Questions about zirconia full arch dental prosthesis

[EastHumboldt]

Sorry about how long this is. For me it feels like a complicated decision. For clarification, I’m only talking about my upper jaw. I’m 67 years old.

I lost several of my upper front teeth in an accident about 45 years ago. I had various veneers, crowns, and about 16 years ago, a six tooth bridge which was anchored on what was left of 3 front teeth. Recently those 3 teeth gave up the ghost and had to be extracted along with the two adjacent teeth which were showing bone loss in the jaw. So now I’m missing my 8 front upper teeth. Four bone grafts were done at the time of extraction in early November, preparatory to installing four future titanium implants and a future 8 tooth bridge. The titanium implants were scheduled for March, 2026 and the bridge install four months after that. I still have two 3 tooth bridges (molars)on either side of my upper arch. One bridge is 2 years old, one is 15 years old. I have a temporary partial denture to get me by in the meantime.

My old dentist who was gonna finish this project no longer takes my insurance, so I went looking for a new one. First one I went to see said it’s not smart to keep the two 3 tooth bridges, and if they fail, I’ll have to redo them or do a full arch anyway, so why not just do a full arch on six implants now for $22k? They also said one of the bridges was showing bone loss on one tooth, so that’s worrisome. I don’t trust this particular outfit because they seemed a little like “What can we do to put you in a new set of teeth today?” That doesn’t mean that the idea of a full arch prosthesis is a bad one.

I’ve had various old school bridges set on natural teeth for years and I understand how to keep the roots somewhat clean, and I also understand that they seem to fail eventually anyway. The two bridges I have left have a gap between the gums and the bridge which is pretty easy to floss, but is definitely a food trap and I get stuff out of there every single night. I was told the full arch would fit so tight to the gums that food and bacteria can’t get in there. Sounds like BS to me.

SUMMARY:

Existing condition upper arch… 8 front teeth gone, 4 bone grafts emplaced early November 2025 and paid for, 3 tooth molar bridge remains on each side.

Plan A was 4 titanium implants, new 8 tooth bridge, keep the two existing 3 tooth bridges. I already paid for the 4 bone grafts. About $16k left to do plan A. Plan A was slow and old school. One visit - Pull teeth, do bone grafts. Let heal 4 months. Next visit install titanium implants, Let heal 4 more months. Next visit install partial arch prosthesis. Seems about right.

Plan B is a 14 tooth full upper arch with six titanium implants, about $22k. Plan B full arch is made of milled zirconia which is sposed to be nearly as hard as diamonds. Plan B is more money but sounds like maybe a better long term solution. Plan B is a new approach. First visit pull remaining teeth ( molar bridges) install implants same day, install temporary prosthesis. Go on a soft food diet for eight weeks while things heal. Install full arch permanent prosthesis at 3 months or so. Seems a bit rushed? Their big theme is “you get new teeth the same day!”

Questions:

Are there any advantages to keeping the three-tooth bridges which are set on natural teeth? ( molars) one on each side. I was told X-rays show bone loss in one of those teeth ( by the lady who was trying to sell me the full arch prosthesis) One bridge is 2 years old, the other is 15 years old.

Are the titanium implants/ full arch prosthesis easy to keep clean?

Life expectancy of this vs existing bridges?

Anybody have one of these full arch set-ups installed? Good or bad stories?

Should I be scared of the “New teeth the same day” approach? Or the purveyors thereof?

 

[Burnsie]

I know $6K (22K vs 16K) isn't chump change, but if I'm up in that range anyway I'm going for everything new, rather than cobbling three different bridges together. If the place you have been dealing with so far seems kind of "used car sales" I'd be shopping around and definitely finding some place reputable. That may mean more $$.

 

[EastHumboldt]

I know $6K (22K vs 16K) isn't chump change, but if I'm up in that range anyway I'm going for everything new, rather than cobbling three different bridges together. If the place you have been dealing with so far seems kind of "used car sales" I'd be shopping around and definitely finding some place reputable. That may mean more $$.

Thanks. Of how I’m leaning. Do you have implants by chance?

