Implant-Supported Prostheses Ankara İncek – Sevgi Savaş Dental Clinic
Ankara İncek · Prosthodontics

Implant-Supported Prostheses

Fixed cemented, screw-retained/hybrid, Toronto prosthesis and implant-supported removable prosthesis. Tailored solution for every level of tooth loss; zirconia or porcelain material.

10–20 yearsImplant-supported prosthesis lifespan
2–4 monthsOsseointegration waiting period
4 typesDifferent implant-supported prosthesis options
Same DayAll-on-4 temporary teeth can be fitted
Implant-supported prostheses are artificial teeth fixed onto or removably fitted over implants placed in the jawbone. While the implant functions as a tooth root, the prosthesis is the visible and functional tooth itself. It can be applied in any situation from a single missing tooth to complete absence of all teeth; different options such as fixed cemented, screw-retained/hybrid (Toronto), removable and All-on-4/6 are available. When the right prosthesis type is selected with the right material, both aesthetics and chewing function are maximized.
◎Implant-Supported Prosthesis ◆Fixed Cemented ◈Screw-Retained / Hybrid ◇Toronto Prosthesis ⊕Removable Supported ✦All-on-4 / All-on-6 ①Material Selection ❋Application Process ⊙Care & Lifespan

What Is an Implant-Supported Prosthesis? What Is an Abutment?

A dental implant system consists of three parts: the titanium screw placed in the jawbone (artificial root), the abutment (intermediate connector piece) that connects the screw to the prosthesis, and the prosthesis (crown, bridge or full-jaw prosthesis) visible at the top.

The abutment is the critical component that determines how the prosthesis sits on the implant and the method by which it is secured. It can be produced from titanium or zirconia; zirconia abutments are aesthetically preferred for front teeth as they do not create a grey reflection at the gum margin.

Titanium Abutment Strong and durable, safe in every region · No grey colour reflection with sufficient gum thickness · Standard option for back teeth · More accessible cost
Zirconia Abutment Aesthetically superior with its metal-free white structure · Absolutely no grey reflection at the gum margin · Ideal for front tooth regions · First preference for patients with metal allergy

Fixed Cemented Implant-Supported Prosthesis

A cemented prosthesis consists of fixed crowns permanently bonded to the abutment with adhesive (cement). It cannot be removed by the patient; it can only be detached by the dentist, usually by cutting the prosthesis. It is the most common option for single tooth and short bridge applications.

Advantages

Highest natural tooth sensation · Perfect in terms of comfort and aesthetics · Abutment screw is invisible; upper surface is completely covered · Gold standard for single teeth and short bridges

Limitations

Prosthesis may need to be cut for maintenance or repair; this incurs cost · Requires a large number of implants in complete edentulism cases · Special tools (superfloss) are essential for under-bridge cleaning

When Is It Preferred?

Single tooth or a few missing teeth · Cases requiring perfect aesthetics in front teeth · Partial edentulism requiring bridge prosthesis · Angulation problems where screw-retained system is not suitable

Care Instructions

Brushing twice daily · If bridge present, under-bridge cleaning with superfloss · Interdental brush and oral irrigator are recommended complements · 6-monthly clinical check-up

Screw-Retained / Hybrid Fixed Prosthesis

In a screw-retained (hybrid) prosthesis, the prosthesis is secured with a screw rather than being bonded to the abutment. This screw access hole passes through a small channel in the chewing surface of the prosthesis; it is invisible during use. The dentist can easily remove and reattach the prosthesis via the screw.

Comparison with Cemented Cemented: Bonded, may need to be cut to remove · Screw-retained: Can be easily removed by loosening the screw · Screw-retained is the more modern and preferred system · Periodic maintenance and repair is easier · Advantageous for long bridges and full-jaw prostheses
In Which Cases Is It Preferred? Multi-implant bridges · Toronto and full-arch (full jaw) applications · Cases where periodic removal and cleaning is anticipated · All-on-4/6 prostheses · When ease of maintenance is a priority

Toronto Prosthesis – Fixed Sensation in Complete Edentulism

A Toronto prosthesis is a special type of prosthesis screwed onto 4–6 implants in complete edentulism cases, offering comfort very close to a fixed prosthesis. It cannot be removed by the patient; it is removed and refitted by the dentist using the screw-detachment method for periodic maintenance.

Toronto prostheses with acrylic or zirconia framework replace the entire front-to-back tooth series in a single piece. They are frequently applied with All-on-4 and All-on-6 concepts.

Advantages of the Toronto Prosthesis Closest comfort and natural sensation to fixed in complete edentulism · Far superior to a plate denture for eating, speaking and smiling · Dentist can perform maintenance via the screw-detachment method · Aesthetic zirconia or durable acrylic option · Slows bone resorption thanks to implants
How Many Implants Are Required? Lower jaw: Minimum 4 implants (2 straight + 2 angled) · Upper jaw: Minimum 4–6 implants · Number of implants is determined by the dentist based on bone quality and prosthesis length · Angled implants bypass the sinus region, reducing the need for additional surgery
Toronto Prosthesis Requires Annual MaintenanceDespite its fixed appearance, Toronto prostheses should be brought to the clinic every year or every 6 months using the screw-detachment method; the peri-implant area, screw torque and prosthesis integrity should be checked. This maintenance is essential for the long-term success of both the prosthesis and the implants.

