Tooth Replacement and Restoration Options

Maintaining a full, functional, and aesthetically pleasing set of teeth is essential not only for chewing and speech, but also for overall systemic health and quality of life. The teeth play a crucial role in maintaining proper nutrition, as compromised dental function can limit dietary choices and lead to nutritional deficiencies. In addition, healthy dentition supports clear articulation during speech and contributes to the structural integrity of the facial skeleton, preserving facial symmetry and preventing premature sagging or collapse of soft tissues.

Tooth loss and structural tooth damage remain prevalent issues globally, with millions affected across all age groups. Beyond the obvious functional limitations, dental defects can have far-reaching psychological effects, influencing self-esteem, social interactions, and mental well-being. Patients with missing or severely damaged teeth often report withdrawal from social situations and reduced quality of life.

Why Cuba

The management of tooth loss and structural dental damage in Cuba is focused on restoring optimal oral function, improving aesthetics, and supporting long-term oral health. Emphasis is placed on the precise restoration of dental anatomy and occlusion through the use of dental implants, bridges, dentures, and crowns, with careful attention to safeguarding periodontal health, maintaining proper jaw alignment, and ensuring balanced bite forces. Cuban dental teams rely on evidence-based prosthodontic and restorative techniques and receive advanced training in implantology and dental rehabilitation, allowing for safe, functional, and natural-looking outcomes. The integrated approach used in Cuba seeks not only to replace missing or damaged teeth, but also to preserve surrounding bone and soft tissue health, minimize future complications, and restore the patient’s ability to eat, speak, and smile with confidence.

Tooth Replacement and Restoration Options

A variety of dental procedures are available to restore or replace missing and damaged teeth, each designed to meet specific clinical needs and patient goals.

• Dental Implants

Dental implants are used to permanently replace missing teeth by anchoring artificial tooth roots into the jawbone, providing a stable, long-lasting solution that preserves bone structure and restores full function.

• Dental Bridges

Dental bridges are carried out to fill the gap left by one or more missing teeth, using adjacent natural teeth or implants as support, helping to maintain bite alignment and prevent shifting of remaining teeth.

• Dentures

Dentures are used to replace multiple or all missing teeth in an arch, restoring the ability to chew, speak, and maintain facial structure, especially when implants are not suitable or desired.

• Dental Crowns

Dental crowns are placed to restore the shape, strength, and appearance of teeth that are severely decayed, fractured, weakened, or aesthetically compromised, preserving the natural tooth structure whenever possible.

Classification and Types

Tooth replacement and restoration procedures can be categorized into several types, each designed to address specific clinical scenarios and patient needs.

Dental Implants

• Endosteal implants (most common): placed into the jawbone.
• Subperiosteal implants: placed under the gum but above the jawbone (less common, used in cases of insufficient bone).

Dental Bridges

• Traditional bridge: supported by crowns on adjacent teeth.
• Cantilever bridge: supported by a crown on only one side.
• Maryland bridge: uses a metal or porcelain framework bonded to the back of adjacent teeth.
• Implant-supported bridge: anchored by dental implants instead of natural teeth.

Dentures

• Complete dentures: replace all teeth in one arch.
• Partial dentures: replace several missing teeth.
• Immediate dentures: inserted immediately after tooth extraction.
• Implant-supported dentures: attached to implants for improved stability.

Dental Crowns

• Porcelain-fused-to-metal crowns: strong with natural appearance.
• All-ceramic or all-porcelain crowns: best aesthetic match for natural teeth.
• Gold crowns: extremely durable, often used on molars.
• Zirconia crowns: strong and aesthetic, increasingly popular.

Pretreatment Diagnosis

A thorough pretreatment diagnosis ensures that the most suitable restoration option is selected. It typically involves:

• Comprehensive dental examination
  Visual and tactile inspection of the teeth and gums.

• Dental imaging
  • Panoramic X-rays
  • Periapical X-rays
  • Cone Beam CT (for implant planning)

• Periodontal evaluation
  Assessment of gum health and bone levels.

• Occlusion analysis
  Examination of bite alignment and jaw function.

• Medical history review
  Screening for systemic conditions that may affect healing or success.

• Patient expectations and aesthetic goals
  Clear discussion of outcomes and treatment preferences.

