Superstructures

Today's implant systems consist of a titanium screw that grows firmly together with the jawbone and a so-called structural element that is firmly screwed to the implant body. These new teeth anchored on the implants are called superstructures. The aim of this modern restoration is to completely replace the function and aesthetics of the lost teeth. Due to the individual circumstances of the patient, the restoration and the costs can be very different. A precise appraisal and assessment by specialist staff is essential.

Explanation of terms for superstructure

Superstructure (lat. Supra "above") is a collective term in dentistry for all parts that are attached to an implant as a dental prosthesis. The dental implant serves as an artificial tooth root and is the connection to anchor artificial crowns, bridge structures or implant-supported prostheses .

The prosthetic work with crowns and bridges as a superstructure is much more comfortable than with removable dentures and its aesthetics increase the patient's self-esteem.

In implantology, the superstructure is incorporated approximately three to six months after the tooth implantation and its healing. The connecting piece between the implant and the superstructure is the implant abutment.
 

Application areas

  • For single tooth restoration, in order to prevent the neighboring teeth from being crowned with a bridge.

  • To lengthen shortened rows of teeth.

  • To avoid removable dentures as there are few remaining teeth.

  • For toothless jaws to give the denture a better hold.

  • In poor anatomical conditions for the hold of conventional dentures - e.g. condition after a tumor resection.

  • For additional support if there is not enough anchoring available.

The most commonly used superstructures are:

First, an impression is taken with a special transfer structure in the patient's mouth. With the help of this impression, the exact position of the implant in the jaw is recorded. On this basis, the dental technician first creates an individual tooth structure. This is later firmly screwed to the implant in the patient's mouth. As a rule, structures of this type are made of titanium or zirconium dioxide. The ceramic crown is then created. This is later cemented or screwed onto the individualized abutment in the patient's mouth like a natural tooth. In many cases nowadays the veneered crown is already made of zirconium dioxide.
The aim should be to design a restoration so that it comes as close as possible to the natural tooth - in terms of function, shape and aesthetics.

A distinction is made between two types:

Implant-supported bridge:
The manufacture of the implant bridge proceeds like that of an implant crown. However, the implant abutments must be produced exactly parallel to one another so that the bridge can be integrated precisely and without tension.

Implant bridge on implant and natural abutment:
The bridge between tooth and implant is a special feature. The implant is rigidly fused with the jaw, while the tooth is elastically connected to the bone by what is known as the tooth holding apparatus. Studies show that these different properties are irrelevant for a bridge solution between a tooth and an implant. However, if several teeth are connected to one implant or several implants are connected to one tooth by a bridge, the fixing cement of the bridge can loosen more easily due to the different cushioning properties of the pillars. That is why these designs should only be used in exceptional cases.

If, for anatomical reasons, a restoration using implant bridges is no longer possible, the missing teeth must be supplemented with so-called partial dentures. So that the remaining abutment teeth are not overly stressed by the acting chewing forces, it sometimes makes sense to position implants as additional abutments in strategically favorable places in the jaw.

The superstructures that are used in such cases are partly screwed to the implant while the other part is incorporated into the partial denture (primary and secondary structure).

The superstructures are now diverse, with the modern dentures supported by a milled bar promising the greatest wearing comfort. The tongue is not hindered in its function and the palate does not have to be covered by plastic (as with the partial framework RPD prosthesis), so that natural sensory and taste sensation is possible again. The lower jaw should be supplied with at least four implants and the upper jaw with at least six implants in order to avoid overloading the individual implants.

Process reliability for superstructures thanks to the latest CAD / CAM technology