the material of Implant-Supported Prostheses must transmit forces correctly.
- Metal-Supported Porcelain: A traditional and economical method. There is a gray metal infrastructure under the porcelain. Preferred in posterior teeth due to durability.
- Zirconia-Based Porcelain: A metal-free, white-colored, and tissue-friendly material. It captures natural tooth aesthetics thanks to its light translucency. Its compatibility with the gum is excellent. Zirconium is frequently preferred in aesthetic zone implant applications within Kırklareli Dental Clinic Atlas Sea Dental.
- Monolithic Zirconia: Obtained by milling block zirconium without processing porcelain on it. Since there is no risk of porcelain chipping, it is the safest option for patients who grind their teeth (bruxism).
- PEEK and Hybrid Materials: Polymer-based materials with a modulus of elasticity close to bone, used to absorb force and provide lightness, especially in systems like All-on-4.
Clinical Application Stages
he construction process of Implant-Supported Prostheses consists of two main phases: surgical and prosthetic. The prosthetic phase begins after the fusion of the implant with the bone (osseointegration) is completed.
- Healing Cap and Gingival Shaping: The top of the implant is opened, and healing caps (gingiva formers) are attached to give the gum a natural emergence profile. This stage is critical for the prosthesis to look like it is emerging from the gum like a natural tooth.
- Impression Taking: After the gums are shaped, the impression stage begins. While “transfer parts” are used in traditional methods (silicone impression), digital impressions can be taken by intraoral scanning with special parts called “scan-bodies” in clinics adopting digital workflows like Kırklareli Dental Clinic Atlas Sea Dental. This method offers an error-free and comfortable process.
- Try-in Sessions: The infrastructure (metal or zirconium) prepared in the laboratory is rehearsed in the mouth. Adaptation with the implant, passive fit, and height are checked. Then, an aesthetic rehearsal where teeth are arranged is performed.
- Delivery and Torquing: When everything is ideal, Implant-Supported Prostheses are placed. In screw systems, screws are tightened at the Newton value (torque) determined by the manufacturer to prevent loosening risks.
Biomechanical Advantages and Functional Contributions
The most important advantage of implant supported prostheses is that they preserve the jawbone. The bone left empty after tooth extraction melts (resorption) over time. However, the implant stimulates the bone just like a natural tooth root, stopping resorption. In addition, problems such as prosthesis movement, teeth flying out while speaking, or pain while eating seen in patients using total dentures are completely eliminated with Implant-Supported Prostheses (especially overdenture or hybrid systems). Chewing efficiency is around 20-30% in total dentures, while it goes up to 90-100% in fixed implant supported prostheses. This directly improves the patient’s nutritional quality and, consequently, general health.
Post-Treatment Maintenance and Importance of Hygiene
Neglecting oral care with the thought that “implants do not decay” is the biggest mistake that can lead to the loss of treatment. Gum disease seen in natural teeth is called “Peri-implantitis” around implants. The undersides of Implant-Supported Prostheses are areas prone to food accumulation.
- Interdental Brushes and Floss: The undersides of fixed bridges should be cleaned with “superfloss” or interdental brushes.
- Oral Irrigator: Pressurized water is the most effective tool for removing residues under the prosthesis.
- Regular Check-up: Whether the screws are loose, bone level, and gum health should be checked every 6 months. Kırklareli Dental Clinic Atlas Sea Dental aims for the long life of prostheses by offering an implant passport and regular follow-up program to its patients.
Complications and Management
As with any medical procedure, some technical problems may occur in Implant-Supported Prostheses.
- Screw Loosening: Intermediate screws may loosen depending on chewing forces. They are tightened by torquing by the physician.
- Porcelain Chipping: Small fractures may occur in porcelain as a result of hard foods or teeth grinding. It can be corrected with polishing in the mouth or repaired if large.
- Food Impaction: If a gap occurs between the prosthesis and the gum, food may accumulate. In this case, the base of the prosthesis is relined in the laboratory and adapted.
Regional Access and Health Service Standards
The Thrace region has a technological infrastructure that rivals Istanbul in the field of dentistry. Kırklareli, in particular, has become an important center for health tourism and patients coming from surrounding provinces. Institutions like Kırklareli Dental Clinic Atlas Sea Dental manage the entire process from implant surgery to the prosthetic stage under a single roof, increasing patient treatment comfort. Implant-supported prosthesis treatment is not just a “tooth insertion” process; it is a blend of engineering and biology. Correct adjustment of occlusion, equal distribution of forces to implants, and correct selection of material require expertise.
Implant Supported Prostheses are the most advanced, comfortable, and biologically compatible treatment method developed against edentulism. These systems, which eliminate the feeling of insecurity created by removable dentures and prevent the cutting of healthy teeth for fixed bridges, are a direct investment in quality of life. Whether for a single tooth deficiency or total edentulism, a suitable implant supported solution is available for every case. The success of the treatment is directly proportional to the correct indication, use of quality materials, physician’s experience, and the care the patient shows for oral hygiene.
Current protocols applied within Kırklareli Dental Clinic Atlas Sea Dental ensure that patients regain their aesthetic smiles and chewing functions with confidence. It should not be forgotten that a successful implant prosthesis is not just a material standing in the mouth, but the recovery of lost living comfort.
