14 September 2026

Équipe Body Expert

15 min de lecture

Fixed dentures: crowns, bridges and implant-supported teeth

Prothésiste dentaire travaillant sur un modèle en plâtre avec ses instruments au laboratoire

A fixed denture is cemented or screwed into place, and you cannot take it out yourself. Only your dentist can remove it, in the surgery. Two kinds of support are possible: your own teeth, prepared to carry the restoration, or one or more implants placed in the jawbone. That choice then governs how long the work is expected to last, what maintenance it needs and how much of it the NHS will cover. This article sets out the devices available, when each is indicated, the survival rates reported in the literature, the two ways a restoration can be held in place and what the whole thing costs in Britain.

The Body Expert view

The right device depends on the state of the remaining teeth far more than on any general preference. Where tooth loss is advanced, we recommend clearing the mouth first, then a screw-retained full-arch bridge per jaw, which stays in place day and night. In other cases, a dental assessment with a panoramic radiograph shows which sites call for an implant and which damaged teeth can be kept under a crown or a bridge. Our patients achieve savings of up to 70% against British private fees.

Before and after views of a smiling bearded patient, damaged front teeth then an even arch, Body Expert logo

Every situation gets its own answer. A written quotation is free and comes back within 24 hours, with no obligation.

What actually makes a denture fixed

British patients use several names for work that stays in the mouth: permanent dentures, fixed dental plates, fixed teeth. Clinically, the dividing line is simple. A fixed restoration is cemented or screwed to its support and comes out only in the surgery, whereas a removable one is taken out by the patient for cleaning. Appliances that clip onto implants sit in between, and we cover that family separately in our article on implant-retained dentures.

Beyond appearance, a fixed restoration restores a working chewing surface on the treated side. A missing tooth lets its neighbours drift and the opposing tooth over-erupt, which gradually unsettles the way the two arches meet. The resulting problems with dental occlusion sustain joint and muscle pain that reaches well beyond the mouth.

3D rendering of an implant placed in the upper jaw and the crown that will sit on it

Where the tooth being replaced has no usable root left, the restoration is carried by an implant instead. A dental implant is a screw, usually titanium, placed in the alveolar bone that once held the teeth. This artificial root fuses with the bone during healing, then receives an abutment onto which the prosthesis is fixed. Removable work stays indicated whenever bone volume, general health or budget rules that route out.

The different types of fixed denture

The choice turns on how much tooth structure has been lost, how many teeth are missing and what usable roots remain. Many patients end up combining several of these devices across the same arch.

Ceramic crown held in tweezers above an implant abutment on a working model

The crown, on a tooth or on an implant

A crown covers the whole visible part of the tooth and gives it back its shape. It is indicated when a tooth is too broken down for a filling, or when root canal treatment has left its walls fragile. Where the root is sound but the crown of the tooth has gone, the dentist first cements a post and core, which gives the crown something to grip.

Three material families dominate: metal-ceramic, a metal coping faced with cosmetic porcelain; monolithic zirconia, milled from a single block; and lithium disilicate, a glass ceramic best known under the IPS e.max brand name. Five-year results for single crowns on implants are close from one material to the next, at 98.3% survival for metal-ceramic and 97.6% for zirconia. The difference shows up elsewhere: 86.7% of metal-ceramic crowns and 83.8% of zirconia crowns go through the period without any complication at all, with chipping of the cosmetic porcelain affecting roughly 2.9% of the former and 2.8% of the latter, while fractures of the framework material itself stay rare and are more common in zirconia, at 2.1% against 0.2% (Pjetursson et al., 2018). Our article on dental crowns sets out the appointment sequence in detail.

Ceramic crown seated on a prepared molar of a plaster model

Inlays and onlays, where the tooth can be kept

These partial restorations are made in the laboratory, then bonded to the tooth. An inlay sits inside the prepared cavity, while an onlay extends over the biting surface and its cusps. The point is to save tooth tissue, since the tooth is not reduced all the way round as it would be for a crown. They are fixed restorations in their own right, indicated on a broken-down tooth whose walls are still solid enough to hold. Where exactly they fall in the decision is covered in our article on inlays and onlays.

Three-unit ceramic bridge being checked with a probe on a lower jaw model

The bridge carried by the neighbouring teeth

A bridge replaces one or more missing teeth with pontics suspended between two abutment teeth. Those abutments are prepared and crowned, which means cutting into healthy tissue when they were intact. That is the main argument raised against a bridge wherever an implant is feasible.

