If you have lost all or most of your natural teeth, it may be time to get implant-supported dentures. Although traditional dentures are economical and efficient, they are not the best solution for someone with no teeth left in their mouth.
Conventional dentures do not offer the best chewing capacity and strength. Besides, continuous bone loss makes it difficult for regular dentures to have enough support on your jaw.
The best option for you is implant-supported dentures.
In this article:
- Types of implant-supported dentures
- What makes you a good candidate for implant-supported dentures
- Difference between implant-supported dentures and conventional dentures
- Is bone grafting required for implant-supported dentures?
- The difference between implant-supported dentures and temporary dentures
- An overview of the implant-supported denture surgical procedure
Are you a good candidate for implant-supported dentures?
Implant-supported dentures are not for everyone. You have to fulfill certain criteria to qualify for them. Here we have gathered a tentative list of related considerations:
- You are missing all or most of your teeth
- You have some teeth left, but they are so damaged that other non-invasive cosmetic options cannot fix them
- You have sufficient jawbone structure
- Your gum tissues can support implants
- Your gums are good enough to heal any surgical wounds
- If you don’t have the required bone density, you are willing to get bone grafts
- You do not have any other oral disorder that requires urgent attention
- Maintaining excellent oral hygiene is a must to make your implant surgery successful, and you are committed to doing it
Types of implant-supported dentures
Once you qualify for implant-supported dentures, it is time to see what options you have available to you.
- For those with all teeth missing: Implant-supported fixed full dentures
- Implant-supported fixed partial dentures
- Implant-assisted removable partial dentures
- Screw-retained Implant-supported dentures
- Cement-retained implant-supported dentures
Implant-supported fixed full dentures
This is a cost-effective way of regaining your chewing ability and improving the quality of your life.
Based on your situation, your oral surgeon will indicate all-on-4 or all-on-6 for you. That means your dentures will be secured inside your mouth with 4 to 6 implants. You do not need an implant for each missing tooth.
If you do not have any teeth left in your mouth, you face some serious problems like the ones below:
- Functional problems like chewing and eating
- Your speech may be impacted
- General embarrassment
- Facial collapse or change of facial structure due to bone loss
You can solve most of these by getting implant-supported fixed full dentures. You may not completely stop losing bones under your dentures.
Although cost-effective, you should be ready to spend a minimum of $20,000 per arch for this treatment.
Also Read: Affordable Dentures: Where to Find Them?
Implant-supported fixed partial dentures
You need these partial dentures if you have some healthy teeth left in your mouth. These teeth may not be extracted for a full set of dentures. Rather, partial dentures will be used alongside them to improve your chewing ability.
They are also called hybrid dentures.
Partial dentures can be made of metal or acrylic. Of them, metal dentures may last much longer than acrylic dentures.
For an extensive comparison between them, read our post Acrylic vs. Metal Partial Dentures: A Brief Comparison.
Implant-assisted removable partial dentures
Removable partial dentures are also called snap-in or snap-on dentures.
Removable dentures can be partial or complete. But here we will talk about the partial ones.
These dentures improve the quality of your social and emotional life drastically. However, you may need some time to adjust to them.
At the same time, do not forget the disadvantages they have. For example:
- Pain in the mouth
- Loose implant
- Oral cancer
- Dry mouth
- Bad breath or halitosis (which can be an embarrassing problem with social consequences).
Even the best partial dentures do not fit perfectly in the mouth. That is why the day of insertion may be a challenge for you.
What may cause implant-supported dentures to fail?
Implant-supported dentures are a good alternative to traditional removable dentures. They have a high success rate, but they may fail. The failure often comes from the implants’ stress on the surrounding tissues.
Besides, it may come from the shrinkage of your jawbones. According to MIT Medical, your jawbones (and gums) shrink 1/32 of an inch yearly if you miss teeth.
It is unclear how much the grafted bone may shrink, if at all.
Any shrinkage will affect the fitness of your dentures. That is why you should have your dentures evaluated at least once every six months.
How can a dentist make sure your implant-supported denture treatment does not fail?
The success of the implant-supported denture depends on the following:
- Careful planning of the treatment
- Determining the number of implants you may need to secure your removable appliances
- Positioning the implants correctly on the jaw to distribute the stress evenly
- Choosing the right type of denture and implant for you
- The oral surgeon has to be able to explain the response your gum tissues may have to the strain. The stress magnitude will influence bone healing around the implant body and the ultimate stability of the implant and dentures
- Maximizing the bone-implant contact surface. The greater the bone‐implant contact surface, the more force is distributed to the surrounding bone.
The stress in the bone around the implant must not cross 3,000 microstrain during the implantation surgery. The mild overload range is from 1,500 to 3,000 microstrain. Any strain beyond the mild overload range may result in fracture and bone loss.
Implant-supported dentures: A possible treatment schedule
- An initial consultation appointment with the dentist to explore your treatment options. This is the first step toward your treatment. You will receive a lot of information about implant posts, bite force, tooth roots, gum tissues, types of dentures, all-on-4, jaw bone, bone loss, bone grafting, removable dentures, snap-on or snap-in dentures, the healing process, denture care, etc.
