Good, better, best!
Good, better, best seems to be an expression we here everywhere these days from the type of car you drive to the kind of lawn sprinkler you use. There always seems to be choices as to the quality and type of product you can invest in that essentially accomplishes the same task. Dentistry certainly falls into this category with so many available types of treatments there can be many acceptable solutions to one particular problem. My father used to refer to it as the Cadillac or the Chevrolet. His sort of tongue and cheek way of presenting two different dental options to fit a particular need.
Good, better, best also depends on your own circumstances, what might be best for one patient with unlimited finances, might be anything but acceptable to a patient with less resources. Health issues, age, budget, and oral anatomy are all variables that have to be considered when trying to apply this over simplified formula. A good example would be a patient who has his or her own natural dentition except for one anterior tooth and one molar. The need is simple, fill in the two spaces with teeth. However the way we go about this, and I can hear my father saying now "Do you want the Cadillac or the Chevrolet?" presents many options.
At the high end of things we could potentially be looking at implants with individual tooth restorations in each of the two locations. Certainly very costly, but no doubt the closest thing to having your natural teeth back as possible. This system has the advantages of being firmly rooted in the remaining residual ridge without any dependence on the remaining dentition surrounding. Another method might be to have two bridges designed, a bridge for the missing anterior tooth would involve crowning the two healthy teeth on either side with an artificial tooth suspended between them, and a similar arrangement for the missing molar. Certainly a solid and desirable treatment plan provided the teeth that are supporting this remain healthy. In the event one of these abutment teeth are lost the bridge is no longer serviceable and a fairly large investment has been lost.
The next rung in the ladder might be a cast frame partial. This would be a singular appliance designed to replace both missing teeth. It would be comprised of a metal framework on to which artificial teeth are attached and precision clasps grip on to remaining dentition. On the up side much less expensive than the previous two options, on the down side a larger apparatus to which a patient must grow accustomed, as well as less pleasing aesthetics if any of the clasping is visual.
One more rung down in the ladder would be an acrylic partial. Again a single apparatus with two artificial teeth but this time with no metal frame work and no metal clasping. It gains retention by simply wedging into the spaces where the natural teeth are missing. The up side of this apparatus is minimal cost, and the versatility to add more teeth should any further tooth loss occur. The down side is less reliable retention and shorter life span.
These are four very basic options and there are many variables on each of these designs. However each one essentially accomplishes the same task replacing two missing teeth. Something to consider the next time you are at your dental office and swear you hear a cash register go ca-ching when you open your mouth. There is usually more than one treatment plan available, make sure you are getting all the information before making a decision on what is good, better or best for you.