Dr. Pamela Doray is an experienced and highly trained restorative dentist in Philadelphia, offering comprehensive treatment for the replacement of missing or extracted teeth. Depending on your needs and the condition of your smile, Dr. Doray may recommend considering an implant-supported denture. This type of teeth replacement option can give you back a secure, comfortable and natural-looking smile.
A denture is an appliance that replaces natural teeth and gum tissues and provides support for the cheeks and lips. A denture is made of plastic acrylic material. There are several types of dentures:
- A conventional complete denture is made after all teeth have been extracted and the gum tissues have healed
- An immediate complete denture is fabricated and inserted immediately after all of the teeth are extracted. The tissues are allowed to heal under the denture. The immediate denture will allow you to avoid the embarrassment of living without teeth.
- A partial denture is made after some of the teeth have been extracted and the gum tissues have healed.
- An implant-supported overdenture is a denture that “snaps” onto dental implants for a tighter and more stable fit. This can be in the form of a complete denture or a partial denture.
Over a normal course of time, the bone and gum tissues under the denture will change shape. The denture will need to be refit to the tissues so that they remain retentive and stable. Regular dental examinations are still important for the denture wearer so that the fit of the denture and health of the oral tissues can be checked for disease or change. It is important to know that any kind of denture should not be worn at night. This allows the denture to be cleaned in an overnight cleaning solution, and it also allows the tissues to heal overnight from daily denture wear.
What you should know about conventional complete dentures
- The upper denture is made with full palatal coverage of plastic acrylic material. The lower denture is made in a horseshoe shape.
- The denture fabrication process is typically around 6 visits, but varies on a case by case basis. The denture will be tried in prior to final fabrication to evaluate the esthetics and the bite. This allows for the most predictable outcome of the final prosthesis.
- Over time, the bone and gum tissues will continue to shrink. This may affect the retention and stability of the denture. The denture will be refit either chairside or at the dental laboratory to improve the fit of the denture.
What you should know about immediate dentures
- The denture fabrication process begins before the teeth are extracted
- In most cases, there is no way of checking the fit and esthetics of the denture in your mouth prior to extraction. Esthetic compromises may have to be made in some cases due to the inability to perform a denture try in prior to fabrication and delivery of the prosthesis.
- After extraction, great care should be taken to follow all post-operative instructions. Your gums and bone will shrink after extraction, and regular check ups and maintenance will monitor healing and reduce complications. Temporary linings or tissue conditioners will be required to create optimal fit and will need to be replaced periodically during the healing process.
- There is an adaptation process that occurs with a new denture so that the patient can become comfortable speaking and eating with the prosthesis. There is a learning curve, but most patients respond well over time.
- After the healing process is complete, a new conventional denture will be fabricated to ensure a comfortable and exact fit of the denture prosthesis during the course of use.
What you should know about implant-supported overdentures
Although most people have no problem with the upper denture staying in place, some people find it difficult to wear and eat with lower dentures. An implant-supported lower denture will be more stable and retentive. Also, some people find it uncomfortable for the upper denture to cover the roof of their mouth. An implant-supported upper denture can allow for the denture to be made in a horseshoe shape to eliminate full coverage of the roof of the mouth.
Two types of implant-supported dentures
- Locator Attachment Overdenture: This attachment is placed on each implant that will be supporting the denture. The male portion is placed on the implant in the mouth, whereas the female portion is placed inside the denture. This creates a “snap” fit of the denture to the implant, allowing for the denture to be more retentive and stable. The female portion of the attachment will need to be periodically replaced as it wears over time.
- Bar-Supported Overdenture: In some situations, it is necessary to connect the implants with a custom-made bar. This bar has the Locator Attachments (as described above) on it so that the denture can snap onto the bar. The bar stays in the mouth permanently and can only be removed by the dentist, but the denture is removed by the patient so that it can be cleaned.
Benefits of the Implant-Supported Denture
- Stability during eating: Chewing function is improved with the presence of implants; therefore, it will be easier and more efficient when eating foods that require more chewing (i.e. steak, raw vegetables, etc.)
- Bone and gum preservation: After a tooth is extracted, the bone shrinks as it heals. The bone will continue to shrink and resorb throughout life if there is no tooth or implant to stimulate it. Over time, a denture will become less and less stable since there will be minimal bone for the denture to grab onto. Therefore, after a tooth is lost the placement of an implant will help to preserve bone volume and minimize resorption over time, thus making the denture more stable.
- Elimination of the palatal coverage of the upper denture
- Excellent esthetics
- Nutritional benefits
- Improved confidence
What you should know about partial dentures
Partial dentures are made out of a metal framework and plastic acrylic to replace the missing teeth and gum tissue. The patient’s specific needs and anatomy dictate the design of the partial denture.
The metal framework of the partial is designed so that the chewing forces are evenly distributed over the entire surface area of the remaining teeth and soft tissues. The metal framework also increases the strength of the partial denture.
In order for the partial to be retentive, there will be clasps that hook onto the teeth adjacent to the missing space. Every effort will be made so that the clasps are as esthetic as possible, but they often cannot be eliminated unless implants are present and the partial denture is fabricated as an implant-supported partial denture.
Partial dentures without a metal framework are not as strong and are generally fabricated as a temporary partial denture.