Implant-Supported Removable Prosthesis

An implant-supported removable prosthesis is a type of prosthesis that rests on 2–4 implants and can be removed daily by the patient. The slipping and movement that is the biggest problem of a classic complete denture is largely resolved with implant support. It is the ideal option when full comfort is desired but surgical load is to be reduced.

Connection Systems Locator/ball connection: Simple mechanism, easy for patient to use · Bar connection: Connects multiple implants; very strong retention · Snap-on mechanism: Patient knows the prosthesis is in place by hearing a "click" · System is selected by the dentist based on bone structure and number of implants
Who Is It Suitable For? Those dissatisfied with a classic complete denture · Those with slipping complaints · Those not fully ready for a fixed prosthesis or seeking a more economical solution · Elderly patients where general anaesthesia load needs to be reduced · Possible with 2 implants in the lower jaw and 4 in the upper

All-on-4 / All-on-6 – Same-Day Fixed Teeth in Complete Edentulism

All-on-4 and All-on-6 concepts are modern full-jaw rehabilitation systems in which temporary fixed prostheses are fitted on 4–6 implants on the same day as the surgical operation in patients with all teeth missing or requiring extraction. The permanent prosthesis is applied after osseointegration is complete.

FeatureAll-on-4All-on-6
Number of implants4 (2 straight + 2 angled)6 (4 straight + 2 angled)
Mechanical stabilityHighVery high
Bone graft requirementUsually not requiredUsually not required
Same-day temporary teethYesYes
Permanent prosthesis timingAfter 3–6 monthsAfter 3–6 months
Bone resorptionApplicable in moderate resorptionRequires slightly more bone
Long-term advantageGoodHigher support

In both systems, angled (tilted) implants bypass the sinus region, eliminating the need for additional sinus surgery in the upper jaw in most cases. Suitability is determined with 3D tomography.

Material Selection for Implant-Supported Prostheses

MaterialArea of UseAdvantageDisadvantage
Porcelain (E.max)Single tooth, front region crownHighest light transmittance, natural appearanceHigh fracture risk in back teeth
ZirconiaSingle tooth, bridge, full-archDurability + aesthetic balance; no metalPorcelain layer can chip in layered version
Monolithic ZirconiaBack teeth, bruxismMaximum durability; no fracture riskSlightly less aesthetic
Acrylic (temporary)Healing period prosthesisEconomical, quick to produceTemporary; limited colour and wear stability
Hybrid (acrylic+metal)Full-arch Toronto/All-on-4Lightweight, economical full-jaw restorationAcrylic teeth may wear over time

For a single-tooth implant, E.max is recommended for the front region and monolithic zirconia for the back region. In full-arch (full jaw) restorations, the choice between zirconia or hybrid is determined by bone structure, aesthetic expectations and budget.

Implant-Supported Prosthesis Application Process

1
Comprehensive Examination and 3D Tomography

Bone quality, sinus structure and nerve canals are assessed with 3D imaging; prosthesis option and number of implants are determined.

2
Digital Planning and Surgical Guide

Implant positions are planned digitally; a surgical guide plate is produced to ensure precise placement.

3
Implant Surgery

Implants are placed in determined positions under local anaesthesia or sedation. Healing caps or temporary prosthesis are fitted.

4
Osseointegration Waiting Period

2–4 months (sometimes 4–6 months for the upper jaw) are awaited; the implant fuses with the bone. A temporary prosthesis is used during this period.

5
Healing Check and Abutment Placement

Osseointegration is confirmed. The abutment (titanium or zirconia) is placed on the implant; 1–2 weeks of healing is awaited.

6
Digital or Conventional Impression

Abutment position is recorded; a personalized prosthesis design is made and sent to the laboratory.

7
Trial and Permanent Delivery

The prosthesis is evaluated in the mouth with a trial session; occlusion, colour and aesthetics are approved. It is permanently fixed with cement or screw.

In All-on-4/6 cases, surgery and temporary prosthesis can be completed the same day; the permanent prosthesis is fitted 3–6 months later.

Implant-Supported Prosthesis Care

The implant body does not decay; however the surrounding bone and gum can be damaged with insufficient care. Peri-implantitis (inflammation around the implant) is the leading cause of implant loss and is a preventable condition.

Daily Brushing (Fixed Prosthesis)

Brushing twice daily is mandatory. The implant-gum junction is particularly important; bacterial accumulation here can lead to peri-implantitis. A soft-bristled brush or electric toothbrush may be preferred.

Under-Bridge Cleaning

The spaces between teeth and under the bridge in fixed bridge prostheses cannot be cleaned with regular dental floss. Use of superfloss (under-bridge floss), an interdental brush and an oral irrigator is essential.

Removable Prosthesis Care

Every night the prosthesis should be removed and first the inside of the mouth, then the prosthesis should be cleaned. Use a soft brush and liquid soap under running water; toothpaste scratches the surface. An effervescent tablet can be added 1–2 times a week.

