Crowns, bridges, implants: What types of replacement teeth are there?

Before suggesting a suitable type of dental prosthesis, your dentist will first examine your teeth to see how large the gap in the teeth is, where it is located, and whether there are still teeth next to it. The dentist will also check how healthy your jaw and any neighboring teeth are.

In Germany, your doctor puts together a treatment plan and cost estimate overview (called a Heil- und Kostenplan) which is submitted to your health insurer before the treatment can begin. Public health insurers cover some of the costs of replacement teeth, but patients generally have to pay a part of it themselves. If your health insurer approves your request, they will send you a written reply and let you know how much of the treatment costs they will cover.

If you have questions about the different treatment options and costs in the plan your dentist suggested, it may be a good idea to get a second opinion from another dentist. For more advice about replacement teeth in Germany, you can contact your public health insurer or one of the patient information centers run by the German dental associations.

There are two main types of fixed dental prostheses: crowns and bridges.

Crowns are used to replace individual teeth that are severely damaged or weakened. They are made of metal, ceramic, porcelain or resin (a synthetic material). Crowns are placed on natural teeth to stabilize and preserve them. Full crowns cover the entire tooth, and partial crowns only cover part of the tooth. In order to create a well-fitting crown, the dentist first trims the tooth and makes a mold of it.

Bridges can completely replace one or several teeth, and are typically used for smaller gaps. They are only an option if there are enough remaining stable teeth or if dental implants are put in first. These can be used as abutments to secure the artificial (false) tooth, which fills in the space between them.

Depending on the location and size of the gap, different types of bridges may be needed. For example, a traditional bridge is used to close a gap between two teeth. It is fixed to two abutment teeth – one on either side of the gap. These provide support for the bridge. Cantilever bridges are used when the molar tooth right at the back of the mouth needs to be replaced, for example. Because the row of teeth ends there, the bridge can only be supported by neighboring teeth on one side. These kinds of bridges are supported by at least two teeth on that side, to keep them stable.

Bridges can be fixed in place in various ways. The abutment teeth can be filed down and reshaped, and then fitted with crowns. After that, the artificial tooth is fixed to the crowns on either side, forming a bridge. In inlay (or onlay) bridges, fillings are put in the abutment teeth that the bridge is anchored to. In resin-bonded bridges (also called Maryland bridges), the artificial tooth is glued to the backs of neighboring teeth using short metal “wings.”

Dental implants are artificial tooth roots made of metal (titanium) or ceramic. The dentist can attach various types of replacement teeth to them, like crowns, bridges or dentures.

Dental implants are anchored in the jawbone, much like screw anchors in a wall. The bone tissue there fuses with the surface of the dental implant to provide a stable foundation for the artificial tooth.

Artificial teeth that are supported by dental implants are also referred to as superstructures.

Dentures can be divided into two categories: partial dentures and complete (full) dentures. As well as being brushed regularly along with the rest of your teeth, both types should be removed and cleaned separately at least once a day.

Partial dentures made of plastic and metal can be used if several teeth are missing, but there are still remaining teeth nearby. They are fixed to natural teeth or implants – for instance, using metal clasps.

Complete dentures replace all of the natural teeth in the upper jaw, lower jaw or both. Ideally, they look just like natural teeth and allow you to chew and speak normally again. Complete dentures are usually made entirely of plastic. The key to properly fitted complete dentures is a good match to the jaw. This creates a slight vacuum between the jaw and the denture, which holds the denture in place. Dentures can also be fixed to the roots of teeth or dental implants – and are then called hybrid dentures.