Fixed against removable: the primary division
All prosthetics divides by how it is held in:
- fixed — the patient cannot take it out: dental crown, dental bridge, implant crown
- removable — they can: denture, partial denture, overdenture
At the boundary sits the pair most often confused: an implant-supported denture rests entirely on implants, while an implant-retained denture is only held by them and the load goes through the mucosa. The difference matters for both cost and prognosis. All-on-4 belongs here too.
The removable range in full: complete denture and full denture are synonyms, plus removable partial denture, immediate denture, and the components clasp, denture base, denture flange, denture tooth. Maintenance: reline, rebase, denture repair, and a rubbed spot is a sore spot. The lay term is false teeth.
The three parts of an implant
- implant fixture — in the bone
- abutment — the connector; during healing a healing abutment or cover screw sits there, secured by the abutment screw
- implant crown — the visible part, screw-retained or cement-retained
Careful: abutment has a second, unrelated meaning — an abutment tooth, the natural tooth supporting a bridge. One word, two entirely different objects, and only context separates them.
The surgical stage: implant placement, osteotomy, immediate or delayed implant, one-stage and two-stage surgery, immediate loading, a surgical guide for guided surgery. Impressions use an impression coping with an implant analogue.
A bridge: pontic, abutment tooth, retainer
A bridge has three kinds of element:
- abutment tooth — the supporting tooth
- retainer crown — the crown on that tooth
- pontic — the artificial tooth spanning the gap
Types: fixed bridge, cantilever bridge (supported at one end only), Maryland bridge (adhesive). Note that retainer here is part of a bridge, not an orthodontic retainer.
Crowns: full-coverage crown, partial crown, and by material porcelain, zirconia, metal-ceramic, gold crown, with temporary and provisional crown in the interim. Preparation: crown preparation, tooth preparation, finish line, shoulder margin, chamfer margin. Completion: try-in, bite registration, shade selection, cementation.
Why implants fail
Implantology rests on osseointegration — titanium fusing with bone. Its conditions are primary stability and adequate insertion torque, followed by a healing period.
Where bone is insufficient it is built up: bone graft and bone augmentation, sourced as autograft, allograft, xenograft or synthetic bone substitute, with guided bone regeneration and a barrier membrane. Larger procedures: sinus lift and sinus augmentation, ridge augmentation, ridge split, block graft.
Complications form a ladder: peri-implant mucositis affects soft tissue only and is reversible; peri-implantitis involves bone loss; implant failure is loss of the implant.
Laboratory: framework, metal framework, casting, digital scan, intraoral scanner, CAD/CAM restoration, milling.
One word, two objects: the ambiguities to watch
- Abutment is an implant connector and a bridge-supporting tooth
- Retainer is part of a bridge here, and an orthodontic appliance elsewhere
- Crown is anatomy, a restoration, or the top of an implant, depending on the chapter
- Analogue is a lab replica of the fixture, nothing to do with analogue signals
- Coping is a component, not a verb — an impression coping transfers implant position
- Loading means putting the implant into function, not adding weight to it