 

[112Savage]

I am a dds but take this for what it cost you. Also being this is a hunting forum I am in no way providing official medical/dental advice since I have never examined you.

This is not a time to shop around. Find someone you trust and who will help you maintain the prosthesis and stick with them. Maintenance isn’t cheap. Yearly you’re looking at around $500-800 because the screws need to be replaced every other year and the prosthesis taken out and cleaned once per year and a cleaning without removal once a year as well. Cleaning around any implant prosthetic is imperative but anyone telling you it’s better or easier than natural teeth is lying.
Are you a diabetic or smoker? Those both greatly affect bone grafting and overall success with implants. Get that under control if you are.

The prices you are quoting are actually quite good. Honestly without radiographs I can’t tell you whether you should go full arch or just segmented bridges.

To answer your questions
Fixed tooth supported bridges/crowns have an average lifespan around 14 years
Implant supported prosthetics lifespan is entirely host/hygiene dependent and could be as short as 5 years or indefinite.
Implant shops that do implant prostheses but do not maintain them like a general dentist does should be avoided in my opinion.

 

[EastHumboldt]

I am a dds but take this for what it cost you. Also being this is a hunting forum I am in no way providing official medical/dental advice since I have never examined you.

This is not a time to shop around. Find someone you trust and who will help you maintain the prosthesis and stick with them. Maintenance isn’t cheap. Yearly you’re looking at around $500-800 because the screws need to be replaced every other year and the prosthesis taken out and cleaned once per year and a cleaning without removal once a year as well. Cleaning around any implant prosthetic is imperative but anyone telling you it’s better or easier than natural teeth is lying.
Are you a diabetic or smoker? Those both greatly affect bone grafting and overall success with implants. Get that under control if you are.

The prices you are quoting are actually quite good. Honestly without radiographs I can’t tell you whether you should go full arch or just segmented bridges.

To answer your questions
Fixed tooth supported bridges/crowns have an average lifespan around 14 years
Implant supported prosthetics lifespan is entirely host/hygiene dependent and could be as short as 5 years or indefinite.
Implant shops that do implant prostheses but do not maintain them like a general dentist does should be avoided in my opinion.

Thanks. I was hoping a dentist would weigh in. I owe you one so feel free to contact me if you have electrical questions!

 

[RockAndSage]

I am a dds but take this for what it cost you. Also being this is a hunting forum I am in no way providing official medical/dental advice since I have never examined you.

This is not a time to shop around. Find someone you trust and who will help you maintain the prosthesis and stick with them. Maintenance isn’t cheap. Yearly you’re looking at around $500-800 because the screws need to be replaced every other year and the prosthesis taken out and cleaned once per year and a cleaning without removal once a year as well. Cleaning around any implant prosthetic is imperative but anyone telling you it’s better or easier than natural teeth is lying.
Are you a diabetic or smoker? Those both greatly affect bone grafting and overall success with implants. Get that under control if you are.

The prices you are quoting are actually quite good. Honestly without radiographs I can’t tell you whether you should go full arch or just segmented bridges.

To answer your questions
Fixed tooth supported bridges/crowns have an average lifespan around 14 years
Implant supported prosthetics lifespan is entirely host/hygiene dependent and could be as short as 5 years or indefinite.
Implant shops that do implant prostheses but do not maintain them like a general dentist does should be avoided in my opinion.

Appreciate you adding your thoughts to this, it's great to hear from someone in the field.

 

[EastHumboldt]

I am a dds but take this for what it cost you. Also being this is a hunting forum I am in no way providing official medical/dental advice since I have never examined you.

This is not a time to shop around. Find someone you trust and who will help you maintain the prosthesis and stick with them. Maintenance isn’t cheap. Yearly you’re looking at around $500-800 because the screws need to be replaced every other year and the prosthesis taken out and cleaned once per year and a cleaning without removal once a year as well. Cleaning around any implant prosthetic is imperative but anyone telling you it’s better or easier than natural teeth is lying.
Are you a diabetic or smoker? Those both greatly affect bone grafting and overall success with implants. Get that under control if you are.

