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Dental Implants were not always such a mainstream fixture in dentistry. There was a time when dental implants were for all practical purposes experiments in seeing what worked and what did not. In the last 15 years we have really entered a new age with dental implants being almost routine in their nature now. Most dentists cannot imagine a day without them anymore as a treatment for our patients.

Dental Implants are an artificial tooth root that a dentist, periodontist, or oral surgeon inserts into your jawbone to hold a replacement tooth or teeth(bridge). Dental implants are the perfect option for people with good oral health maintenance who are missing one tooth or multiple teeth due to periodontal disease, via trauma, or some other reason.

Dental Implants use the most modern materials that dentistry has to offer. Years and years of research have gone into the dental implants in use today. Dental implants are much more tooth friendly than traditional bridgework. Dental implants do not rely on neighboring teeth for support nor do the neighboring teeth need to be prepared to be part of the bridgework.

With optimal conditions and in the hands of a skilled dentist, dental implants can look as natural as your own teeth. Only you and your dentist would ever know you even have one. This gives patients the utmost in self confidence giving them the ability to broadly smile as well as eat as they choose. People missing teeth are generally self conscious about their smile and appearance. Following successful placement and restoration, dental implant patients can expect them to last a lifetime if they maintain good oral hygiene.

Modern dental implants can play a few roles in tooth or teeth replacement. These include:

-Replacement of one or more teeth without affecting the neighboring teeth.
-Act as support for a bridge. This will eliminate the need for a removable partial denture.
-Provide support and stability for a denture. Attaching a denture over dental implants make the denture more secure and comfortable. This is also called an implant supported overdenture.

Dental Implants and their advantages over Traditional Dentistry

-Cosmetics. When done properly dental implants will look and feel like your own teeth. Another plus is that since dental implants are placed directly in bone they prevent bone loss and gingival recession that happens over time in areas where teeth are missing. No one but you and your dentist will ever know you have a dental implant.

-Dental Implants allow conservation of tooth structure. Dental implants allow the dentist to save your adjacent teeth from preparations. A traditional bridge requires the preparation of neighboring teeth. Utilizing dental implants is a long term benefit to the patients dental health by saving their natural tooth structure.

-Self Confidence. The wonder of dental implants is that they allow patients to talk and eat full of self confidence. Dental implants offer security and freedom.

implant dentistry

Dental implants Diagram

-Highly Predictable. Dental implants have had a long track record of a very high success rate. Due to this they are an excellent option for tooth replacement.

Treatment

Any treatment for dental implants begins with a thorough examination to develop a proper treatment plan.  Without a good game plan the treatment will be doomed to fail.

As mentioned earlier, dental implants are ideal in the following situations:

-Single tooth replacement. Dental implants are an ideal option for patients with the quantity and quality of bone necessary to hold an implant. The dental implant will allow you to maintain the natural tooth structure of adjacent teeth while replacing a lost tooth.

-Multiple teeth replacement. Dental implants are also ideal in this situation. If you are missing several teeth, implant supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

-Replacing all your teeth. If you are missing all of your teeth, an implant supported full bridge or full denture (also called an implant overdenture) can replace them. This renders traditional dentures to the curb as dental implants used in this fashion will be more stable allowing patients to eat and talk as if they have their own natural teeth.

In some cases, patients will need help to allow for placement of dental implants. Luckily, modern dentistry has developed a few procedures to “help” patients along. These include:

-Sinus Augmentation.  Dental implants need a good quantity of bone along with good quality of that bone to succeed. The upper jaw is known to have poorer quantity and quality bone structure as opposed to the lower jaw. The maxillary sinus also plays a role in increasing difficulty in this area. Sinus augmentation can remedy these issues by raising the sinus floor and placing bone grafts in the area to aid in dental implant placement.

-Ridge Modification. When the bone is not 100% adequate for dental implant placement, dentists are able to make it perfect by performing a dental bone graft. A bone graft is the placement of bone in the jaw to to build it up. This gives an excellent platform for dental implants. Ridge modification has been shown to improve both appearance and long term success of dental implants.

Expectations of patient

Following placement of implants and restoration with crowns or dentures, patients can expect a life long restoration that will be stable and cosmetic. Just because these products are man made does not mean oral hygiene should be forgotten and neglected. Dental hygiene must be maintained at a high level if the patient wants to ensure these restorations last. Follow up dental visits are required just as if you had your own natural teeth. If dental implants are well taken care of the patient should expect them to last a lifetime!

Dental Implants have changed the way we look at dentistry. Dental implants are not just for single tooth or multiple teeth replacement. They can also be used in support and stabilization

of removable dentures. Long time denture wearers will tell you that over time the bone remodels and resorbs resulting in loose and ill fitting dentures. When this happens patients used to be forced to grin and bear it using various denture adhesives. Now with the development of dental implant supported dentures those days can be a relic left in the past for many patients.

Dental Implant Overdenture – What is it?

A dental implant supported denture is also called an overdenture. A traditional removable denture rests directly on the gums, and is not supported by dental implants. This is because the denture sits over the dental implants. The dental implants give support and stability to the denture.

A dental implant supported denture is recommended when a person is missing all the teeth in the jaw. The patient needs to have enough bone in the jaw to support the dental implants. The denture is able to stay in place using special attachments that allow the denture to “snap” into place over the dental implants.

