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!

Lower Arch Reconstruction

Today's patient came to us with porcelain and metal crowns on all of their lower teeth. With time, these restorations had become chipped and worn, making it obvious that they were not natural teeth. Additionally, gum recession had revealed the dark metal collars around these crowns, creating an obvious transition from enamel to porcelain. Finally, porcelain and metal crowns are inherently opaque (do not transmit light) to block out the inner metal layer. This contrasts harshly with the natural translucency of dental enamel and makes the teeth look "old" or yellow. 

After considering the many options, Dr. Kari Ann Hong and the patient decided to replace the existing crowns with new Emax lithium disilicate restorations. Emax provides increased durability over porcelain and metal crowns with better esthetics and more design possibilities. The results speak for themselves! The new crowns have a much more natural shape and contouring, while the shade and translucency better matches natural enamel. Additionally, the increased wear resistance will help ensure these teeth for years to come. If you would like to know more about dental crowns, fillings and other cosmetic procedures, please give our office a call! 

Specialist Spotlight: Pacific Oral Surgery

At Thousand Oaks Family Dentistry, we are proud of the network of skilled dental specialists we have created. Whether you are in our office or one of our associates’ offices, know that you will be treated with respect, kindness and experience. Today, we would like to highlight Doctors James Jacobs and Sebastian Carlson of Pacific Oral Surgery!

Oral surgeons handle many dental treatments where the teeth and bones have to be modified or removed in an "operating room" environment. Most commonly, they are tasked with difficult extractions, implant placement and bone grafts. Beyond these, oral surgeons perform a wide array of corrective jaw surgeries for cosmetic and developmental concerns.  Doctors Jacobs and Carlson are well skilled in all these disceplines and bring both expertise and the latest technology to every procedure.

Doctors Jacobs and Carlson are both active members of the American Association of Oral and Maxillofacial Surgeons and the California Dental Association. They operate out of offices in Thousand Oaks, Simi Valley and Ventura to best serve you locally. With your referral, make sure to check out their website for a comprehensive list of pre-operative and post-operative instructions, along with articles on what to expect during your surgery. If you have any more questions or would like to know more about your referral, please give our office a call!

Website: http://www.pacificoralsurgeon.com/

Phone Number: 805-497-8571 (Thousand Oaks Location)

Address: (Thousand Oaks Location)

 

Dental Questions: Who Places Dental Implants?

Implants represent a new shift in how dental offices can replace missing teeth. Never before have dentists been able to reproduce one or more teeth in a non-removable fashion without altering adjacent teeth. In the midst of this new treatment trend, many different general practices and specialists are placing implants. In this article, we hope to make sense of who offers implant surgeries and why they do so!

For starters, almost any licensed dentist can become trained to place implants. There is no specific requirement for a specialist to place them, and training programs are very common. As such, our office places implants on healthy, long standing patients in uncomplicated scenarios. We feel that any case beyond these parameters requires the expertise of a specialist.

Many times, an oral surgeon will place implants. They benefit from years of surgical training and managing medically complex patients. Most offices will offer various sedation options when providing the surgery. Periodontists also frequently perform implant treatment. Here, their specialized knowledge of gum tissue, bone characteristics and healing allows them to place implants in highly esthetic areas. They also typically offer sedation as a part of treatment. Other specialists, such as prosthodontists and endodontists may place implants on a case-by-case basis.

No matter who places your implant, know that your referral from Thousand Oaks Family Dentistry was made with the highest quality care in mind. We take surgical treatment very seriously and only refer patients to our trusted network of specialists. If you want to know more about implants and how they might improve your treatment options, please give our office a call!

Dental Implants: Our Office Policies

Without a doubt, implants are the newest and biggest trend in the dental profession. Never before have dentists been able to replace teeth so easily without dentures or bridges. Thousand Oaks Family Dentistry is at the forefront of implant treatment, offering tried and true techniques and procedures. As such, we would like to take a moment to inform our patients of how our office handles implant treatments.

A dental implant essentially consists of three parts: the titanium screw that sits in your bone. the "abutment" that extends above the gum line and the crown that is cemented or screwed to the abutment. At out office, we typically have one of our specialists place the implant screw. They bring years of knowledge and expertise to the procedure, along with advanced technology like Cone Beam CT scanners. All of this allows them to get better results in more difficult areas. Our specialists use Swiss made Straumann implants, which utilize the highest quality components and materials available. We don't want to take any chances with a procedure as sensitive as implant therapy.

