After placing the dental implants and attaching abutments, comes the time to make the new replacement teeth.
This is called the prosthetic phase, and technical expertise is needed, especially if a patient has multiple teeth replaced. In this phase, a prosthodontist or a restorative dentist makes sure that the mouth gets back the function, integrity and aesthetics.
Preparing the Implant Crowns
Using the impressions of the teeth and abutments done by the restorative dentist, the technician makes new crowns, most often fusing porcelain with metal. The colour of the cowns is consulted with the dentist so as to look natural. There are two ways of mounting the crowns on the abutments. The first way is by cementing and the second by retaining them with tiny titanium screws. The choice will be made based on the location of the gap, either by the dentist or the prosthodontist. The advantage of using screws is that replacing, loosening or retightening the crowns becomes easier. However, for aesthetic reasons they are mostly used on the posterior teeth. Cementing is commonly used for anterior crowns because it is a lot better for appearance. When the laboratory technician completes the crowns they are fitted and if everything works they are attached to the abutments.
Permanent Implant Prosthesis
As in the case of implant crowns, new replacement teeth need impressions of the abutments and the proper shade to be chosen. With this data, the technician is now ready to develop the new replacement teeth, and all the additional structures necessary for securing the prosthesis. There are two types of prosthesis, acrylic, which is a very hard plastic, and porcelain. Whether one or the other is used is dependant on bite strength, aesthetic requirements and factors, such as teeth grinding. Before the prosthesis is placed, there is research is needed, trying out the framework, checking if it is properly fitted and positioned and the overall appearance. All this can take a couple of appointments at the dentist. The last stage is attaching the prosthesis using the screws to the abutments so they are secure, and the patient is unable to remove them.
Overdentures – retained dentures
Making overdentures for existing dentures is much the same. There are mouth and abutment impressions made, the shade is selected and send to the technician. The laboratory technician makes overdentures, which have attachments that fit specifically to the abutments. The technician will also fabricate the overdentures, which are supported with a bar fitted between the implants and abutments. Before the replacement teeth can be placed, they need to be properly fitted and positioned, which could take a couple of visits to the restorative dentist. The overdentures can be secured to the attachments of the abutments, or the bar, when factors like position, fit and appearance require. The patient is able to remove the overdenture for cleaning.