Implant supported removable dentures usually are fabricated for the lower jaw. This is because regular dentures tend to be less stable on the lower arch due to tongue and musculature present. Usually, a regular denture made to fit an upper jaw is much more stable and tolerable on its own and doesn’t need the extra support offered by implants. If the patient chooses they can receive a dental implant supported denture in either the upper or lower jaw.

Dental implant supported denture should be removed daily to clean the denture and gum area just like traditional dentures. Also, you should not sleep with the dental implant supported dentures at night. Some people prefer to have fixed (permanent) crown and bridgework in their mouths that can’t be removed but this is not always possible in every patient’s case. Your dentist will consider your particular needs and preferences when suggesting fixed or removable options.

Dental Implants with bar supporting denture

Dental Implants with Bar Supporting Denture

Types of Dental Implant Supported Dentures

 

There are two types of dental implant supported dentures:

1) Bar-retained dentures. Your dentist will have a thin metal bar custom fabricated for your mouth. This bar will follow the curve of your jaw and is attached to 2-5 dental implants that have been placed directly into your jawbone. Clips or other types of attachments are fitted to the bar, the denture or both. The denture is then designed to fit directly over the bar stabilized by the attachments. The dental implants along with the bar and attachments gives the denture support and stability.

2) Ball-retained dentures. The dental implants in the jawbone hold a metal attachment(ball) that fits into another attachment(socket) on the

Dental implant supported denture - Ball retained

Dental Implants – Ball Retained Denture

denture. In most cases, the attachments on the implants are ball-shaped (“male” attachments), and they fit into sockets (“female” attachments)

on the denture. In some cases, the situation is reversed and the male attachment is in the denture and female attachment is on the dental implant. This also gives the denture wearer increased stability and retention over the traditional removable denture without dental implants.

In both scenarios, the removable denture will be made of a custom fabricated acrylic base that will look like gingival tissue. The teeth can be made of porcelain or acrylic. These teeth will look very natural. Either type of denture needs a minimum of 2 dental implants to work properly over the long term.

Placement of Dental Implants

The prime location for placement of the dental implants is in the front of the mouth. The reason for this is due to the fact that there is

supporting denture with dental implants

Visualization of dental implants supporting dentures

generally more bone present in this area for the dental implants. This is the case even if the teeth have been missing for a long period of time. When teeth are lost, bone is lost in that surrounding area.  Anatomy plays a role as well. In the front of the mouth there are less nerves orother important structures that could interfere with he placement of the dental implants.

The time schedule to complete the dental implants can be complicated. The general time frame is approximately 5 months for the lower jaw and approximately 7 months in the upper jaw. The process can take much longer if the case is more complicated. Complications can include the need for bone grafting or even sinus lifts.

The procedure generally requires two surgeries. The first surgery is for placement of the dental implants in the jawbone under your gingival tissue. The second surgery is to remove the gingival tissue that has now covered the dental implants. The second procedure comes 3-6 after the first.

There has been increased use of a one stage procedure.

A one-stage procedure is now used sometimes. In this procedure, your dentist places the implants and the supporting bar all at same visit.  The success rate of this procedure is high. if properly treatment planned.

Dental Implant Supported Denture Care

The dentures need to be removed at at night and to clean them. The attachments and/or bar need to be cleaned as well. Your dentist will give you instructions on how to clean these as they can be delicate.

Your dentist will periodically check the parts of your new denture to ensure they are secure and in proper place. Your denture may seem stable but over time these attachments can loosen. If they loosen even slightly it will cause the denture to move when chewing. This movement of the denture can cause sore spots as the denture rubs against your gums. Your dentist will also check to make sure your bite is correct and make any adjustments as needed.

The clip or other attachments on the bar retained denture usually will need to be replaced every 6-12 months. They are made of a plastic material (nylon) and will wear after continued use.

Complications that may Arise

The actual dental implant surgery carries its own risks but so does a bar retained denture. The fabrication of a bar retained denture needs extra space inside the denture to allow for the bar to fit inside. This means there is less support for the teeth in the denture. Due to this, the teeth sometimes come loose. This is an easy fix but an inconvenience for the patient.

Another important item is that the denture fits on the bar passively. This means that the bar is evenly balanced across all implants. If the fit is not passive, the extra strain can cause the screws holding the bar down to loosen. A special note for teeth grinders or clenchers is that their parts are more likely to break due to the excessive force they are placing on the components and dental implants.

Dental Implant Overdenture Expectations

A denture supported by dental implants will be far more stable than a traditional removable denture. Patients will find everyday tasks easier. They will find speaking easier. They will also not be concerned that their denture may fall out or become loose. Patients report being able to eat foods they have not been able to eat in years. A word of caution is to avoid sticky or very hard foods as you can damage the denture with these types of food.

A big advantage to having dental implants support the upper denture is the dentist can make your denture much less bulky. A traditional denture covers your entire palate whereas a dental implant supported denture does not need that extra material for support.

A whole new world has opened up with dental implants for both patient and dentist. The old compromise and limitations are slowly being worn away. We are entering a new world of dentistry and dental implants are leading the way!

 

Benefits of Dental Implants with Removable Dentures
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