A Multidisciplinary Approach to Single-Tooth Replacement

Author(s):

Sergio Rubinstein, DDS;Alan J. Nidetz, DDS, Masayuki Hoshi, RDT

Date Added:

1/1/2004

Over the last several decades, dentistry has focused on more conservative treatment modalities and preventive techniques. This has been possible not only because of improved techniques and materials, but also because of the understanding that tooth preparation, regardless of how conservative it may be, is an irreversible procedure.

A missing tooth in the anterior region is not only a physical loss, but also may be an emotional experience for the patient as well. To remove healthy tooth structure of adjacent teeth to replace a congenitally missing tooth or a tooth lost to decay, trauma, root fracture, failed root canal treatment, or pathology is, for some patients and dentists, a very aggressive treatment option. Infection in any of these situations creates an environment in the hard and soft tissues that makes regeneration procedures more difficult, thereby complicating the ability to create a natural appearance in the definitive restoration.

While a conventional three-unit fixed partial denture is a predictable technique to replace a missing tooth, the invasive nature of the treatment can lead to other complications throughout the life of the restoration. Complications may include mechanical overload of the abutment teeth with weakening or fracture, risk of endodontic treatment, periodontal problems, decay, and cement failure. If any of these complications occurs on one of the abutment teeth, the entire prosthesis will fail. Splinting teeth can overload the supporting structures because teeth function individually, and oral hygiene techniques become more cumbersome.