John E. Hutton, DDS, MS, MPH

As a Board Certified prosthodontist  I have the pleasure of seeing people from a very broad range of the 5 Cities area, the state, the other states of the U.S. and even form other countries. Many of these are referred by my colleagues spread out over the globe  Some of these individuals have old implants that are still healthy and functional but need replacement of their overlying restorations for various reasons.  Often the implant companies no longer exist or cannot be located and therefore replacement parts are not easily available.  This makes the restoration more difficult but not impossible. I have never had to tell someone that they should have their implants removed and to start over. I also see many people who have had their implants placed by surgeons in the area but they come to me for their restoration.  There is much less difficulty encountered while fabricating their restoration.  For many people I have the pleasure of both placing the implant and fabricating their restoration.   In these situation the most appropriate implant can bee matched to the most ideal abutment parts and restoration type.    

The type of implant restoration which is most appropriate for you as an individual  is as varied as the number of people on planet earth and is greatly influenced by your desires and goals ( ie. what do you expect from your implant restoration, what is your time line for completion, and what is your budget?).  Is your implant restoration in the aesthetic zone or is it a molar far back in your mouth?  Do you wish for the restoration to be fixed or do you think a removable restoration would be easier for you to clean? 

Many people who come to me have consulted other practitioners and have received a single implant/restoration recommendation.  I do not agree with the concept that one approach fits all but think that the treatment planner should be flexible enough to identify the patients wants and needs and let those if at all possible drive the design.  And then discuss in detail the advantages and disadvantages for the selected treatment plan. .Another way of stating this is to review and understand the benefits and risks of implant/restoration treatment.     

Even a cursory review of the available implant restorations would require an entire text book of encyclopedic size.  Therefore this discussion is limited to the main categories of restorations and gives some internet links for the reader that wants a more detailed discussion. 

One way of categorizing dental implant restorations is to divide them roughly  into four groups determined by the number of teeth being replaced: 

1) Single tooth replacement (single crown on a single implant). 

2) Fixed bridge or partial denture (multiple splinted crowns and pontics on multiple implants). 

3) Full arch fixed restoration (fixed implant restoration replacing all of the upper or lower teeth on a strategically placed implants).

 4)  Implant supported and retained removable complete denture or partial denture (removable implant restoration replacing all of the

upper or lower teeth)

 .

Each of these categories can be subdivided by the implant brand and size, the abutment style (straight or angled), whether the restoration is attached by a screw or cemented to place and what materials the restoration is made of (all metal, a combination of metal and ceramic, a combination of metal and resin, or all ceramic.   .

If you have questions about implant restorations or would like to schedule a consultation, please contact our office.