Fixed Implant-Supported Prostheses

Table of Contents

Fixed implant-supported prostheses are one of the most effective and permanent solutions for tooth loss. These prostheses, which are specially designed on titanium implants placed in the jawbone, function like your natural teeth and allow you to have an aesthetic smile.

Since they are fixed, they cannot be removed by patients and give the feeling of natural teeth. They offer the closest solution to natural teeth in terms of aesthetics, durability, function and comfort. With proper planning and regular maintenance, they can be used comfortably for many years. It prevents the jawbone from melting and restores chewing functions.

Fixed implant-supported prostheses are selected according to the patient’s needs, aesthetic expectations and economic situation. Since each method has its own advantages and disadvantages, a detailed examination and treatment planning is essential. When determining the most suitable treatment option, the dentist pays attention to the bone condition, chewing force and the patient’s oral hygiene.

Who Is It Suitable For?

Individuals with missing teeth.
Patients with sufficient jawbone density.
Individuals who are in good general health and can tolerate surgical procedures.

Unsuitable Conditions

Those whose diabetes is not under control.
Those with high cigarette use (May reduce implant success).
Those with bone insufficiency (bone graft support may be required).

Types of Fixed Implant-Supported Prostheses

Single Tooth Implants

Applied in the absence of a single tooth. Implants are artificial tooth roots placed in the jawbone. Missing teeth are completed by placing fixed prostheses on these implants. No treatment is required for other adjacent teeth. An implant is placed in place of the missing tooth and a crown made of porcelain or zirconium is placed on it.

Prostheses on Multiple Implants

Applied in the absence of more than one tooth. Implants are placed at both ends of the missing teeth and the gaps in between are closed with a bridge prosthesis supported by the implants.

Full Arch Prostheses

Applied in fully edentulous mouths. It is designed to replace all teeth in one jaw and is fixed to implants. All-on-four and All-on-six systems belong to this group. It is preferred in cases where all upper or lower jaw teeth are missing. The entire jaw prosthesis is placed on only 4 or 6 implants.

Hybrid Prostheses

Applied in completely edentulous patients. Hybrid prostheses are solutions that combine the aesthetic and functional features of fixed prostheses with the cleanability of removable prostheses. It has a metal substructure and is prepared using acrylic or porcelain materials in the appearance of teeth and gums. It can be applied in completely edentulous patients, in cases with serious resorption in the jawbone, and in advanced cases requiring prosthetic rehabilitation.

Advantages of Fixed Implant-Supported Prostheses

Provides an appearance compatible with your other teeth.
It is resistant to chewing and biting forces like natural teeth.
You can use it comfortably like your own teeth.
Implants stimulate the jawbone and prevent melting.
There is no need to cut adjacent natural teeth.
Can be used for life with proper care.

On the other hand;

It is more expensive than traditional prostheses.
It takes time for the implant to fuse with the bone.
May involve risks such as infection, implant loss, or healing problems.
Patient’s systemic disorders, smoking, and oral hygiene neglect may cause implant loss.

Application Process of Fixed Implant-Supported Prostheses

Your dentist will evaluate your oral structure in detail and create your treatment plan.
Titanium implants are placed in the jawbone.
A certain period of time is waited for the implants to integrate with the bone.
Healing abutments are placed.
The gums are shaped and prepared for prosthesis placement.
Precise measurements are taken and sent to the laboratory for the preparation of the prosthesis.
A temporary prosthesis is placed on the implant and aesthetic harmony is evaluated.
After the healing process, prostheses are fixed on the implants.

Types of Materials Used

Metal Supported Porcelain (PFM)

Durable and long-lasting. Due to the metal substructure, the light transmittance is low, so it is preferred in the posterior teeth.

Full Ceramic Prostheses

Gives the best result aesthetically. Especially used in anterior teeth.

Zirconium Prostheses

Durable and high light transmission. Since it does not contain metal, it is biocompatible and aesthetically natural.

Care of Fixed Implant-Supported Prostheses

Brush your teeth at least twice a day.
Use dental floss for interdental cleaning.
It is used to clean between implants.
Oral showers help to clean plaque and food debris.
You should go to the dentist for check-ups every 6 months.

Cemented Implant-Supported Veneers

Cemented implant-supported veneers are fixed onto the implant by the dentist with a special adhesive (cement). These prostheses give the closest results to the appearance of natural teeth.