After the implant screw is placed, it generally takes three to four months for the bones and gums to heal. In the meantime, we can offer you a temporary denture called a "stay plate" or "flipper" to fill in the missing space. Once the implant is fully integrated, it generally takes two appointments three week apart for us to take an impression and for our lab to create the final crown. While the process is long, implants are the ideal treatment for replacing lost teeth. We avoid having to alter adjacent teeth (as with a bridge) and there is no need for a removable appliance (as with dentures). It truly functions like the tooth that was there before. 

Does our office ever place our own implants in-house? We do, but only in specific cases. Firstly, we do not accept new patients solely to place implants (you must be a patient of record). You must also be healthy, have adequate height/width of bone and only need a single implant. For these patients, we can place implants replacing posterior teeth (molars and premolars). Any case that violates these parameters deserves the expertise and attention of a dental specialist. 

At Thousand Oaks Family Dentistry, we are ready and excited to handle your implant treatment. The first step is an evaluation to check your teeth and discuss options. If you would like to schedule this exam or learn more about implant dentistry, please give our office a call! 

Dental Questions: What is a flipper?

With the rise of dental implants, many patients are electing to have teeth extracted rather than spending time and money on a losing battle. Since implants can take months to heal before a crown is placed, there is now a question on what to do with the missing spaces in the meantime. While you can elect to leave these areas open in the interim, this is not an option when the implant is placed in the smile zone. For these situations, you may be made a flipper- or temporary denture. 

Flippers are also known as stay plates or temporary partial dentures. They are made of a hard, pink acrylic resin that supports the prosthetic teeth. They may also have a series of metal clasps that hold the frame firmly in place. Flippers differ from permanent dentures primarily in the way they rest on the teeth and gums. Partial dentures are fitted to the mouth so that the teeth serve as the primary supporting structures. If the gums have to be utilized in holding the denture, very specific areas are used, as to not cause any lasting damage. In contrast, flippers rest entirely on the gums and soft tissues. Over time, the constant pressure on gums can cause the underlying bone to resorb or irritate the periodontal tissues. With this in mind, they are inappropriate as permanent appliances. However, they can be a great interim solution in implant placement. 

Flippers are created by a dental laboratory and take about two weeks to complete. They typically blend seamlessly with the natural tissues and aren't noticeable as "denture teeth." If you would like to know more about flippers and how they can be a part of your implant treatment, please give our office a call!

Case Presentation: Maxillary Dentures

With the rise of implants and implant dentistry, many patients assume that dentures are no longer a "modern" treatment option. On the contrary, dentures are a great way to replace missing teeth without the need for additional surgeries or trauma. Pictured above is a complete upper denture fabricated for one of our patients. It is in the wax try-in stage: this is a proposed shape for the final denture made out of adjustable wax. Once we confirm the fit and cosmetics of the prosthesis, we will have a permanent acrylic version made by our lab. 

Dentures have a number of advantages of implant supported prosthetics (and vice-versa). From a functional standpoint, dentures allow us to "replace" both teeth and soft tissue. A well made denture can create the appearance of gums in deficient areas or level out resorbed bone. Implants have a more limited range of soft tissue enhancement and frequently require other procedures to get the full effect. Furthermore, dentures have a considerable cost advantage over implants, especially for replacing full arches of teeth. 

When this denture is seated in the patient's mouth, it will be nearly undetectable during daily activities. However, some may find the idea of having a removable dental device objectionable. This is why our office offers a number of restorative services- from bridges and dentures to implants. If you would like to know more about the tooth replacement options available to our patients, please give us a call!

The Bottle Opener Implant

Warning: the above video includes footage from a dental surgery. Please be advised. 

Here is a service we WON'T be offering at our office! Salta, an Argentinean beer company, decided to support their local rugby clubs in a unique way. Players who lost teeth due to gameplay injuries were sponsored to receive dental implants. However, these were no normal implants. As you can see in the video above, the players' new teeth incorporated working bottle openers- a truly wild idea! While the procedure is "questionable" at best, it does underline the importance of mouth guards and dental safety in contact sports. Implant or not, we never recommend trying to open a bottle (or anything else) with your teeth!