A fixed denture is a permanent form of dental restoration designed to replace multiple missing teeth or an entire dental arch. Unlike appliances that rely on suction or adhesive, this prosthetic is securely anchored to underlying structures in the mouth, providing stability. This restoration offers a long-term, non-removable solution for patients seeking functional and aesthetic replacement for lost teeth.
Defining Fixed Dentures
The distinction of a fixed denture lies in its permanent attachment to the jaw, meaning the patient cannot remove it at home. This prosthesis is secured either to remaining natural teeth or, more commonly, to titanium dental implants surgically placed in the jawbone. This mechanism eliminates the movement, slippage, and need for messy adhesives often associated with traditional, removable dentures. Because the denture is firmly held in place, it restores a significantly higher degree of chewing efficiency, often reaching 80–90% of natural bite force, compared to the 50–60% offered by removable options.
The secure anchoring also stimulates the jawbone, which helps prevent the bone resorption, or shrinkage, that naturally occurs after tooth loss. This bone preservation helps maintain the natural contours of the face and the long-term fit of the restoration. Fixed prosthetics are only removed by a dental professional, typically during annual maintenance appointments, to ensure the health of the underlying gums and implants.
Types of Fixed Denture Systems
Fixed dentures are classified by their anchoring method and the extent of the restoration. A fixed partial denture, commonly known as a dental bridge, replaces a small section of missing teeth and is cemented onto adjacent natural teeth or existing implants. This system requires the neighboring teeth to be strong enough to support the restorative load. For patients missing an entire arch of teeth, the solution is typically a fixed full-arch restoration, which is exclusively supported by dental implants.
Full-arch systems often utilize a strategic placement of four to six implants per jaw, a technique sometimes referred to as All-on-4 or All-on-6. The prosthetic can be fabricated from different materials, each offering a distinct balance of durability and aesthetics. Zirconia is a highly durable ceramic material known for its exceptional strength and lifelike light-reflecting properties, making it the premier choice for long-term function and appearance. Acrylic prosthetics, often reinforced with a metal framework, are a more cost-effective option, though they may require replacement more frequently than ceramic alternatives.
The Installation Process
The process begins with a comprehensive consultation and diagnostic phase. The dental team performs detailed examinations, including 3D imaging, to evaluate the density and volume of the patient’s jawbone. This assessment confirms that the bone is sufficient to support the titanium implants; if not, a preliminary bone grafting procedure may be required. Following the planning stage, the surgical phase involves placing the titanium implant posts into the jawbone.
After implant placement, a temporary denture is often secured, allowing the patient to function while the critical healing period begins. This phase, known as osseointegration, is where the jawbone tissue fuses directly with the titanium surface of the implant, creating a stable and permanent anchor. Osseointegration typically requires three to six months of healing time. Once the fusion is complete, the final, custom-fabricated fixed denture is attached to the implants, often secured with screws, and adjusted for a precise fit and natural bite alignment.
Daily Care and Longevity
Caring for a fixed denture requires specific attention to the area where the prosthetic meets the gum line. Daily hygiene involves using a soft-bristled toothbrush and non-abrasive cleaners to gently clean all surfaces of the prosthetic. Because fixed dentures are secured to the implants, specialized tools are necessary to clean the space beneath the prosthetic and around the implant posts to remove plaque and food debris.
Tools such as water flossers, floss threaders, or interdental brushes are recommended to access these hard-to-reach areas, which helps prevent gum inflammation and infection around the implants. Consistent home care is directly linked to the longevity of the restoration. While the titanium implants themselves can last decades or a lifetime, the prosthetic overlay may need maintenance. Regular professional check-ups, often every six months, are necessary for the dentist to inspect the implants and remove the fixed denture for a thorough cleaning.