Learn About Dental Implant Dentures
A dental implant over-denture connects to cylinder-like configurations (called implants) that have been surgically implanted into the jawbone.
The dental implant denture appears like a traditional prosthesis. However, the part of the denture overlying the dental implants is modified to retain various semi-rigid attachments that receive dental implant extensions projecting above the gum. This arrangement helps keep a denture securely in place while eating, speaking, and during other oral activities, but still allows easy self-removal of the denture for cleaning purposes.
There are two phases to this process. The first is a surgical phase consisting of two stages, and the second is a prosthetic phase (making the implant denture).
The Surgical Phase of Dental Implants
1. Surgical Implant Insertion Stage
- Dental implants are completely inserted into precise preparations in the jawbone. While there are various dental implant configurations, they are essentially cylindrical in shape and made of pure titanium metal. After dental implants are inserted into the jawbone, gum tissue over the dental implant is closed with sutures, in most cases.
- While a minimum of two dental implants may be inserted for an acceptable outcome, a person may plan to receive three or more, depending upon individual needs and anatomical limitations. More dental implants will give additional support and retention to the dental implant denture.
2. Healing and Surgical Exposure Stage
- During healing, an existing or temporary denture may continue to be worn after adjustments have been made to adapt it to the surgical site. If the existing denture cannot be altered sufficiently, a provisional prosthesis should be fabricated.
- Dental implants are left undisturbed beneath gum tissue for at least several months as determined by the dentist. During this time, bone reorganizes and grows around the dental implant surface, anchoring it securely into the jaw (this is called osseointegration).
- At the end of the healing stage, the top of the dental implant is exposed by removing gum tissue directly over it. An extension that is then screwed into the exposed dental implant projects slightly above the gum tissue.
- After adjustments, an existing denture can be worn over an dental implant denture extension while the gum heals. However, the denture must be reshaped to conform to surgical site contours in order to avoid unnecessary pressure areas on the newly inserted extensions and the surgical area.
The Prosthetic Phase (Making the Dental Implant Dentures)
- A precision superstructure is fabricated and is screwed into the dental implant extensions. This superstructure may have various interface configurations, ranging from interconnecting metal bars to specially shaped singular extensions.
- A dental implant denture is fabricated with special provisions on the inside surface to receive various types of attachments (interlocks). Depending on the attachment, they interact in various ways with the superstructure. For example, a metal or plastic attachment may clip onto metal superstructure bars, a nylon receptacle may receive a specially configured dental implant extension, etc.
- The attachment/superstructure configuration helps to securely maintain a denture while eating and speaking, and still allows a person to comfortably and easily remove the prosthesis for cleaning purposes.
Essential Dental Implant Dentures Maintenance Needs
As might be expected, exemplary oral hygiene is essential to help prevent the development of disease around dental implant dentures that could cause their failure.
Implants, superstructure, attachments, and the over-denture must be checked and professionally maintained by a licensed dentist on a regular basis. Attachments often need periodic adjustment or replacement due to wear.
While the dental implant over-denture approach is complex and expensive, the value received by an individual usually far exceeds monetary considerations.
How Long Will Dental Implant Dentures Last?
Dental implant dentures may last for a lifetime (current reports show many dental implants lasting 20 years) or deteriorate in a few years. Many factors are involved that reduce the life expectancy of dental implants, such as oral hygiene, general health, habits such as smoking, grinding, etc. The superstructure or dental implant extensions may need to be replaced after five years. Depending on the dental implant system used, some parts may need to be replaced annually, or sooner, because of wear or deterioration. These time frames are generalities. The dental profession continues to strive for long-term durability of dental implant dentures.
by Joseph J. Massad, D.D.S.
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.
What To Expect From Immediate Dentures
Immediate dentures are placed in the mouth directly after the remaining teeth are extracted. This approach is utilized when a person does not want to be without any teeth for several months while extraction tooth sockets heal and a denture is fabricated.
Immediate Dentures Involve a Two-Step Denture Process
Optimally, immediate dentures are the first denture of a two-denture process and should be considered as a temporary interim prosthesis until a second refined and esthetically enhanced denture may be constructed after healing.
First Stage
- Usually, most or all of the back teeth are removed and extraction sites are allowed to heal for a minimum of six weeks or more, depending upon an individual's healing rate.
- After adequate healing, the immediate dentures unit is fabricated.
- The remaining teeth are extracted and the immediate dentures are placed in the mouth. Wearing immediate dentures right away over extractions normally is no more uncomfortable than the extractions alone.
- Discomfort is managed with proper anesthesia and pain medication. Immediate dentures act like a Band Aid bandage, holding tissues together and protecting them during healing.
- Generally, the dentist does not remove immediate dentures until the day after surgery. Surgery is checked and denture adjustments are made as necessary.
- Immediate dentures will gradually become loose because of bone shrinkage as the jaw continues to heal. Provisional liners are placed in the loosening denture to help hold it in place during healing.
- Adhesives also maintain the denture in place as it becomes looser. If immediate dentures become too loose during this healing period of several months, it may be necessary to reline multiple times.
Second Stage
- After adequate healing has occurred, a second refined denture is fabricated. This denture allows the dentist to artistically position teeth in an optimal and enhanced esthetic relationship, which was not possible with immediate dentures. It also is now possible to establish better functional relationships of the jaws.
- Approximately six months after the second denture is delivered, it will most likely need to be relined to compensate for continuing jaw shrinkage. After this reline, a patient usually needs annual relines to accommodate a continually shrinking jaw.
- The frequency of relines is an individual matter unique to each patient and is best determined by a licensed dentist after a thorough periodic examination that should occur at six-month intervals.
Modified Approaches to Immediate Dentures
- It is possible to extract all the back and front teeth at one time and insert immediate dentures. However, such an approach is problematic and generally is discouraged unless the patient has no other alternatives.
- All teeth may be extracted with no interim denture while the jaws heal and a denture is fabricated. This is generally a more economical approach, but an individual would be without teeth for several months.
Advantages of Immediate Dentures
- A person is not without teeth for any extended period of time.
- Immediate dentures act as a bandage while bony tooth sockets are healing after tooth extractions.
Disadvantages of Immediate Dentures
- A second refined and esthetically enhanced denture is necessary soon after the immediate dentures.
- While the cost of immediate dentures is generally about the same as a conventional denture, the second denture needs to be fabricated soon after the immediate denture. Therefore, a person would be experiencing the additional cost of the second denture sooner.
by Joseph J. Massad, D.D.S.
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.