Types of Implant Dentures

(Left): An Implant overdenture retained by two implants. (Right): A hybrid implant denture resting entirely on four implants. 

While we often consider dental implants as a solution to replace single missing teeth, they can also be used in conjunction with dentures to replace entire arches of teeth. Many of the aspects of denture use that patients find objectionable can be alleviated with the addition of implants. However, it is important to understand the different ways that implants are used to support dentures, and the benefits of the specific appliances. 

Most patients with “implant dentures” are using a system called implant overdentures.  Here, a fairly traditional denture rests “over” two to four implants on the top or bottom jaw. It is designed to be removable and snaps onto the implant anchors. This makes cleaning around the implants easy and convenient. When compared to regular dentures, implant overdentures have much more stability and retention on the soft tissue. This is particularly beneficial for the mandible, which does not benefit from the “suction cup” action that maxillary dentures have on the palate. It is important to note that the support for biting force with this system still relies on the gums and soft tissue. Thus, you will never be able to generate as much force as natural teeth. Additionally, some patients will still object to the removable nature and bulk of these appliances. However, they are an excellent compromise between usability, cosmetics, ease of cleaning and cost for denture wearers.

A newer system of implant dentures is the all-on-four or "hybrid" implant supported dentures. This appliance is permanently screwed or cemented on four to six implants on the top or bottom jaw. They are not designed to be removed, and thus are more difficult to clean versus implant overdentures. However, they function much more like natural teeth, as the entire arch rests solely on implants. They are much less bulky than traditional dentures and provide easier chewing and biting. Most all-on-four appliances are milled out of a single piece of zirconia. Thus, if any part of it chips or breaks, an entirely new arch of teeth needs to be created. The biggest drawback to this system is cost. Treatment for all-on-four dentures is typically two to three times the cost of implant overdentures. For this price, you are getting the best permanent replacement for natural chewing and eating.

Other factors, such as bone health, gum tissues, jaw relations and face shape will all play into your choice between implant overdentures and all-on-four implant dentures. Surprisingly, cosmetics varies from patient to patient, with some seeing more realistic results with implant overdentures. Making an informed decision relies on a thurough exam and consultation to create a comprehensive treatment plan. If you would like to know more about dentures, implants or other methods of replacing teeth, give our office a call!

Temporary tooth replacement for implants

This is an example of a typical stayplate with hidden metal/acrylic.

If you have been looking to have a tooth replaced with a dental implant, you were probably surprised to learn about the treatment time line. Some television shows and ads make implants seem like a single step process- you go to the dentist, they place the titanium anchor and attach a crown in a single visit. On the contrary, most implants need about six months to fully heal before being fitted with a crown. For patients replacing anterior teeth, this can be a huge esthetic concern. 

When preparing for anterior implants, careful planning and consideration can make the difference between "acceptable" results and "outstanding" results. With this in mind, we typically do not recommend putting an immediate load on the implant (placing a crown at the same visit as the surgery). This allows time for proper bone healing and gives us a chance to perfect the soft tissue around the anchor and create a natural gum line. However, you certainly can't walk around for six months with a missing front tooth!

To fill in the time between implant surgery and crown placement, we typically have our lab create a temporary partial denture called a stayplate. These devices, also known as flippers, are removable partial dentures that are made prior to implant placement. At the same visit as your surgery, you leave the office with the fitted stayplate replacing the missing tooth or teeth. They are typically made out of acrylic and metal and more closely resemble orthodontic retainers than traditional dentures. In most instances, the clasps, wires and acrylic are fully hidden from your smile, presenting only the replaced tooth!

We use stayplates as temporary tooth replacements in a number of circumstances. However, we do not use them on the back teeth (molars and premolars) to restore chewing function. Due to the design and materials used in stayplates, they cannot be used for eating and can cause irritation to the underlying gum tissue. For a full picture on stayplates and what they can accomplish, please give our office a call! 

Lower Incisor Implant Restoration

The top photos show the shade guides used by the lab to match the adjacent teeth. The metal pieces indicate the location of the implants for the impressions. The bottom photo highlights the great job Opus One Lab did in matching the colors of the teeth and gums!

Bet you've never seen implants like this! Today's patient came to us after having lost their lower anterior incisors due to periodontal disease. Periodontal problems are common in this area due to a combination of plaque buildup, poor access due to crowding and (sometimes) tension of the lower lip on the gum tissues. Unfortunately, losing these teeth can have many undesirable effects, such as problems tearing food and lack of esthetic support for the lower lip. 

In treating this patient, two implants were placed by a specialist next to the lower canines. Once the surgical sites were healed, impressions were taken and sent to Opus One Dental Laboratory. At the lab, Four prosthetic teeth were created in a bridge from implant to implant. To correct for the missing bone, pink porcelain was added to the bottoms of the teeth to simulate gum tissue. The result is a very functional and natural looking replacement! If you would like to know more about amazing transformations we can achieve with dental implants, please give our office a call!