Implant Supported Dentures

Traditional dentures can sometimes be challenging. Dentures on the upper jaw usually fair better than the lower jaw. The upper denture is able to cover the palate and usually obtain suction. However, covering the palate degrades the eating experience because the palate plays an important role in tasting food and feeling cold and hot. Speech is also often affected by covering the palate. The lower denture is notorious for being a challenge to manage. It is more likely to move around due to the tongue and other muscles and cannot obtain suction due to the shape of the lower jaw. As a result, chewing efficiency is severely decreased compared to a person who has all of his or her natural teeth. Dentures are about 80% less effective than natural teeth for chewing.  With the advent of dental implants, we have been able to address many of the challenges that conventional dentures face. These implant retained dentures can either be removable or fixed and each have advantages and disadvantages.

Benefits of Removable Implant Retained Dentures

– They provide much better retention and stability of the dentures while still allowing them to be removed by the patient and easily cleaned.

– Chewing efficiency is increased, allowing you to eat the normal foods you would with your natural teeth.

– On the upper arch, if enough implants are placed, the palate can be left uncovered allowing for better taste and speech. 

– When teeth are lost, the bone of the jaw usually starts to shrink, making stability and retention of dentures more difficult.  Utilizing implants helps hold the bone and prevent it from shrinking away.

– Easier to repair than fixed implant supported dentures.

Types of Removable Implant Retained Dentures

Stud Attachment Dentures- In these types of implant dentures, each implant in the jawbone has an attachment that fits into another attachment on the denture. The attachments on the implants are usually ball or button-shaped, and they fit into sockets on the denture.

Bar Attachment Dentures- Two or more implants have a thin metal bar attached that follows the curve of the jaw. Clips or other types of attachments are fitted to the bar, the denture or both. The denture then seats over the bar and is securely clipped into place by the attachments.   

Benefits of Fixed Implant Supported Dentures

– They most closely resemble having natural teeth.

– They do not come out and are fixed to the implants.

– Chewing efficiency most closely resembles natural teeth, allowing you to eat the foods you would with your natural teeth.

– Speech will be most natural, not requiring adaptation to a bulkier prosthesis.

– Since there is no movement of the denture, there are no gum sores or pain associated with removable dentures.

– Usually they are the most aesthetic type of prosthesis.

– In favorable circumstances, they do not require transitioning through a conventional denture and may be attached to the implants the same day of the surgery.

– Usually lower maintenance than removable implant supported dentures.

Challenges of Fixed Implant Supported Dentures

– They can be difficult to clean underneath and maintain the implants in a healthy state. Certain types can and should be removed by Dr. Goring yearly to allow for a thorough cleaning around the implants and inspection of the prosthesis.

– They are the most expensive type of implant retained denture, but the long-term benefits often outweigh the initial investment.

– They require an adequate amount of restorative space (space for the materials used to make the prosthesis) which may necessitate the removal of some bone at time of surgery.

– Certain types that utilize normal denture teeth will wear over time and need to have the teeth replaced.

– Because of the greater forces that can be generated with fixed implant dentures, there is an increased risk for material failure. Certain designs and types are better than others. Dr. Goring can help you make an informed decision of which type is best for you.

Types of Fixed Implant Supported Dentures

Bar-Reinforced- This type of fixed denture utilizes a bar (usually made from titanium but some newer materials are also being used) that attaches to all the implants and has the teeth and gum material placed over the bar. The prosthesis is not removable by the patient but can and should be removed by Dr. Goring at least once a year for in depth cleaning and inspection.

Bar-Reinforced with Crowns- This newer design is similar to the traditional bar-reinforced design but differs in that the bar has pegs that individual crowns or false teeth are placed on. The advantage of this design is improved aesthetics, less wear of the teeth, and it is easier to repair.

Full-Arch Zirconia- This type of fixed denture does not utilize a bar substructure as the whole prosthesis is made out of zirconia. Zirconia is a very strong material that can be altered to both tooth and gum coloring. The advantages of zirconia are minimal wear and long durability. The disadvantages of zirconia are its increased weight, less translucency of the teeth, difficulty to repair, and sometimes metallic sound when teeth come together.

Full Arch Implant Bridges- Implant bridges most closely resemble having natural teeth. This treatment requires the most implants per arch, a minimum of 6 per arch but often more. Instead of one solid prosthesis that attaches to all the implants, implant bridges are broken up into 3 or more segments. This makes cleaning easier, less bulk of material, and usually a more natural appearance. Implant bridges are usually made from either zirconia, porcelain fused to zirconia, or porcelain fused to metal. Dr. Goring can discuss the advantages and disadvantages of each material choice.