The prices you are quoting are actually quite good. Honestly without radiographs I can’t tell you whether you should go full arch or just segmented bridges.

To answer your questions
Fixed tooth supported bridges/crowns have an average lifespan around 14 years
Implant supported prosthetics lifespan is entirely host/hygiene dependent and could be as short as 5 years or indefinite.
Implant shops that do implant prostheses but do not maintain them like a general dentist does should be avoided in my opinion.

Do you have an opinion about the healing process with plan b? Meaning pull teeth and install implants the same day? Then let the implants and the extraction pockets heal under a temporary arch mounted on the newly installed implants?

 

[Slickhill]

I’m not a dentist. But like you I lost all my front teeth in an accident some years ago, I now have a bridge on top sitting on 2 implants and another on bottom sitting on two more. Mine are Zirconia on top of titanium, aside from taking about 5 years to get used to I’ve had no issues. I’d far prefer to have the real ones but they’re long gone so this is the best alternative available for now.

I also have a cousin I’m very close with who is an implant specialist. Her opinion is any real tooth that is save able should be kept as long as possible, no prosthetic will be as good as a real tooth. She also says to run far and fast from any outfit that extracts teeth and places implants in the same visit. She says she wants to see fully healed and healthy bone structure before any implant placement takes place, it lengthens the process but raises chances of long term success. And for the record she didn’t do any of mine, I lived several thousand miles away at the time but I trust her and consulted with her before proceeding when I had mine done and my surgeon was of the same opinion as she gave.

 

[112Savage]

Do you have an opinion about the healing process with plan b? Meaning pull teeth and install implants the same day? Then let the implants and the extraction pockets heal under a temporary arch mounted on the newly installed implants?

Really that depends on the condition of the bone, available bone, health/medications of the patient. I’m not a fan of immediate loading unless the patient is very healthy and very compliant. Every time gingiva are flapped you lose approximately 0.5mm of bone height and width, so fewer surgeries are better but I do like placing the implants, allowing them to integrate and then loading them with a prosthesis after 3-6 months of being in a conventional denture.

 

[abbrown]

DDS here too. From a high level only as I haven’t seen your case, I would recommend plan A while keeping the current bridges as long as possible, assuming they really are in decent shape. The longer you keep your natural teeth the longer you can avoid multiple surgeries and implants that have a shelf life and might fail and need to be redone. Get the anteriors done as planned in the controlled timing fashion to allow proper bone integration of the implants prior to loading, and then get a nice bridge done across the anterior. Then clean the crud out of it and follow your dentist’s recall and maintenance advice.
Should your posterior bridges fail in the future, and assuming there is still bone to work with through grafts, etc; I would then look at implant supported bridges in those areas to replace. Eventually you might get to one posterior implant bridge on each side and a third bridge in the anterior. That setup is fine as long as they are built to function together, and has the added benefit that if any one of those three has problems or fails it doesn’t doom the rest of the arch. If a full-arch supported prosthesis has an implant or 2 fail or the prosthesis fail you could be left having to almost start over. My 2c

 

[Burnsie]

Thanks. Of how I’m leaning. Do you have implants by chance?

Just my canine on the left side. I've watched father mess around with the patchwork method - he's told me several times he wishes he would have just got full implants, but at his age now he says he isn't going to drop that much money into it, and is just going to make due until the end.

 

[abbrown]

So many considerations though, as mentioned before:
Healthwise: smoking, diabetes, reflux, osteoporosis, general ability to heal, etc are all factors or possible contraindications to surgery.
Function: do you brux; are your posterior bridges in the right position within your arches to put your jaws in the right relationship to get the most functional anterior implants/bridge? If not, could possibly make more sense to look at full arch change.
Financially: realistically whether you are in network with insurance or not you’re not gonna get that much of this large treatment plan covered by the insurance because they suck and will be out of pocket a lot. I’d recommend sticking with a trustworthy clinician with proven results for you and set up a payment option rather than shop insurance providers you don’t know.