What are they?
An implant-supported denture is a type of denture that is supported by and attached to implants. It has special attachments that fit over the implants, like a snap fastener or a press-stud. These help to keep the denture in place, preventing movement, and dramatically improving the fit and chewing ability.
Implant-supported dentures can be made for either jaw, but are particularly beneficial in the lower jaw because regular dentures tend to be less stable there.
Why a denture instead of fixed porcelain teeth?
Many people do not like the idea of a denture because it is removable, but it offers some advantages over fixed implant teeth:
- Better cosmetics, particularly when a lot of the gum and bone has shrunk away
- Easier to clean and maintain
- Cheaper then porcelain crowns and bridges
Is it suitable for me?
If you are in good health and you DO NOT SMOKE, then it is likely that you are suitable for dental implants. Age is not an impediment to treatment, in fact senior patients may particularly benefit from the improved fit of implant supported dentures.
How Does It Work?
There are two types of implant-supported dentures: bar-retained and ball-retained. In both cases, the denture will be made of an acrylic base that will match the shade of your gums. Porcelain or acrylic teeth that look like natural teeth are attached to this base. We need at least two implants for support; we more often use ball-retained dentures for their simplicity and reduced cost.
- Bar-retained dentures — A thin metal bar that follows the curve of your jaw is attached to two to five implants that have been placed in your jawbone. Clips or other types of attachments are fitted to the bar, the denture or both. The denture fits over the bar and is securely clipped into place by the attachments.
- Ball-retained dentures (stud-attachment dentures) — Each implant in the jawbone holds a metal attachment that fits into another attachment on the denture. It works like a press-stud mechanism, keeping the denture steady in the mouth, but allowing its removal for cleaning.
The Process for implant dentures
The implants are usually placed in the jawbone near the front of your mouth because there tends to be more bone in the front of the jaw than in the back. This usually is true even if teeth have been missing for some time. Once you lose teeth, you begin to lose bone in the area. Also, the front jaw doesn't have many nerves or other structures that could interfere with the placement of implants.
The time frame to complete the implant depends on many factors. The shortest time frame is about five months in the lower jaw and seven months in the upper jaw. This includes surgeries and the placement of the denture. However, the process can last a year or more, especially if you need bone grafting or other preliminary procedures.
Two surgeries usually are needed. The first one places the implants in the jawbone under your gums. During the second surgery the abutment is placed on top of the implant so that it protrudes through the gums. The second procedure comes three to six months after the first.
A one-stage procedure is now used sometimes. In this procedure, we can place the implants and the supporting bar in one step. The success rate of this procedure is high.
Before any work is done, you will have a comprehensive consultation, during which we will review your medical and dental histories, take X-rays and create impressions of your teeth and gums so that models can be made. In some cases, we may order a computed tomography (CT) scan of your mouth. This shows where your sinuses (located above your upper teeth) and nerves are. It allows us to make sure they will not be affected by the implant placement. A CT will show us how much bone is available and will help us determine the best locations for the implants.
If you are not already wearing a complete denture to replace your missing teeth, we will make one for you. You will use this temporary denture until the implant-supported denture is placed. It will take about four visits, spanning several weeks, to complete this denture. By making this temporary denture, we can determine the best position for the teeth in the final denture. The temporary denture also can be used as a backup if something happens to the final implant-supported denture. The temporary denture can sometimes also be used as the final denture to reduce overall costs.
First surgery Month 1
The first surgery involves placing the implants in the jawbone. During this procedure, the implants are positioned in the bone under the gum and allowed to heal.
After this surgery, you should avoid putting pressure on the implants. The temporary denture can be made so that direct pressure is placed on other areas, not on the implants. It may also be given a soft reline (new lining next to your gums) to help to reduce the pressure on your gums.
After the first surgery, we will wait three or four months if implants were placed in the lower jaw, and five or six months if they were placed in the upper jaw, before scheduling the second surgery. During this time, the bone and the implants integrate (attach and fuse).
Second surgery Month 4 or 5
Once the implants have become fused with the bone, the second surgery can be scheduled. We will confirm whether the implant is ready for the second surgery by taking an X-ray. This surgery is less involved than the first.
A healing cap (collar) is placed on the head of each implant after it is exposed. This guides the gum tissue to heal correctly. The collar is a round piece of metal that holds the gums away from the head of the implant. The collar will be in place for 10 to 14 days. About two weeks after the second surgery, the healing caps will be replaced with regular abutments. Your gums should now be healed enough for us to make an impression of your gum tissue and abutments. The impression is used to make a working model of your abutments and jaw. This model is used to make the denture framework and teeth.
Completion Month 5 or 6
At this point, press stud attachments are placed on the implants, and the new denture is made. When the denture is inserted, it is clipped onto these attachments. We will test all the parts of your new denture to see if they are secure. We will check your gums and also will check the way your top and bottom teeth come together (your bite) after insertion of the denture.
Caring for Your Implant-Supported Denture
You will need to remove the denture at night and for cleaning. You also should carefully clean around the attachments. The clip or other attachments in the denture usually will need to be replaced every 6 to 12 months. They are made of a plastic material (nylon) and will wear with use. The cost for these replacements is covered for two years after you receive your denture. The abutments (the half of the press stud system that is attached to the implants) can also wear out, and need to be replaced every 3-5 years.
What Can You Expect From Your Implant-Supported Denture?
Your implant-supported denture will be more stable than a regular denture. You will find it easier to speak and you won't have to worry about the denture becoming loose or falling out of your mouth. You generally will be able to eat foods you could not eat before. However, you will not be able to chew very hard or sticky foods because they can damage the denture.
If you have an implant-supported denture in your upper jaw, it can be made to cover less of your palate (roof of your mouth) than a regular denture. That's because the implants are holding it in place instead of the suction created between the full denture and your palate.
Maintenance & Cleaning
You should remove an implant-supported denture daily to clean the denture and gum area. Just as with regular dentures, you should not sleep with the implant-supported dentures at night.