Use of Oral Irrigator

Especially in full-arch and multi-unit bridges, the oral irrigator cleans areas unreachable by brush and floss. Start using on the low pressure setting. Very effective for peri-implant cleaning.

Regular Clinical Check-Up

Every 6 months: screw torque, peri-implant bone level and gum health are assessed. For fixed screw-retained prostheses, annual removal and professional cleaning are recommended.

Bruxism Management

Teeth clenching causes significant damage to implant-supported prostheses. Masseter Botox and night guard use are mandatory for patients with bruxism; otherwise prosthesis and implant lifespan is shortened.

Dr. Sevgi Savaş Akbaş – Dentist, Implant-Supported Prosthesis, Ankara İncek

Dr. Sevgi Savaş Akbaş

Dentist · Prosthodontics · Implant-Supported Prosthesis · Ankara İncek

Dr. Sevgi Savaş Akbaş comprehensively offers implant-supported prosthesis applications at her Ankara İncek clinic with fixed cemented, screw-retained/hybrid, Toronto prosthesis and removable implant-supported options. Each case's bone structure, aesthetic expectations and usage habits are evaluated to determine material selection (zirconia / E.max / monolithic) and prosthesis type; high precision is ensured with digital implant planning and surgical guide.

Implant-Supported Prosthesis – Frequently Asked Questions

How many years does an implant-supported prosthesis last?
With correct care and regular check-ups, implant-supported prostheses can be used for 10–20 years or even longer. While the implant itself can last a lifetime, the prosthesis on top (zirconia or porcelain restoration) may be renewed in 10–15 years. Prevention of peri-implantitis and bruxism management are the factors that most affect longevity.
What is the difference between a cemented and a screw-retained prosthesis?
A cemented prosthesis is bonded to the abutment; cutting the prosthesis may be required to remove it. A screw-retained/hybrid prosthesis is secured with a screw; the dentist can easily remove and reattach it by loosening the screw. For single teeth and small bridges, cemented is advantageous; for full-jaw restorations, the screw-retained system is more advantageous.
What is a Toronto prosthesis?
A Toronto prosthesis is a full-jaw fixed prosthesis screwed onto 4–6 implants that cannot be removed by the patient but can be removed by the dentist for periodic maintenance via the screw-detachment method. It is frequently applied with the All-on-4/6 concept. It offers comfort very close to a fixed prosthesis.
What is the difference between All-on-4 and All-on-6?
All-on-4 uses 4 implants and All-on-6 uses 6 implants. All-on-6 is mechanically more advantageous thanks to more support points; however it requires slightly more bone. In both systems, same-day temporary fixed teeth can be fitted. Suitability is determined with 3D tomography.
Should zirconia or porcelain be preferred for implant-supported prostheses?
E.max (all-ceramic) offers the most natural light transmittance for front teeth. Monolithic zirconia is much more durable for back teeth and bruxism cases. Zirconia or hybrid material is used for full-arch (full jaw) restorations. The decision is made together by evaluating tooth position, aesthetic expectations and chewing load.
Is care for an implant-supported prosthesis different from natural teeth?
Basic brushing is the same; however the areas requiring extra attention differ. If there is a bridge, superfloss and an interdental brush are essential; an oral irrigator is highly effective. For fixed screw-retained prostheses, annual dentist check-up and screw torque assessment are required. Removable implant-supported prostheses should be removed at night for cleaning.
What is peri-implantitis and how is it prevented?
Peri-implantitis is bacterial inflammation of the gum and bone around the implant. If left untreated it leads to implant loss. It is largely prevented with daily brushing, under-bridge cleaning, an oral irrigator and 6-monthly professional check-ups.
Should I prefer a titanium or zirconia abutment?
Zirconia abutments are preferred for front teeth; they do not create grey gum reflection and contain no metal. Titanium abutments are more advantageous for back teeth in terms of durability and cost. Zirconia abutments can be applied in all regions for patients with metal allergy.
Is implant-supported prosthesis application painful?
The surgical stage is performed painlessly under local anaesthesia; sedation can also be applied when necessary. Mild pain and swelling for 2–4 days after surgery is normal; it is controlled with painkillers. The prosthesis fitting stage does not require surgery; it is completely painless.
I have a teeth clenching habit — can I have an implant-supported prosthesis?
Yes; however having an implant-supported prosthesis made without bringing bruxism under control seriously shortens the lifespan of the prosthesis and implant. Teeth clenching should first be managed with masseter Botox or a bruxism splint, then the prosthesis should be planned; bruxism protection should also be maintained in the long term.
Why Sevgi Savaş Clinic in Ankara İncek for implant-supported prostheses?
At our clinic, fixed cemented, screw-retained/hybrid, Toronto and removable implant-supported prosthesis options are applied in a personalized manner with digital implant planning and surgical guide use. Zirconia or E.max material selection is determined together by evaluating aesthetic expectations and bone structure.

Book an Appointment for Implant-Supported Prosthesis Planning

Let us determine the most suitable solution at our Ankara İncek clinic — from a single missing tooth to complete edentulism; from fixed cemented to All-on-4 Toronto prosthesis.

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