Whether the tooth is missing in front of or behind, it changes everything for obvious reasons of aesthetics. But regardless of the location, the more "holes" in a jaw, the more the bone loses its density and the greater the risk of other teeth becoming damaged or falling prematurely.
The solutions
The dental prosthesis or denture.
It is partial or total depending on the number of missing teeth. Nevertheless most of the time, the "denture" causes a lot of dissatisfaction because it can move during meals, it takes the prosthesis remove every night and as it is not implanted in the maxillary bone, the latter tends to to resorb. Good to know: a dental prosthesis must be changed every five years because the gum on which it relies evolves and adjustments are necessary.
The bridge .
It is a fixed prosthesis composed of one or more artificial teeth . It is not anchored in the gum, but is placed between two healthy teeth (called pillars), then covered with a crown resting on the neighboring teeth (it forms like a bridge, hence the name of bridge) . But this solution is only possible when the surrounding teeth are solid and the gingiva healthy because the bridge inflicts extra work to these teeth which are then weakened. Especially since it is often necessary to "cut" a little these dental supports to be able to crown them with a crown. The duration of the bridge is about ten years .
The implant .
The dentist first installs an artificial root in the bone (under local anesthesia). This false root is titanium, a material that causes no reaction and has no difficulty in integrating with the bone. Even after the placement of an implant, bone redensification is noted in the area concerned (osteoporosis is therefore not a contraindication, quite the contrary)! This is why, in the case of prosthesis replacing several teeth (partial denture or even bridge), dentists willingly propose to put 3 or 4 implants to fix these artificial teeth and thus continue to stimulate the bone of the jaw. In a second step (between four to six months later), after the good "catch" of the root in the bone, the dentist screws a false stump on which comes to rest a crown . Sometimes the crown can be placed at the same time as the implant. The decision to do everything at the same time or not depends on the tooth involved (whether it is likely to bear significant loads during chewing or not) and the condition of the underlying bone. The implant has an almost definitive lifespan ; on the other hand, it is necessary to plan to change the crown every fifteen years or so . Finally, the failure rate is on average 5%.
The bone graft . If the bone is not good enough or if there is not enough bone , the dentist must first perform a bone graft , taking bone from the body (the chin, the tibia for example) to graft it to the jaw . This delays the installation of the implant.
Change my old amalgams?
Evidence of the harmfulness of old mercury-based amalgams has never been clearly established. And if there is a risk, it is when you change the amalgam that the risk is maximal because it is at that time that there may be emissions of mercury vapors, potentially neurotoxic. Also, in the absence of recurrence of caries and except for aesthetic reasons, there is no need to change its old amalgam only for the "just in case" ...
The costs .
It takes between € 400 to € 600 per area treated for a bone graft and € 1,500 to € 2,000 for an implant (not reimbursed by the Secu) with its crown. The cost of a bridge is a little lower (€ 1,300 for a replaced tooth, so 3 crowns, reimbursed € 195). The complete removable prosthesis costs € 1,200 (€ 127 are reimbursed per jaw). Some mutuals agree to cover part of the costs.
