As advancements in dental science continue, new techniques and discoveries emerge, offering patients longer-lasting, healthier, and more attractive smiles. Among these innovations are dental implants, which have revolutionized restorative dentistry. Full-mouth implant-based solutions are relatively new, and not all dentists are up to date with the latest research and methods.
The Early Days of Full-Arch Restorations
When dental implants were first utilized for full-arch restoration, it was commonly believed that implants needed to be splinted together across the arch for added support, reducing the risk of implant failure. This approach, known as cross-arch stabilization, aimed to distribute the chewing forces evenly across all implants. The fear was that excessive pressure on a single implant could compromise its integration with the bone, leading to failure. Thus, a single-unit prosthetic was often used to reduce stress on individual implants.
While extreme pressure can indeed cause implant failure, this is also true for natural teeth. Yet, dentists don’t connect natural teeth with splints. Why? Because they understand that jawbone health relies on the stimulating forces of chewing.
The Science of Bone Adaptation
In 1892, German anatomist Julius Wolff introduced The Law of Bone Remodeling, which established that bone strength and thickness adapt to the physical stresses placed on it. Without sufficient stress, bones become weaker and thinner over time. American orthopedic surgeon Harold Frost later expanded on this with the Mechanostat model, demonstrating how forces determine whether bones grow or resorb.
This principle is evident in everyday examples: tennis players develop denser bone in their dominant arm, while paraplegics experience bone loss in their legs. Similarly, denture wearers often face bone resorption because the reduced and dispersed forces of chewing fail to adequately stimulate the jawbone.
Challenges with Full-Arch Prosthetics
Cross-arch stabilization is useful during the healing process, much like a cast supports a broken arm. However, just as a cast is removed after healing, a prosthetic splinting all implants should ideally be replaced with a more dynamic solution. Single-unit full-arch prosthetics, such as the All-on-4, have been popular for decades but often result in bone resorption over time. The gaps that develop between the prosthetic and gum tissue are common and mistakenly accepted by some dentists as inevitable.
This misconception has led many practitioners to remove healthy bone and replace it with artificial gum material, underestimating the impact of the prosthetic’s design on bone health. In reality, the lack of adequate stimulation is often the primary cause of bone loss.
How Segmented Bridges Benefit Bone Health
Research and clinical experience show that increasing the forces on implants promotes bone maintenance and even growth. Segmented bridges, such as those used in the 3 on 6 treatment, divide a full arch into smaller units, allowing each implant to experience direct stimulation. For instance, biting on one side of the mouth applies force specifically to the implants on that side, encouraging healthy bone adaptation.
This approach is akin to physical therapy for the jawbone. By “removing the cast” of a single-unit prosthetic and using segmented bridges, the bone is engaged in its natural function. Long-term follow-ups with 3 on 6 patients have shown promising results, with stable bone health even 5 to 10 years post-treatment.
Beyond bone health, segmented bridges with 3 on 6 offer several practical benefits:
• Natural Feel: Unlike bulky single-unit prosthetics, segmented bridges are thinner and feel more natural during eating and speaking.
• Durability: Studies show full-arch prosthetics are six times more likely to fracture than smaller segmented bridges. In a Smile Systems study, only 3 fractures were reported out of 5,000 zirconia bridges placed over six years—a rate of just 0.0006%.
• Cost Efficiency: If a full-arch prosthetic breaks, replacing it is expensive. In contrast, repairing a fractured segmented bridge involves only the affected section, significantly reducing costs.
Conclusion
Bone health, like muscle strength, relies on consistent use. Without proper stimulation, bone resorbs over time. Segmented bridges provide the forces necessary for long-term bone maintenance and growth, making them a superior solution for full-mouth restoration.
You can visit with a Smile Clinic dentist at a free consultation to learn more about segmented bridges.
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