Dentures and PartialsA fixed denture is a bridge permanently mounted to dental implants.  This offers a solution that is comfortable and successful, and the most reliable alternative to removable dentures.  It’s the closest thing to having your natural teeth back because they look, function, and feel just like natural teeth.  

Most importantly, they literally become part of your jaw, which gives them a strong anchor that will allow you to eat virtually anything you want. Tooth loss can be a traumatizing event.  When teeth are gone, the bone immediately begins to dissolve and shrink, both horizontally and vertically. This causes loss of support and stability for a prosthetic device (denture), meaning dentures loosen and cease to fit well, and must be relined or new ones made. 

But even worse, as bone loss increases, support for the mouth and face is compromised, and the negative effect on facial esthetics, speech, self-esteem, and even nutrition and overall health cannot be overstated.  That is why the gold standard now in alternatives to removable dentures is dental implants, because they provide the ridge of bone that holds your teeth with continued stimulation, just like natural tooth roots, keeping the bone healthy and whole, and thus preventing features from sagging and shifting, causing that old-age sunken-in appearance, like a witch’s chin.

An overwhelming majority of patients with implants are extremely well satisfied with their restored dental health and function.  Studies have shown that around 75% of denture wearers would have chosen implants if they had known about the bone loss they would experience.  However, they may not be ideal in every case, due to:

  • Higher cost – this may be a significant barrier, particularly for seniors on fixed incomes.
  • A lack of adequate bone to support an implant, if teeth have been missing for a long time, necessitating bone grafting treatment, adding more expense and recovery time
  • Seniors may be concerned with time (months for implants to osseointegrate) and quality of life, plus the pain associated with the procedure.
  • A history of uncontrolled diabetes, bisphosphonate use, or certain blood dyscrasias

The complete loss of teeth, sometimes top and bottom, is a major problem among older adults, especially those at or below poverty level, rising to 33% in this group.  In fact, it’s estimated to affect tens of millions of Americans today.  If left untreated, tooth loss can negatively affect a person’s health and well-being in dramatic ways. On the down side, compared to removable dentures, dental implants are more expensive initially — but you’re paying for a solution that offers high quality and long-term service, which is a smart way of saying “value.”  

When you look at it from that perspective, you’ll understand that dental implants are the most cost-effective way to replace all or some missing teeth, whether it’s a partial or full set of teeth.  With proper maintenance, they can last a lifetime. Implants for fixed dentures can be All-on-4, 5, 6, or 8, signifying the number of implants that support a fixed bridge that can only be removed by a dentist.  Unlike a removable denture, a bridge doesn’t need to be taken out for cleaning every night and can be brushed and flossed like natural teeth.  It doesn’t get loose or shift during conversations and eating.  It eliminates the acrylic covering over the palate of removable upper dentures, which can cause a gagging sensation and a reduced sense of taste. 

And most importantly, implants prevent further bone loss, and vastly improve bite force and chewing ability.  And finally, because it feels so natural, most patients forget that they are not real teeth.

Fixed Full-arch Implant Supported Bridge:  The All-on-4 is the most popular and least expensive, but sometimes 5, 6 or 8 implants are needed.

All-on-6 is like an all-on-4 supercharged.  The difference is that the 6-implant option has a future if you ever lose an implant.  That is because the bridge can survive without all the implants being successful. Some types of permanently fixed implant systems are:

Titanium Hybrid Bridge:   Titanium framework permanently fixed to implants that have nano-resin teeth set in denture acrylic over it.  The term “hybrid” refers to the acrylic that, like a denture, fills in the space of missing gum and bone to the proper position where teeth should be placed. This hybrid is only removed periodically at professional dental cleanings.

Prettau Hybrid Bridge:  Zirconia framework and Zirconia crowns permanently fixed to implants.  If needed, tissue colored porcelain is then applied over the gum area of the bridge to mimic the soft tissue of the gums.  Zirconia, being very strong, is the material recommended for crowns on severe tooth grinders.

Zurick Bridge:  Zirconia framework permanently fixed to implants, mimics individual crown preparations with beautiful EMax porcelain crowns.  If needed, tissue-colored EMax porcelain can be artistically designed to mimic healthy gums.

Mini Implants:  An alternative for patients for whom regular implants are not suitable.   A pilot drill is used to create entry points for four implants, meaning a full osteotomy is not necessary.  This allows the denture to be tissue supported and implant retained, giving it immediate loading capability.  Usually chosen for people who have worn removable dentures for a time, to provide a boost in confidence and stability.  Some of the benefits are:

  • Greater ease of placement
  • Minimally invasive
  • Lower costs
  • High levels of patient satisfaction
  • The small diameter works in bone that is inadequate for traditional implants
  • No flap surgery required
  • Immediate loading, allows same-day completion (implant placement and crown)
  • Existing denture can be retrofitted to snap on

However, they may not be a permanent solution.  Mini implants were brought to the dental industry as a temporary solution to use for snap in denture while the permanent implants were healing.  Then the ball-head of the mini implant would be cut off and the conventional implants would support the screw retained, non-removable restoration or denture.  They are generally not meant to be used as permanent solution for missing teeth. Denture technology is evolving rapidly, and that’s great news for patients missing all or some of their teeth as more options are becoming available.  In addition, scanning techniques have dramatically improved diagnostic abilities, meaning quantity and quality of bone can be determined prior to surgical intervention, making the whole process more accurate and successful than ever before.


If you are interested in fixed dentures in Costa Rica, fill out the “Find a Dentist” form on this page.  One of our patient advocates will reply to your needs.