Implant Supported Fixed Bridge: How Difficult Is This to Maintain?


Russ asks:

I currently have a full upper denture which I have had for several years. I hate the way the denture feels and want to have it replaced with dental implants. Ideally, I would like to get what I believe is called a fixed bridge - meaning an implant attached porcelain over metal appliance that is non-removable (at least not removable by me).

Because I have been missing a significant number of upper teeth for quite some time, my dentist tells me that there may not be sufficient bone mass for this type of implant fixed bridge. So my dentist recommends is a removable overdenture. Evidently, the removable overdenture doesn't require as many implants, so bone mass isn't as much of a problem.

However, if my CAT scan shows sufficient bone mass for a non-removable upper fixed bridge I am really inclined to go with that option. However, my dentist told me that a downside to a non-removable fixed bridge is that it accumulates food and bacteria between the bridge and the gum, is difficult to keep clean, and can lead to dental infections.

Is this true? Are dental infections common with non-removable implant supported fixed bridges? Are they that difficult to keep clean? All things considered, if I have enough bone is the non-removable fixed bridge a better consideration for me? Is it more comfortable than an overdenture?

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Expert Advice and Comments
mtischler's picture

Implant Supported Fixed Bridge: How Difficult Is This to Maintai

Answered By: Dr. Michael Tischler - Woodstock , NY


If a CT scan shows there is enough bone to place 6 implants between the maxillary sinuses then a Hybrid type non removable prosthesis is a great choice. A Hybrid bridge can be made so that it can be cleaned by you easily. If you and your dental hygienist maintain a hybrid bridge, there is no reason for infections to occur. The advantage of this over an overdenture is that it stays in your mouth and requires less maintenance of parts that wear out and need to be replaced. Also it is usually a lot smaller and there is nothing in your palate at all with a Hybrid.

Dr. Michael Tischler

Dr.Grossman's picture

Implant Hygiene

Hi Russ
The palateless, removeable overdenture is the best choice for a patient wanting daily ease of access to maintain implants. The availability of hygiene aids make the fixed implant-bridge a readily maintainable prosthesis too. The overdenture and hybrid can easily make up for lost bone mass, is more cosmetically flexible, less expensive and easier to construct.
Plastic-needles(Zoms) are flexible and allow floss to be threaded beneath a fixed bridge. An oral irrigator (ie. Water-Pik), is a fundamental requirement for patients maintaining fixed bridgework.
A hybrid prosthesis is screw retained prosthesis and offers advantages of both appliances. It requires the assistance of a professional to remove it for complete hygiene .

Theodore Grossman DMD

drkazemi's picture

Maintaining implant supported bridge / prosthesis

Answered By: Dr. H. Ryan Kazemi - Bethesda , MD


The design and shape of the prosthesis is an important factor in keeping it easily clean and also natural feeling. Depending on the anatomy of the bone and gum tissue, as well as your bite, a design will be created in collaboration with your restorative dentist and oral surgeon. It is possible to design a fixed prosthesis in a way that can be easily cleaned and maintained with good surrounding health. A prosthodontist, in my experience, may be the right restorative dentist to see regarding this.


Dr. H. Ryan Kazemi

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