The prosthetic phase begins once the implant is well integrated or has a reasonable assurance that it will integrate. Even in the event of early loading (less than 3 months), many practitioners will place temporary teeth until osseointegration is confirmed.
The prosthetic phase of restoring an implant requires an equal amount of technical expertise as the surgical because of the biomechanical considerations, especially when multiple teeth are to be restored.
The dentist will work to restore a functional bite (or occlusion), the aesthetics of the smile, and the structural integrity of the teeth to evenly distribute the forces of the implants.
a. Fixed prosthesis
A fixed prosthesis is when a person cannot remove the denture or teeth from their mouth. Where the prosthetic is fixed, the crown, bridge or denture is fixed to the abutment with either lag-screws or cement.
- Prosthesis is attached with lag-screws
The restoration is secured with screws that traverse the dental crowns and attach to the threaded holes inside the abutments. After the screws are positioned, the holes that penetrate the crowns are sealed with a composite material.
- Prosthesis is secured with dental cement
In this case, the restoration is secured with dental cement, just like crowns and bridges are attached to natural teeth.
b. Removable dentures
Removable dentures are held in place by special adapters (or retainers). Generally, a male-adapter is attached to the implant and a female-adapter is housed in the denture.
The retainers allow movement of the denture (that should be daily removed, to clean the denture and gum area), but enough retention to improve the quality of life for denture wearers, compared to conventional dentures.