The follow-up data explain the trade-off. At ten years, 89.1% of tooth-supported bridges are still in the mouth (95% confidence interval: 81 to 93.8). The success rate, which additionally requires that nothing went wrong over the period, stands at 71.1%. The gap between those two measures marks the bridges kept at the cost of an intervention. The most frequent events at ten years are loss of retention, at 6.4%, fracture of the veneering material, at 3.2%, decay under an abutment leading to removal, at 2.6%, and abutment fracture, at 2.1% (Tan et al., 2004). The figures make the point that the health of the abutment teeth governs how long the whole thing lasts.

Full-arch bridges on implants (all-on-4, all-on-6, all-on-8)

On a fully edentulous arch, a complete bridge replaces the fourteen teeth of one jaw while resting on a small number of implants, anchored in the maxilla above and the mandible below. Each protocol is named after the number of supporting implants.

Full-arch bridge fixed on four implants in a lower jaw, shown in transparency

All-on-4 uses four implants, the two posterior ones tilted so that they engage the areas where bone has stayed densest. That tilt often makes a preliminary bone graft unnecessary.

Full-arch bridge fixed on six implants spread along the lower jaw

All-on-6 spreads six implants along the arch. It suits patients with enough bone volume and allows the bridge to extend further back, which brings posterior chewing units back into use. Our article on all-on-6 treatment follows the protocol from end to end.

Full-arch bridge fixed on eight implants in an edentulous lower jaw

All-on-8 multiplies the anchorage points, mainly in the upper jaw, where bone is less dense and the span to be supported is longer.

Body Expert directs most of its patients towards all-on-6, a workable middle ground between the number of implants placed and the length of arch restored. The bridge takes the form of an arc carrying a false gum, onto which ten to twelve ceramic teeth are mounted. No palatal plate covers the roof of the mouth, so taste and temperature are preserved.

The number of implants is settled on the radiograph and on the prosthetic plan, according to the bone available and the length of arch to be restored.

The screw-retained bridge on six implants

A screw-retained bridge is fastened directly into the implants through access channels left in the biting surface of the prosthetic teeth. It also goes by the names stilt bridge and Brånemark bridge, after the Swedish surgeon who described osseointegration. By passing chewing forces down into the bone, the implants slow the ridge resorption that tooth loss sets off.

Screw-retained bridge with its six implants and abutments, lower jaw

Fitting happens in two stages. The six implants go into the jawbone first, which requires enough bone volume, and a graft is still needed in some patients. The definitive bridge is then made and fitted after three to six months of healing, the time it takes for bone and implant surface to knit together.

Multi-unit prostheses carried by implants show 95.4% survival at five years and 80.1% at ten, across all generations of work. Restricted to metal-ceramic prostheses, which leaves out the older acrylic-on-metal bridges, the figures rise to 96.4% at five years and 93.9% at ten (Pjetursson et al., 2012). The difference between those two readings comes down to the material used, which is something a quotation should state.

The clip-on denture over four implants is not fixed work

A stabilised denture clips onto four implants, through press-stud attachments or over a retention bar known as a Dolder bar. It needs no adhesive and holds far better than a conventional complete denture. It still comes out every evening for cleaning, which places it with removable work despite its implant anchorage. Where bone allows, Body Expert offers a screw-retained solution instead, which the patient never handles.

Patient reclined in the dental chair while a gloved clinician holds a demonstration model of both dental arches

Screwed or cemented: what the retention method changes

On implants, a restoration can be screwed into the abutment or cemented onto it like an ordinary crown. The two are equivalent for survival: 96.03% at five years for cemented reconstructions and 95.55% for screw-retained ones, a difference that is not statistically significant. Screw-retained full-arch bridges reach 96.71% over the same period. What separates them is the incident rate, since screw-retained work shows fewer technical and biological complications overall, in particular less loss of retention, fewer loose abutments, less porcelain chipping and fewer episodes of suppuration around the implant (Wittneben et al., 2014).

The explanation is mechanical as much as biological. A screw-retained prosthesis comes off by unscrewing, which allows professional cleaning, a reline or a laboratory repair without breaking anything. A cemented one has to be destroyed to be taken off, and the excess cement that escapes below the gum at fitting is a well-recognised trigger of peri-implant inflammation. The decision stays a clinical one all the same: cementation absorbs differences in implant angulation that screw access will not tolerate, and it avoids visible access channels on front teeth.

Complications, maintenance and reviews

Fixed work does not end the need for follow-up. Over five years, only 66.4% of patients with a multi-unit implant prosthesis get through without any incident, technical or biological. The most frequent events are fracture of the veneering material, in 13.5% of patients, peri-implant and soft tissue complications, in 8.5%, loss of the access hole restoration, in 5.4%, a loose abutment or screw, in 5.3%, and loss of retention on a cemented prosthesis, in 4.7% (Pjetursson et al., 2012). None of these means losing the restoration, but each one means an appointment.

