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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.

False Teeth: Porcelain vs. Plastic - Discover The Difference!

In the past, false teeth made with porcelain were generally preferred over false teeth made from plastic due to their greater durability and esthetics. However, in recent years, new generation biomaterials have resulted in the development of very wear-resistant false teeth made from plastic.

Clinically, the esthetics of plastic and porcelain denture teeth is nearly comparable, with good quality false teeth made from porcelain still being the standard for esthetics. However, the majority of dentures today probably are fabricated with false teeth made from plastic. For all practical purposes, the cost of porcelain and false teeth made from plastic are about the same.

While porcelain and plastic teeth are competitive with regards to durability, and to a lesser extent, esthetics and wear, there are other factors that may favor the selection of one type of tooth over another.

Some Selection Factors for False Teeth

Balanced bite and force transmission:

Denture bite (called occlusion) changes due to the constantly changing jawbone (called alveolar bone) upon which a denture rests, and, to varying degrees, uneven tooth wear resulting from use. Unless a denture is evaluated and its occlusion adjusted to a uniform and even contact (called balanced bite or balanced occlusion) at regular intervals, denture occlusion will become unbalanced.

Since false teeth made from porcelain are more wear-resistant, their occlusion will not become significantly self-altered by wear, as will false teeth made from plastic. However, when alveolar bone changes cause an unbalanced occlusion, the resulting biting forces from false teeth made from porcelain will be unevenly transmitted to underlying supporting alveolar bone. Frequent tissue refitting of the denture usually eliminates or lessens this problem.

Porcelain denture teeth tend to transmit the impact of biting forces to the alveolar ridge with greater intensity than that transmitted by plastic teeth in an unbalanced tooth contact situation. Some practitioners are of the opinion that this greater force, especially when uneven as in an unbalanced occlusion, may be damaging to the alveolar ridges and could result in accelerated bone loss.

Therefore, unless denture occlusion is checked and balanced on a regular basis, false teeth made from plastic would probably be a preferred choice over false teeth made from porcelain.

Bone loss:

If a person has lost a great deal of supporting alveolar bone and their gum tissue is not of a sturdy type, then plastic denture teeth might be a better choice. These teeth are more forgiving of excessive forces developing from habits such as clenching, grinding, and tapping or "clacking" of teeth, which seems to be more prevalent among older individuals. Plastic teeth do not transmit forces to underlying bone as intensely as false teeth made from porcelain.

Noise:

If false teeth made from porcelain are vigorously used or sometimes habitually tapped together, a "clacking" sound can be heard. Plastic teeth will muffle this sound and be quiet during normal function or habit jaw motions (called parafunction).

Which Type of Tooth Is Best?

If a person has been successfully wearing dentures with false teeth made from porcelain, then they should probably continue with false teeth made from porcelain. These teeth will not wear as fast as false teeth made from plastic, and the relationship between upper and lower jaws will tend to stay normal for a longer time than with false teeth made from plastic.

Regardless of which type of tooth is selected, the success of the selection is strongly based upon regularly checking dentures for proper balanced occlusion and fit on regular intervals.

If a denture is going to be worn against opposing natural teeth, then false teeth made from plastic should be selected because false teeth made from porcelain, being harder, could excessively wear natural teeth away.

After a thorough examination and frank discussion of what a person wants from wearing a denture, a licensed dentist can effectively discuss which type of tooth would best meet a particular individual's unique needs and desires.

Tooth Strength

Because false teeth made from porcelain are extremely hard in comparison to false teeth made from plastic, they tend to chip and crack more easily. For this reason, when dentures having false teeth made from porcelain are brushed and cleaned, they are generally handled over a sink filled with water or over a towel. Should the denture accidentally fall, the water or towel would help break the fall and hopefully reduce tooth breakage.

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.