A fixed denture is a non-removable dental restoration designed to replace a full arch of missing teeth. This prosthetic solution offers a high degree of stability and permanence. Unlike traditional options that rely on suction or paste, a fixed denture is securely anchored in the mouth, providing a feeling and function much closer to natural teeth.
Understanding Fixed Dental Prosthetics
The term “fixed” in dental prosthetics specifically means the patient cannot remove the device themselves; only a dental professional can unscrew it for maintenance or repair. This level of secure retention is what distinguishes it from removable dentures, which must be taken out daily for cleaning. Fixed prosthetics are designed to function like natural dentition, restoring the ability to chew and speak without the worry of the appliance shifting, slipping, or wobbling.
These restorations replace an entire row of teeth. Fixed dentures are typically anchored directly to the jawbone using dental implants or, in some cases, cemented to remaining natural teeth. When supported by implants, the prosthetic helps stimulate the jawbone, which prevents the bone loss that commonly occurs after teeth are lost.
Common Types of Fixed Denture Systems
The most modern and stable interpretations of fixed dentures are predominantly implant-supported, utilizing titanium posts surgically placed into the jawbone. One common approach is the Implant-Supported Bridge, which is used to replace a limited span of missing teeth, often anchored by two or more implants. This bridge permanently connects the artificial teeth to the implants, distributing chewing forces efficiently.
For patients missing an entire arch, Full Arch Implant Solutions are the preferred fixed method. The “All-on-4” system replaces an entire set of teeth with a fixed prosthetic secured by only four strategically placed dental implants positioned to maximize contact with the densest available jawbone, often allowing for the fixed denture to be attached shortly after implant placement. Other full-arch solutions may use five to eight implants for increased support, particularly in the upper jaw where bone density can be lower.
A less common, but still fixed, option is the traditional fixed bridge, which can replace a small number of adjacent missing teeth by cementing artificial teeth to crowns placed on the healthy teeth on either side. However, this method requires modifying healthy neighboring teeth, which is why implant-based fixed solutions are often preferred for larger restorations. Implant-supported fixed dentures are directly screwed onto the implants.
The Installation Process
Installation begins with a consultation, including digital imaging and bone assessment to ensure adequate jawbone density for the implants. If bone loss is present, a preparatory procedure like bone grafting may be necessary before proceeding. Once the mouth is ready, the surgical phase involves placing the titanium dental implants into the jawbone.
After the implants are placed, a healing period called osseointegration begins, during which the jawbone tissue fuses directly with the titanium implant surfaces. This process typically takes between three to six months. Patients often wear a temporary, healing denture during this time.
Following successful osseointegration, a minor procedure is performed to attach abutments to the implants. Impressions of the healed gums and abutments are then taken and sent to a lab where the final fixed denture is fabricated. The process concludes with the permanent prosthetic being secured to the abutments, often using small screws, which only the dentist can remove.
Maintenance and Long-Term Expectations
Maintaining a fixed denture differs significantly from caring for a removable one, as the fixed prosthetic is cared for much like natural teeth. Daily oral hygiene involves brushing the prosthetic and gums twice a day with a soft-bristled brush. Specialized cleaning tools, such as floss threaders or interproximal brushes, are necessary to clean thoroughly underneath the fixed denture and around the implant sites.
Rigorous hygiene is necessary to prevent plaque buildup and the development of peri-implant infections, which can compromise the long-term success of the implants. Fixed implant-supported prosthetics are designed to be a long-term solution, with the titanium implants themselves often lasting for decades or even a lifetime with proper care. The prosthetic teeth and bridge material, however, may require periodic maintenance, repair, or replacement, typically lasting 15 to 25 years before the material wears down. Regular professional dental check-ups and cleanings remain necessary to monitor the health of the surrounding gum tissue and the integrity of the fixed restoration.