Applied in single tooth deficiencies, multiple missing teeth, and in cases requiring aesthetic and functional restoration.
No visible screw hole, unlike screw-retained prostheses.
Provides good marginal fit and reduces leakage risk.
Easier to install and align.

However;

If repair is required, the prosthesis may not be removed without breaking.
If the cement is not completely cleaned, risk of infection (peri-implantitis) increases.
Maintenance and revision procedures may be complicated.
Generally, zirconium substructure-supported porcelain or monolithic zirconium crowns are preferred due to aesthetics.

Screw-Retained Implant-Supported Veneers

Screw-retained implant-supported veneers are prostheses that are attached with a screw to the abutment (connecting part) placed directly on the implant.

Applied in single tooth deficiencies, multiple missing teeth, and complete edentulism.
Ideal when crown height is short or bone support is insufficient.
When angled implant placement is necessary, multi abutments ensure proper alignment.

Advantages

Can be easily removed for maintenance, repair, or revision.
No adhesive used, reducing cement-induced peri-implantitis risk.
Placement angle can be adjusted.

Disadvantages

Requires more careful and sensitive work.
Aesthetic concerns due to visible screw hole (especially in anterior region).
Screws may loosen or break.
Generally more costly than cemented prostheses.

Classification of Screw-Retained Implant-Supported Veneers

a) In the absence of a single tooth: Single tooth implant-supported veneer on T-base
b) In the absence of multiple teeth: Bridge-shaped screw-retained veneers made on multi abutments
c) In full arch edentulism: Full arch prostheses fixed on 4 or 6 implants (e.g., All-on-Four, All-on-Six, Hybrid prostheses)

All-on-Four

4 implants are placed in the upper or lower jaw.
Posterior implants are angled for stronger bone support.
Temporary prosthesis can be placed on the same day if stability is sufficient.
However, implant loss may disrupt the whole system — oral care is crucial.

All-on-Six

6 implants are placed per jaw.
Provides better support for chewing forces.
Preferred in patients with excessive bone loss.
Although costlier, offers longer-term system continuity.

Hybrid Prostheses

Combines fixed prostheses’ functionality with removable prostheses’ cleanability.
Metal substructure, acrylic or porcelain tooth-gum design.
Ideal for fully edentulous patients or severe resorption cases.

Advantages

Long-lasting metal support
Natural imitation of gums and teeth
Easy repair due to removability
More affordable than fixed prostheses

Disadvantages

Heavier due to metal
Infection risk if not cleaned properly
Porcelain aesthetics are better than acrylic

Removable Implant-Supported Prostheses (Overdenture)

Placed on specially prepared supports on implants in the jawbone. Ideal for patients with insufficient support in the jawbone.

Includes:

Locator-connected prostheses
Ball attachment prostheses
Bar prostheses

Each has unique benefits and uses.

Who Can Apply?

Completely edentulous individuals
Patients with sufficient bone or who can receive grafting
Patients who don’t want removable traditional prostheses

Overdenture Prosthesis Application

Intraoral examination and diagnosis
Preservation of root or placement of implants
Preparation of supports
Measurement and fabrication of prosthesis
Fitting and adjustment by dentist

Overdenture prostheses provide stable, comfortable, bone-preserving long-term solutions.

Types of Removable Implant-Supported Prostheses

Ball Attachment Prostheses

Uses balls on implants and corresponding sockets
Easy to wear and clean
Economical
Slightly more mobile

Locator-Connected Prostheses

Uses magnetic attraction for tight fit
Low mobility
Easy to clean
More costly

Bar Prostheses

Metal bar placed on implants
Very firm and stable
Natural chewing/speaking function
More complex and expensive

Advantages of Overdenture Prostheses

Appearance and feel similar to natural teeth
Strong chewing support
Improved speech
Slows bone resorption
Aesthetic smile
Long-lasting
Preserves remaining teeth

Disadvantages of Overdenture Prostheses

More expensive than traditional prostheses
Time-consuming treatment
Requires regular care and check-ups
More complex construction stages

Overdenture Prosthesis Care

Brush prosthesis and supports at least twice a day
Dentist check-ups are essential
Use cleaning tablets to prevent bacterial buildup

In summary, overdenture prostheses offer both functional and aesthetic solutions for tooth loss. They enhance appearance, improve chewing and speech, and help preserve jawbone health.