Missing Teeth Replacement Procedures
Diagnosis - Treatment Relationship
The process of determining the best or most sensible treatment for replacing one or more teeth either on a singular basis (one at a time) or as a group of adjacent teeth can be different from patient to patient.
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| Birth Defect - 12 Missing Teeth |
The primary reason or cause of the missing structure influences the range of choices for replacement which can involve the use of many basic treatments and even the use of today's more advanced technologies that can match what Mother Nature provides.
Diagnostic Basics
Missing tooth structures (or appearance of absent teeth) can be caused by:
- Genetic Birth Defects (Hypodontia - e.g, missing incisors ~ bicuspid)
- Developmental Abnormalities - Growth Factors (e.g., Amelogenesis Imperfecta, Biliary Atresia)
- Missing Adult Tooth Buds (primary teeth not being replaced)
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| Missing Laterals (Common) |
- Gum Disease - Periodontitis
- Non Recommended Extractions
- Severe Tooth Decay - impending removal
- Occlusal Breakage
- Physical Trauma (car accidents, sports injuries, etc.)
- Edentulous Jaw (perio disease treatment outcome, existing prep for dentures)
The outline above reflects many of the different causes for having a missing tooth structure. Age is the first major factor that can limit the availability of different treatments.
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| Bone - Tooth Loss |
As a general rule, infants, toddlers, elementary age and early teen aged children are rarely recommended for any surgery or prosthodontic treatments due to on going growth factors.
Prosthodontic Specialists, as part of an Oral Surgery team may develop custom prosthetics to treat certain genetic deformities (e.g., cleft palate). Oral Surgeons may perform specialized surgeries to correct jaw bone abnormalities in infants or toddlers, as a developmental intervention.
Dental implants and general prosthetics are routinely available to patients who have completed developmental growth cycles (spurts), which can occur somewhere between 17 to 22 years of age.
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| Severe Decay - Excessive Extractions |
Causes and Treatments
The range and choice of treatment possibilites for the tooth loss causes outlined above are listed below. To promote understanding of replacement choices for any given condition, the same outline format is provided.
- Genetic Birth Defects: Conventional bridges, maryland bridge, dental implants
- Developmental Abnormality: Custom prosthodontics, denture prosthetics, partials, implants, bridgework
- Missing Adult Tooth Buds: Implants, bridge work, orthodontics (to close spacing)
- Gum Disease - Periodontitis: Possible bone grafts, Implants, All On 4, fixed bridges, denture
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| Severe Gum Disease - Resorbing Bone |
- Untreated Extractions: Bone grafting (as needed), Dental Implants, partials, dentures, fixed bridge
- Severe Tooth Decay - impending removal: Implant, dentures, bridge
- Occlusal Breakage: Single or multiple implant, short bridge, partial
- Physical Trauma: (same as occlusal)
- Edentulous Jaw: Implant retained - anchored - supported denture, All On Four, Teeth In An Hour, fixed bridge
Replacement Basics
There is no hard fast rule about tooth replacement procedures. The best replacement method should include a consideration of what caused the missing tooth (teeth) and a range of treatment choices that emphasize either degrees of being minimally invasive or providing the most advanced, health promoting procedure.
Minimally Invasive versus Best Definitive Treatment
In many instances minimally invasive procedures and those that create the best functional result can be mutually exclusive.
For example, a single unit maryland bridge can offer the ideal in terms of creating a great cosmetic and being minimally invasive (low tooth prep, non surgical) ... a dental implant is known to be the Gold Standard of tooth replacement but can involve degrees of invasive surgery and relatively higher cost.
Editorial Staff
Contributing Editors:
Mitchell Pohl, DDS
Kristin Petulla, DDS
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