Direct answer

Several teeth may be replaced with individual ceramic implants, a bridge supported by fewer implants, or a combination of implant and non-implant treatment. The best design depends on the span, bone, implant dimensions and positions, bite forces, esthetics, cleanability, system components, and evidence for the proposed zirconia implants under multi-unit loading.

Key takeaways

  • One implant per missing tooth is neither always necessary nor always preferable.
  • A bridge connects the mechanical and hygiene consequences of several units.
  • Evidence for zirconia fixtures supporting multi-unit prostheses is more limited than for single crowns.
  • The temporary and final restoration should be planned before surgery.

Which designs can replace several teeth?

Options include separate implant crowns, an implant-supported fixed partial denture, a tooth-supported bridge, a removable partial denture, or a mixed plan. Connecting a natural tooth to an implant requires special consideration because they move differently and is not a default solution.

How are implant number and position chosen?

The plan considers span length, available bone, implant diameter and connection, restorative material, crown height, cantilevers, opposing teeth, grinding, and whether the bridge can be cleaned. More implants do not automatically correct unfavorable position, and fewer supports can increase mechanical demand.

What is known about zirconia fixtures?

A 2025 systematic review found short- to mid-term multi-unit zirconia implant evidence promising but heterogeneous, with 13 studies and fewer demanding indications than the titanium literature. Results from a zirconia bridge placed on titanium implants do not prove the same outcome for zirconia implant fixtures.

Questions for a multi-tooth plan

  • Why are this number and distribution of implants proposed?
  • Which units are connected, and are there cantilevers?
  • Are the implant fixtures, abutments, screws, and bridge all ceramic?
  • How will floss, brushes, or irrigators reach beneath the restoration?
  • What can be repaired without removing an integrated implant?

Selected references

  1. Monteiro CGJ, et al. Clinical outcomes of zirconia implants supporting multi-unit and complete arch prostheses: a systematic review and meta-analysis. Journal of Prosthetic Dentistry. 2025;134(5):1631.e1–1631.e8. doi:10.1016/j.prosdent.2025.07.020.
  2. Roehling S, Gahlert M, Bacevic M, Woelfler H, Laleman I. Clinical and radiographic outcomes of zirconia dental implants—a systematic review and meta-analysis. Clinical Oral Implants Research. 2023;34(Suppl 26):112–124. doi:10.1111/clr.14133.