Fixed Dental Implant Crown and Bridge Materials Options: An Overview By Burbank Dental Implant Expert, Ramsey Amin, DDS

Fixed Dental Implant Crown and Bridge Materials Options: An Overview By Burbank Dental Implant Expert, Ramsey Amin, DDS

Fixed Dental Implant Crown and Bridge Materials Options: An Overview By Burbank Dental Implant Expert, Ramsey Amin, DDS

This post is intended toward dental implant crown and bridge restorations that stay in the mouth and are not removable.  Denture implants called overdentures are not “fixed”, they must be removed daily. All materials have advantages and disadvantages.  The following is a summary of the materials that can be used.

Dental Implant Restorations:  Crowns and Bridges
There are basically four options that I use:

 Full Cast Gold (High Noble Metal) Made of a gold alloy, full cast gold is the longest lasting of any of the laboratory-processed materials. The alloy consists of gold, silver, palladium, and sometimes zinc, copper, and platinum. Although it is a very strong material, the yellow color makes it not as esthetically pleasing as other options.

 Full Cast Noble Metal Similar in properties and qualities to full cast gold, this material contains mostly palladium plus silver, gold, and other trace metals.  Full cast noble material is more silver in color than a full noble metal.

 PFM -Porcelain Fused to Gold (High Noble or Noble Alloy Metal) This material is very esthetic and can last 5 to 20 years. The gold substructure is covered with porcelain, which can wear opposing teeth or fracture under forceful biting or grinding. The porcelain can be applied to just the surface of the crown facing on cheek.  The result will not be as esthetic, but will last longer. A night-guard may be recommended for protection.

 All Ceramic or All Porcelain (Zirconia) This is the newest technology in laboratory-processed restorations and is considered very esthetic.  They look very real. No metal is used in the process, and therefore no metal will ever be visible. It is excellent for restoration of front and back teeth. The same cautions exist as with any porcelain or ceramic material: it can wear opposing natural enamel, and a night – guard may be recommended for protection from bruxing or grinding.  Some processes in fabrication of the all ceramic or porcelain crown are actually controlled by a computer!

All the above take at least two appointments to finish.


Abutment preparation, impressions, and temporary crown or bridge will be done at the first appointment.  Your final cementation will take place during a second appointment.  Because of the highly technical nature of the process and my exacting standards, I may need to take more than one impression. If I detect an irregularity with the returned laboratory restoration, I will take a new impression and redo the dental implant restoration.

I will recommend the best material to meet your specific needs and answer any questions you have.

Longevity of any of the restorations depends on the quality of the materials (and I only use the best), the technical skills in construction, and what you need to do with the restorations once they are in your mouth.
Clenching and grinding habits will significantly shorten the useful life of any restoration placed. What can break your natural tooth can break any man made restoration!  Don’t chew ice! 

Your oral self-care will affect the length of service of the restoration. You will need regular dental examinations and cleanings at intervals determined by your particular needs and gum health.

A rule of thumb is that the more restorations you have in your mouth, the more care you will need. Any problem that begins can be discovered and corrected when it is small: with regular dental examinations, you can protect your dental implant investment.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Burbank, California
https://www.burbankdentalimplants.com

11 Comments

  1. LouAnn Scott

    Hello Dr. Amin,

    My general dentist said Lava Zirconia is the best material to use for the front teeth, 6 unit fixed bridge.
    What are your thoughts?

    September 11, 2016 at 3:06 am Reply
    1. RamseyAminDDS

      Many times it is!! It is a concept of “layering” porcelain over a zirconia substructure…. kind of a hybrid of strength and beauty.

      October 23, 2016 at 12:27 am Reply
  2. Bruce

    Hi Dr. Ramsey

    Last year, I completed my all-on-4 implant and fixed acrylic upper arch procedures. My acrylic teeth have broken several times, and I’ve had to have the prosthesis repaired. Considering the poor durability of acrylic “teeth”, I’m looking for a replacement. In a previous post reply, you mentioned
    “replace your acrylic dental implant bridge with a Prettau solid zirconia bridge if you have enough from the edges of your teeth to the tops of your implants** – See more at: https://www.burbankdentalimplants.com/fixed-dental-implant-bridge-vs-implant-denture-what-is-the-real-difference/#sthash.Kvm5ZqCW.dpuf
    Assuming I’m not a candidate for a “Prettau Zirconia” type of arch, what’s the next best thing? It’s been suggested that I use a “Ceramic Hybrid”
    Thanks so much for such an awesome site and professional advice.

    June 5, 2014 at 4:46 pm Reply
    1. Ramsey Amin DDS

      Hello Bruce!

      Thank you for your very kind words. Your definitely a candidate to replace your broken all on 4 dental implant bridge with a solid zirconia Prettau dental implant bridge! I do this all the time! I see at least 1 broken all on 4 bridge every day. It is one of the main reasons why I do not do it. Is long as you have adequate interarch space, you can replace your bridge with a Prettau bridge.

      Are you local enough to come in?

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      June 11, 2014 at 1:06 am Reply
  3. David. M. Ponce

    I;m having a tooth extracted, because I Have bone loss, I’m also having a bridge put in, which would be the best for me: 1. High Noble metal 2.noble Metal 3. Porcelain fuse to Gold 4. All Ceramic or all Porcelain

    June 17, 2012 at 12:54 am Reply
    1. Hi David,

      Great question! Shorter bridges in general can be done with high noble or all porcelain depending on many factors. If the bridge is longer, the noble metals flex less. I suggest staying away from non-precious metals unless the bridge is really long and you have little choice. Full Zirconia may be an option too.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      June 24, 2012 at 9:52 pm Reply
  4. Hi Becky,
    If you have upper teeth above it, it is far better to have 2-3 implants. This will support your bone and prevent bite collapse.
    Avoid “minimal engineering” for your dental implant restorations.
    Dr. Amin

    May 2, 2011 at 8:43 am Reply
  5. Becky Gommer

    I don’t know the size. Actually had numbers wrong it would be an implant next to 29 so at 30 only as there is not a tooth at 31 and 32 has to be pulled. So question would be if only one implant was put at 30 is that enough to be able to function versus having 2 implants or 3 implants or 2 implants and a bridge? thank you.

    April 27, 2011 at 10:43 am Reply
  6. Is the space larger or smaller than 14mm?

    April 25, 2011 at 8:16 am Reply
  7. Becky Gommer

    Is there a crown large enough to put in place of where teeth numbers 29 and 30 would be on an implant instead of placing 2 implants there and in particular for someone who tends to grind their teeth? Lower Molar and wisdom teeth are absent….
    Upper teeth above those area’s are there but wisdom tooth is small.

    April 22, 2011 at 1:51 pm Reply
  8. Ramson

    excellent article

    January 8, 2010 at 3:20 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!