Implementation of the Procedures

Each tooth replacement and restoration procedure follows a structured sequence of clinical steps to ensure optimal function, longevity, and aesthetic outcome. The following outlines how each procedure is typically implemented in modern dental practice

• Dental Implants
  • Implant Placement Surgery
    • The first phase involves the surgical placement of the implant fixture into the jawbone.
    • A small incision is made in the gum tissue to expose the underlying bone, and a precisely sized hole is drilled to accommodate the implant.
    • The implant is then inserted and secured within the bone. The gum tissue is sutured over or around the implant, and the initial healing phase begins.
    • This procedure is typically performed under local anesthesia, with or without sedation depending on patient preference and clinical needs.

• • Healing Phase (Osseointegration)
    • During this time, the bone gradually fuses with the surface of the implant, creating a stable and durable foundation capable of supporting chewing forces.
    • Proper osseointegration is essential to the long-term success of the implant and minimizes the risk of implant mobility or failure.

• • Abutment Placement
    • Once osseointegration is confirmed the implant is ready for the placement of an abutment — a small connector that links the implant post to the final restoration.
    • In many cases, a minor surgical procedure is required to expose the implant and secure the abutment.
    • The surrounding gum tissue is carefully shaped around the abutment to promote optimal healing and aesthetic contour.
• • Crown Placement
    • The final stage involves fabricating and attaching a custom-made dental crown to the abutment.
    • This procedure is typically performed under local anesthesia, with or without sedation depending on patient preference and clinical needs.

• Dental Bridge
  • Tooth Preparation
    • The first stage for dental bridge is the preparation and reshaping of the abutment teeth — the natural teeth adjacent to the gap where teeth are missing- by removing a portion of enamel to create sufficient space for the placement of dental crowns.
    • If an implant-supported bridge is planned, this step may involve implant placement instead of tooth preparation.
  • Impression Taking
    • After the abutment teeth are prepared, a precise impression of the teeth and surrounding structures is taken.

• • Temporary Bridge Placement
    • To protect the prepared abutment teeth and maintain function and aesthetics while the final bridge is being fabricated, a temporary bridge is placed.

• • Permanent Bridge Placement
    • Once the custom permanent bridge is completed, the temporary bridge is removed, and the underlying abutment teeth are cleaned and prepared for final placement.
    • The dentist carefully evaluates the bridge for proper fit, occlusion (bite alignment), and aesthetics. Once confirmed, the bridge is permanently secured in place.

• Dentures
  • Initial Consultation and Impressions
    • After initial consultation, precise impressions (molds) of the gums and any existing teeth are taken using dental impression materials or digital scanning techniques.

• • Bite Registration and Tooth Selection
    • During this stage, the dentist performs a bite registration to determine how the upper and lower jaws come together (occlusion) and to record the proper vertical dimension of occlusion.
    • A trial denture, typically fabricated in wax, is created based on the earlier impressions and bite registration. The trial denture is then placed in the patient’s mouth to assess fit, comfort, function, and aesthetics.

• • Final Denture Fabrication
    • After the try-in is approved, the denture is finalized. The wax model is converted into a durable acrylic or composite material using precise laboratory processes.
    • Once complete, the final denture prosthesis is fitted to the patient.

• Dental Crowns
  • Tooth Preparation
    • The tooth preparation phase is the removal of any existing decay, defective restorations, or structurally compromised portions of the tooth.
    • The remaining tooth structure is then carefully shaped to accommodate the crown.

• • Impression Taking
    • Once the tooth is properly prepared, an accurate impression (mold) of the tooth and surrounding dental arch is taken.

• • Temporary Crown Placement
    • While the permanent crown is being fabricated in a dental laboratory, a temporary crown is placed over the prepared tooth.
    • The temporary crown protects the tooth from sensitivity, bacterial contamination, and mechanical damage during this period.

• • Permanent Crown Placement
    • Once the final crown is completed, the temporary crown is removed, and the underlying tooth is cleaned and prepared for final restoration.
    • The dentist evaluates the fit, margins, color match, and bite alignment of the permanent crown before proceeding.
    • Once verified, the crown is secured to the tooth using strong dental cement, ensuring long-term stability.
    • Minor adjustments may be made to fine-tune the bite and comfort.