Implant Dentures

What is a dental Implant?

A dental implant is a titanium screw similar to that used by orthopedic surgeons. The fixture is allowed stay under the gum for approximately 4 to 6 months which facilitates bone to implant bonding. The process of bone covering the implant surface, called “osseointegration”, makes the screw solid enough for us to use it as tooth. The key element of osseointegration is the fact that the fixture must not move within the bone in order to allow for bone to implant bonding. Once healing process is complete, a permanent porcelain crown can be fitted.

What are Implant Dentures?

Implant supported dentures (also called overdentures) are another option for patients who are missing multiple teeth. They are removable appliances that are attached to the jaws of the patient. They are secured by two or more implants and are very different from the traditional dentures your parents or grandparents may have worn (which may have required adhesives to keep them in place). Overdentures are full or partial dentures that are designed to attach to dental implants, so they can be snapped in for a secure fit and pulled out for easy cleaning and care.

Why would one consider implant overdentures vs conventional dentures?

The main reason why people complain about their dentures is that the dentures move away from their gums. When the tongue pushes on the denture from behind during speech or chewing, the denture moves away from its original space. When there is contact w/ opposing denture or teeth, the denture gets pushed into the gum. If the denture is not aligned properly, this can cause sore spots and overall soreness for the patient. This is how dentures become uncomfortable, not to mention the embarrassment that comes with dentures randomly falling out of the patients mouth. Clips or attachment systems can retain the denture and prevent upward movement, or movement away from the patients gum. This system is ideally utilized when there is contact with the opposing dentition; the denture sits in place and does not cause injury to tissue.

Are all overdentures the same?

There are two different kinds of overdentures. They can be retained tooth overdentures (dentures held by teeth), or implant overdentures (held by implants). Implant overdentures can be further divided into two subgroups: stud overdentures and bar overdentures. Stud overdentures, also known as ball or locator overdentures, are held by individual implants while bar overdentures are retained by a bar with attachment clips.

The main differences between stud and bar overdentures include:

  • Stud Overdentures
    • Require at least two implants to retain overdenture
      • Tend to require more implants than Bar Overdentures
      • Prevent the denture from moving away from the gums
  • Bar Overdentures
    • The bar provides enhanced stability of the denture
    • Prevent the denture from moving away from the gums AND prevent the rocking of the denture

Stud overdentures require a minimum of two implants to support the overdenture. There can be more implants placed to improve the stability of the denture. When two implants are placed, they need to be placed anteriorly (towards the front) of the patients jaw. The only function they have is to prevent the denture from moving away from the gums, they are not designed to hold the denture down.  Nonetheless, patient comfort is significantly improved with this design.

Bar overdentures have a bar that constitutes the infrastructure of the dentures. The advantage of having a bar is that it not only prevents the denture from moving away from the gum, but it also prevents the rocking of the denture and improves stability, which contributes to the enhanced comfort for the patient. Another benefit of the bar overdenture is that, typically, the denture has a superstructure framework that fits exactly over the bar, making the denture stronger. Ultimately, this can help prevent random fracture of the dentures.

How do implant overdentures compare to traditional dentures?

Traditional dentures were commonly used in dentistry during a time where there were no better options. They provided patients with a removable set of teeth that restored minimal form and function to the patients mouth. This treatment came with inherent problems due to the denture design; ranging from progressive bone loss, to instability, dentures were far from an ideal, long-term treatment. In order to improve on traditional dentures, overdentures were invented to help keep the dentures in place. Other benefits not found in traditional dentures include improved support, stability, retention and tactile sensation, as well as no bone loss when compared to conventional dentures. Your chewing strength can even increase by up to 300 percent.

The most valuable improvement made by implant dentures is their ability to stabilize and keep the dentures in place. The effect of the implants prevents the movement of the denture with respect to the gums, which makes it easier for the patients to speak and chew.

Implant Dentures

The design of an overdenture will depend on the number of implants supporting it. With two implants (usually placed in the positions of the canine teeth), overdentures will likely have the same design as conventional dentures. But when more implants are used and connected with a bar, the denture flanges (extensions) can be reduced and the palate of an upper denture can be removed. The implants provide significantly more stability, comfort, and biting force to the denture. This allows for better sensation of food on the roof of the mouth and a less cumbersome feel.

What are the health effects of Implant Dentures?

Most patients who wear dentures are unaware of the fact that they are losing bone and gum tissue. Natural teeth, generally, do an adequate job of stimulating bone tissue, which prevents the bone from resorbing. Once the teeth are gone, there is nothing to prevent the bone tissue from decreasing and dentures have been known to accelerate the resorbtion process. A solution to this problem is the addition of implants. With implant overdentures, the resorption process is slowed due to the fact that the implants stimulate the bone tissue, to some degree. While implant overdentures are not as effective at stopping bone resorption as implant bridges, they do a significantly better job than dentures alone.

How should denture implants be maintained?

Denture patients without teeth should maintain their dentures and expect to see a hygienist every 12 months. However, implant dentures will be expected for recare every 6 months, due to the involvement of implants. In those appointments, dentures will be polished and cleaned of any bacteria or fungus. When the surface of the denture is smooth, it becomes unattractive for plaque and bacteria. The same applies to removable appliances that contain acrylic.

In the case of overdentures, there are movable parts and plastic inserts so replacement of inserts may be necessary every 6-12 months. Poorly constructed overdentures may be very expensive to maintain, as some of these mobile parts will wear quicker than they were designed to. It is not difficult to find patients who have had poorly designed overdentures and implant distribution, where the replacement of clips occurs within a couple of weeks of the insertion. Therefore, it becomes very important to see a dentist who can think the design through and make sure the attachments are well distributed in order to optimize the results.

Major Dental Clinics prosthodontists have extensive training and experience in all aspects of dentures and implant dentistry, which allows them to create natural-looking, precision-fit, implant-supported dentures and partials.

Are there other treatment options I should consider?

While implant overdentures are a great step-up from traditional dentures in terms of stability, comfort, and technology, the best denture alternative that modern dental medicine has to offer is an implant bridge. Implant bridges are commonly known as “All-on-4 Dental Implants” or “All-on-4 Immediate Implants”.