Dental Implants have changed the way we all look at tooth replacement and 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 dental 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.
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
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
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 From Dental Implants
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!