Day-to-day care resembles looking after natural teeth, with brushing twice a day, and it adds the cleaning of the space left between the false gum and the ridge, using interdental brushes or a water flosser. The professional review is a different matter from an ordinary check-up: the mucosa around each implant is probed, the screws are checked and the bridge is sometimes removed for cleaning. The brand and range of the implants placed determine how easily spare components can be sourced for that work, a point our article on which implant brand to choose develops.

What fixed dentures cost in the UK

On the NHS

NHS dental treatment in England is grouped into three charge bands, and you pay the band that covers the most complex item in your course of treatment. Crowns, bridges, inlays and onlays all sit in Band 3, at £332.10, alongside dentures and orthodontic appliances. Two consequences follow. A single crown and a full set of crowns and bridges carried out in one course of treatment attract the same charge. Anything falling outside the NHS system is not covered by it at all.

NHS charge band	Patient charge
Band 1, examination and X-rays	£27.90
Band 2, fillings and extractions	£76.60
Band 3, crowns, bridges, dentures	£332.10

Implants are the main exclusion. They are normally available privately only, and the NHS provides them rarely, for patients who cannot wear a denture for particular reasons such as mouth cancer or an accident (NHS, 2026). An implant-supported crown or bridge therefore falls outside band charges, whatever the restoration on top of it may be. Our article on dental implants and the NHS goes through the referral criteria.

Privately

Private fees vary with the practice, the materials and the complexity of the case, and published guide prices should be read as ranges rather than quotations. Kiss Dental, a Manchester practice, put a single dental implant at £2,000 to £3,000 in its April 2026 guide, implant-retained dentures at £4,000 to £8,000 and an all-on-4 arch at £6,000 to £25,000 and above. MyoDental, in Surrey, advertised implant-retained dentures from £5,600 and all-on-4 from £9,995 in December 2024. The spread across the upper end of those ranges reflects the number of implants, the material of the bridge and whether grafting is needed.

Having fixed dentures fitted in Turkey with Body Expert

Istanbul concentrates most of the Turkish dental activity aimed at patients travelling from Europe. Several clinics in the city run their own prosthetic laboratory, so a try-in can be adjusted the same day instead of being sent out to an external workshop. Direct flights serve the city from the main British airports, and there is enough to see between appointments.

Body Expert works with partner clinics in Istanbul selected for their facilities and their surgeons’ experience, where savings of up to 70% against British prices are achievable. Your stay covers nights in a five-star hotel with breakfast, VIP transfers between airport, hotel and clinic, a dedicated English-speaking patient coordinator and 12 months of post-operative follow-up. Flights remain your own expense. A written quotation is free and comes back within 24 hours, with no obligation.

A quotation worth reading names the crown material, the retention method chosen, screwed or cemented, the kind of temporary work you will wear while healing, and how many trips the plan involves. It also identifies the clinician who will see you for reviews once you are home, since restoring a full set of teeth means appointments spread over several years. For any plan built on dental implant treatment, that arrangement matters as much as the figure at the bottom of the page.

Frequently asked questions

Is a fixed denture the same thing as a permanent denture?

The terms overlap in everyday use but not in the surgery. A permanent denture usually means a definitive appliance as opposed to a temporary one, and it may still be removable. Fixed means you cannot take it out: the restoration is cemented or screwed, and only your dentist removes it.

Can ceramic on a fixed restoration chip?

Yes, and it is the most common technical complication on implant-supported work. A small chip in the cosmetic porcelain can be polished in the chair. A larger fracture means remaking the unit concerned, which is straightforward on a screw-retained prosthesis and considerably heavier on a cemented one.

Can a bridge rest on a single tooth?

It can in certain configurations, known as a cantilever bridge, with the pontic carried in extension. The mechanical load on the single abutment is higher than in a conventional bridge, which restricts the design to particular situations and to teeth that are not heavily loaded.

Does a screw-retained bridge come off for a review?

Your dentist can take it off by removing the screws, usually for deep cleaning or a repair, and refit it in the same appointment. That ability to remove and refit is one of the arguments for screw retention on extensive reconstructions.

How long is the wait between implant placement and the definitive bridge?

Allow three to six months of healing before the definitive bridge is fitted, with the delay depending on bone density and on whether grafting was needed. Most protocols provide a fixed temporary prosthesis to wear during that period.

Does fixed work mean fewer dental visits?

No, it makes regular reviews more important. The tissue around implants is monitored by probing, screws are checked and contact points wear. Regular follow-up catches a loose screw or early inflammation before either threatens the anchorage.