We often are asked about tooth replacement options. There are different options available depending on how many teeth are missing, and the health of the teeth and bone around the missing teeth.
For one to two adjacent missing teeth, here are a few biocompatible options for consideration, along with their benefits, drawbacks, and approximate costs:
Zirconia Dental Implant
- Benefits: No need to drill on adjacent teeth; can easily floss; biocompatible; looks and functions very similar to natural teeth
- Drawbacks: Needs adequate bone height and width; no very-long-term studies on possible material fatigue and fracture
- Cost: cost of CBCT (~$250), cost of possible bone grafts at a specialist’s office (cost varies greatly), and cost of each zirconia implant+abutment+crown (~$6000)
Conventional Zirconia-Porcelain Bridge
- Benefits: Replaces one tooth, or two adjacent missing teeth
- Drawbacks: Need to drill on all surfaces of adjacent teeth; more difficult to floss than an implant; if one margin fails the entire bridge may need to be replaced; the teeth that it will be anchors need to have good bone support
- Cost: ~$4400 (3-unit bridge consisting of 2 crowns and 1 pontic) or ~$5600 (4-unit bridge consisting of 2 crowns and 2 pontics)
Maryland-type Zirconia Bridge
- Benefits: Saves a lot of the enamel around the teeth by using inlay/onlay type of tooth preparation for support; easily cleansable margins in enamel which can prolong the life of the bridge
- Drawbacks: more difficult to floss than an implant; if the margin between the teeth fails, the entire bridge may need to be replaced, however if one of the easily accessible margins fails, it may be possible to place a filling in the area and keep the bridge without replacing it; in some cases the inlay or onlay may not be as strong as a full coverage crown and may fracture
- Cost: ~$4400 (3-unit Maryland-type bridge consisting of 2 inlays/onlays and 1 pontic) or ~$5600 (4-unit Maryland-type bridge consisting of 2 inlays/onlays and 2 pontics).
Maryland-type Composite Bridge
- Benefits: Saves a lot of the enamel around the teeth by using minimal tooth preparation for support; bonds directly onto the adjacent teeth
- Drawbacks: more difficult to floss than an implant; if the margin between the teeth fails, the entire bridge may need to be replaced, the Maryland-type composite bridge works best for front teeth, but may not be strong enough for back teeth; it is not strong enough for two adjacent missing teeth
- Cost: ~$1500 (3-unit Maryland-type composite bridge consisting of reinforced retainer wings and 1 composite pontic)
A partial denture
- Benefits: Replaces missing tooth; if another tooth fails its possible to add another tooth to the partial; can use even when adjacent teeth are weak
- Drawbacks: It needs to be removed at night to allow gums to rest; interferes with speech (until the tongue learns the new position of the acrylic); feels bulky but most eventually get used to it.
- Cost: ~$2,200
For three to four adjacent missing teeth, here are a few options:
Zirconia Implant Bridges
- Benefits: Biocompatible
- Drawbacks: No very-long-term studies on possible material fatigue (implant fracture); needs adequate bone height and width
- Cost: Approximately $6000 per implant and an additional ~$1200 for each pontic (piece of bridge where there is no supporting tooth or implant)
A partial denture
- Benefits: Replaces missing teeth; if additional teeth fail its possible to add them to the partial; can use even when adjacent teeth are weak
- Drawbacks: It needs to be removed at night to allow gums to rest; interferes with speech (until the tongue learns the new position of the acrylic); feels bulky but most eventually get used to it
- Cost: ~$2,200