Unfortunately, many people have had their teeth extracted due to consequences of life experiences. In other cases, the dentition has broken down beyond repair. Dentures are a reasonable replacement for the above situations. Properly fabricated dentures can provide patients with a functional and aesthetically pleasing replacement of their teeth.
The American Dental Association places the life of a complete denture at 5 years. The value of a properly fitted and fabricated prosthesis not only lies in the longevity of the prosthesis itself but also in the functionality and aesthetic value of the prosthesis.
Our goal as dental professionals is to restore function to a patient’s dentition. There are instances where patients have lost teeth due to life circumstances. Many times a complete denture is the only available option to replace missing or non-restorable teeth.
Our office utilizes the highest quality teeth and acrylics along with a specified protocol for fabrication of the prosthesis in order to provide patients with the best quality dentures available.
When discussing upper vs lower dentures there are many differences to be considered. Regarding the upper denture: most people function reasonably well with similar complaints such as loss of palatability of food and in some cases overactive gag reflex.
Lower dentures tend to be the cause of many issues with patients. As dental professionals we offer an analogy to define the difference between eating with natural teeth versus a lower denture: It goes as follows: With your natural teeth you insert 5 marbles in your mouth and chew your favorite food. The key is you cannot spit the marbles out or swallow them. This is the oral dexterity it takes to chew and function with a traditional lower denture. For this reason dental implants have become a very mainstream popular solution to a wide array of issues related to function with dentures. Improved function and quality of life for these patients makes this procedure a valuable treatment.
Removable Partial Denture
Patients missing multiple teeth in either the upper or lower arch many times choose to have a removable partial denture fabricated. In most instances, this is the most economical way to replace missing teeth. While this does provide function and in most cases better aesthetics, there are many drawbacks to a partial denture. A short list include the following:
- Bulk/thickness of the metal and acrylic necessary to give the appliance strength.
- Retention clasps that may fall in areas that are visible when the patient smiles.
- Food attraction and impaction around those clasps during eating that requires removal and cleaning after each meal or snack.
- Some level of movement of the prosthesis; as the removability of the appliance will create some amount of movement while in function.
In essence one needs to keep in mind that replacements such as partials and dentures fall under a category in dentistry known as Prosthetics. Sound familiar? Prosthetics is also utilized to define replacement of a missing body part. All of us would probably agree that having a leg cut off to replace it with a wooden leg is not going to provide the same function as the original leg. There will obviously be many shortfalls and drawbacks to the prosthetic replacement. One needs to apply this same concept to a removable denture (partial or complete) prosthesis.
With all that information in mind, many patients choose to have a partial denture fabricated to utilize while moving through the implant treatment planning and surgery phase of restoration. This provides teeth to smile with and function with while the implants are integrating into the bone beneath the partial. This also allows the patient to move at a restoration pace that may fit their personal budget more readily.
Implant Supported Upper Denture
There are multiple options for implant supported upper dentures. Below are different options for support and restoration to retain the upper denture. Depending on the level of retention a patient seeks there are several different options regarding the number of implants placed and how they can be restored.
Two implants placed in the anterior corners of the upper ridge with semi precision abutments to engage the denture upon insertion
4 implant sites selected in the upper arch, two anterior as noted above, and two posterior along with custom semi precision abutments to engage the denture upon insertion. The real value of this treatment in comparison to option 1 noted above, resides in the ability to remove the palatal acrylic out of the middle of the denture. This restores the patient’s ability to move food across the open palate and provide maximum retention.
Known as hybrid prosthesis in dentistry, this innovative treatment option provides support via 4 implants. A laboratory metal substructure is cast and bridged across all implant abutments and denture acrylic, and the teeth are bonded to the substructure frame. This appliance is screw retained by the dentist and not removable by the patient. The patient’s dental hygienist can remove the prosthesis to provide routine preventative hygiene procedures. This option provides the best support and function for an individual who wants the best function available to replace a traditional removable upper denture.
In this treatment option, implants are placed in ideal sites that provide for individual or fixed implant supported crowns or bridges to restore the entire arch with teeth solely supported by implants. This is the premier benchmark standard in implant restoration and function.
Implant Supported Lower Denture
As previously stated by the examples above; through the analogy of eating food with a lower denture, many patients struggle with lower denture success. For those that do have difficulty chewing and functioning with a lower denture this treatment option will be life changing.
Placing 2 implants in the lower anterior mandible allows for improved retention and stability for the denture wearer. Once integrated the semi precision attachments are secured to the implants and nylon changeable attachments are cured into the denture bay allowing for engagement upon insertion of the denture. This treatment option has become one of the most popular options for lower denture wearers.
Patients looking to take the lower denture to the next level can follow the same approach for the upper arch in the form of hybrid prosthesis above for the upper denture treatment as the protocol is similar in execution and function.
As with the upper denture; patients looking to restore function of the lower arch with multiple implants and fixed bridges and crowns can consider this treatment as well. Limiting factors for this type of treatment include availability of remaining ridge and supporting bone. With the noted upper restoration of this type, cost of treatment is many times the limiting factor.