When several teeth are missing but some healthy teeth remain, there are two proven routes. The first is a combined restoration, in which a skeletal (cast metal) partial denture locks onto crowns on your own teeth with attachments. The second is a restoration on implants. A combined restoration needs no surgery and as a rule costs noticeably less; implants do not depend on the remaining teeth, but they need enough bone and two to six months to fuse with it. Which one is right for you depends on how many teeth remain, their condition and where they are, and that becomes clear at the examination.
What is a skeletal partial denture with attachments?
A skeletal denture has a metal framework that is mechanically very strong, so it is much smaller than a conventional denture and rests on the teeth, not only on the gums. It does not hook onto the remaining teeth with clasps; it locks on with attachments or telescopic crowns, precise connectors that cannot be seen.
The result is a denture that sits firmly, that you get used to quickly and that is not noticeable when you smile. Read more about every type of denture we make on the removable prosthodontics page.
What is a combined restoration, and how does the denture stay in place?
A combined restoration joins two types of restoration into one. Fixed crowns are made for the remaining teeth, attachments are built into them, and the skeletal denture locks onto the attachments. The denture rests on the crowns, sits firmly and comes out easily for cleaning, while the connectors stay invisible.
The crowns in a combined restoration are usually metal-ceramic, because they carry the load the denture passes onto the teeth. We explain the difference between crown types in metal-free or metal-ceramic crown. The whole process is described on the combined restorations page.
When are implants the better choice, and when a combined restoration?
Neither is better in every case. The question is which one suits your teeth, your bone and what you want.
A combined restoration makes sense when there are healthy remaining teeth that can carry crowns, when you do not want surgery or it is not medically justified, and when a shorter, more predictable treatment matters to you.
Implants have the advantage when one tooth is missing and its neighbours are healthy, because the neighbouring teeth are not ground down as they would be for a conventional bridge. They also have the advantage when you want work that does not come out, provided there is enough bone, which we check on a 3D scan of the jaw. Every type of work on implants is described on the implantology page.
| Combined restoration | Work on implants | |
|---|---|---|
| Surgery | not needed | placement under local anaesthesia |
| Waiting for healing | none | two to six months |
| What it rests on | crowns on your own teeth | implants in the bone |
| Does it come out | yes, for cleaning | fixed work no, locator-retained denture yes |
| Requirement | healthy remaining teeth | enough bone, assessed on a 3D scan |
| Overall cost | as a rule noticeably lower | higher |
How much does each option cost?
The final price is always worked out from the treatment plan, but the items on our price list show what each option is made of.
A combined restoration consists of:
- a skeletal denture with attachments: 72,000 RSD;
- attachments: CK 9,000 RSD or Bredent 6,000 RSD per attachment;
- crowns on the supporting teeth: metal-ceramic 15,600 RSD, metal-free 30,000 RSD per tooth.
For one tooth on an implant the price list has three items: implant placement 72,000 RSD, the abutment 11,700 RSD and the crown on the implant 33,000 RSD, a total of 116,700 RSD per tooth, not counting any bone grafting. With implants the price rises with the number of implants, whereas one skeletal denture replaces several teeth at once. The treatment plan decides how many crowns and attachments are needed.
How long does it take, and how many visits?
For a combined restoration, at the first examination we look at the X-ray and the remaining teeth and propose several treatment plans, with prices and timelines. Once you decide, the teeth are prepared, an impression is taken, the crowns and the denture are made and fitted precisely, and at check-ups we make sure everything sits as it should. You receive the exact number of visits and the timeline with the treatment plan.
For implants, placement is done under local anaesthesia and the stitches come out after seven to ten days. The bone then grows into the implant threads over two to six months, and during that time you can wear a temporary restoration. The permanent work is made once the implant has firmly fused with the bone.
How do you get used to a denture with attachments?
After a short period of adjustment you speak and eat completely normally with the denture. Because a skeletal denture rests on the crowns and teeth, it is smaller than a conventional one and adjusting is usually quicker.
The denture comes out every day for cleaning and goes straight back in. At check-ups we see how the denture sits and how the crowns and attachments are holding up to everyday use.
How do we make the decision?
At the examination we go through both options openly, with prices and timelines, and tell you what is realistic in your case. The decision is yours, in your own time. If several teeth are missing and you are weighing up the options, get in touch to book an examination.