REPLACING A CONGENITALLY MISSING
TOOTH OR LOST TEETH WITH DENTAL IMPLANTS 

The single missing tooth in a dental arch allows for several restorative options. Conventional techniques include a removable partial denture, a cemented fixed bridge and a resin-bonded fixed bridge. Each of these options can be successfully used. However none of these alternatives can actually replace the original tooth and the way it emerges from the gingival tissue with the ability to maintain bone height. A prosthetic tooth, supported by an endosteal implant, may be the closest match to the natural tooth.

For a single missing tooth, the conventional removable partial denture would be an option of last resort. It is bulky, unaesthetic, and can be difficult to wear. The three-unit fixed cemented bridge is certainly a time-tested prosthodontic treatment option, however, it requires adjacent often intact teeth, be prepared as terminal abutments.  The acid-etched resin bonded bridge was first introduced as a conservative approach to tooth replacement. Most resin-bonded bridges involve nonrestored teeth, with minimal tooth preparations, to serve as retention. This bridge often results in over contoured bulky attachments on the lingual of the retention teeth, resulting in plaque traps. In one 10 year retrospective study, an overall debonding rate of 31% was recorded.

The implant-supported fixed prosthesis is an excellent alternative to replace a missing tooth if there is adequate width and height of remaining alveolar bone. Therefore, treatment planning for an endosteal root form implant requires accurate planning, but can result in a very realistic natural appearance that aides in maintaining bone height. The ability to restore the fully edentulous mandible and maxilla through the use of endosteal  implants, has expanded to include the partially edentate population. Conventional dental treatment options such as the removable partial denture, the three-unit fixed bridge and the resin-bonded retainer may need to be thought of as secondary treatment options, now that endosteal root form implants have been proven effective. The prosthetic tooth, supported by an endosteal implant emerges from the tissue attached to a "root" (the implant), in a manner which more closely resembles the natural tooth it replaces than any other treatment option available. In a clinical situation where there is adequate bone and adjacent virgin teeth, the single tooth implant restoration can certainly be considered as the primary treatment alternative.

Follow the links below to learn more about specific types of treatment utilizing dental implants

• Replacing a Single Congenitally Missing Upper Anterior Tooth with a Dental Implant

• Replacing Multiple Posterior Teeth with Dental Implants

• Extraction with Immediate Implant Placement and Bonded Provisional Restoration

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