- You consent to the chosen treatment
- A clinical examination follows
- Radiography test
- Cone beam computerized tomography (CBCT) scan
- Provisional virtual implant simulation
- You are given appropriate oral antibiotics
- Local anesthesia is administered to your implant site
- The cosmetic dentist positions the implants and sutures the wounds
- Removal of sutures after seven days
- A six-month healing period is recommended
- After six months, cover screws are removed and replaced with healing abutments
- Healing abutments are removed after two weeks
- Implant sites are ready for impression
- Abutments and dentures are attached
- You are advised to appear after 24 hours, one week, one month, and one year for an inspection
Advantages of implant-supported dentures
Implant dentures offer the following advantages:
- A smaller number of implants for your mouth. A full set of dentures may require only four implants.
- Fewer time-consuming procedures
- Simplified oral hygiene
- Cost-effective (compared to one implant for each crown)
- High success rate
- Better distribution of chewing forces to abutments and implants
- Better preservation of the remaining bone around the implants and the remaining teeth, if any
- Improved chewing ability
- They prevent phonetic disorder
- Help create a better oral health
- Increased stability
- Increased patient satisfaction
According to a study published in the International Journal of Oral Implantology and Clinical Research in 2017, implant-supported dentures increase chewing efficiency in dental patients by almost 20% compared to complete dentures.
Complications related to implant-supported dentures
The most frequent complications of implant-supported dentures are as follows:
- Marginal bone loss around implants
- Mucositis or sore and inflamed mouth
- Bone graft may fail
- Loose abutment screw
- Fracture of the abutment
- Fracture of the dentures
- Surgical complications
- Damage to nerve
- Delayed wound healing
- Relining of the denture base may be required
- Denture teeth may be decayed through natural wear and tear
- Implant removal may be required
The failure rate of implant-supported dentures
- The failure rate of single crowns (5.5%)
- Fixed partial crowns failure rate (4.8%)
- Failure rate after five years of use (5.7%)
- Failure rate after ten years of use (7.2%)
The effectiveness of implant-supported artificial teeth in enhancing your chewing efficiency
A study published in the International Journal of Implant Dentistry proves that implant-supported dentures can provide superior chewing efficiency.
The authors measured the chewing efficiency with the following 3 conditions:
- Without dentures
- With dentures but dentures were not supported by implants
- Dentures were supported by implants (dentures used: Implant-supported removable partial dentures)
The chewing efficiency with dentures supported by implants showed significantly higher scores than the other two conditions.
Conditions or risk factors on both the lower jaw and the upper jaw that may complicate the health of your implants and partial or full dentures
- Inadequate plaque control
- Smoking (smokers have eight times higher risk for gum disease than non-smokers)
- History of gum disease
- Lack of regular oral examination
- Lack of oral hygiene
- Extreme bite force
- Implant design, including implant’s shape, height, diameter, location, and placement protocols
- Implant surface
- Implant material
- Grafting material
- Denture material
- Experience level of the dentist
One or more of the above may result in loosening your dental implants, thus causing your denture treatment to fail.
Also Read: Premium Dentures: What Are They?
According to research, cement-retained implants have fewer retention failures than screw-retained implants. Although screw-retained implants are easily retrievable, which is one of their main advantages, they are also costlier than cement-retained implants. But then cement-retained implants may cause inflammation to the soft tissue surrounding the implant body.
Cement-retained implants have a higher chance of having gum disease around them than screw-retained implants.
The amount of bone you may lose around your implants after 15 years is between 0 to 2mm. Another expert put the amount at 1.65mm and 1.63mm for premolar and molar regions, respectively.
Zygomatic implants are dental implants with extra-long tails. If you do not have enough bone left in your jaws, you can still have dental implants. The zygomatic implants reach into your cheekbones, giving your replacement teeth the needed stability.
What are the costs of implant dentures?
The costs indicated here are for reference only. Understand that the costs vary by location, oral surgeon, the number of implants required, the specific needs of the patient, other dental services the patient may need before the implant surgery process begins, etc.
Your dentist will give you a quotation only after examining your mouth. Roughly speaking, the implant-supported denture treatment will cost you somewhere between $15,000 and $40,000, based on your situation.
According to Forbes, all-on-4 dentures may cost you as much as $55,000.
Kadam, Kuntal & Dange, Shankar & Mahale, Kishore & Khalikar, Smita & Khalikar, Arun. (2017). Implant-supported Overdenture. International Journal of Oral Implantology and Clinical Research. 8. 22-25. 10.5005/jp-journals-10012-1162.
Atieh MA, Almutairi Z, Amir-Rad F, Koleilat M, Tawse-Smith A, Ma S, Lin L, Alsabeeha NHM. A Retrospective Analysis of Biological Complications of Dental Implants. Int J Dent. 2022 Aug 12;2022:1545748.
Murakami, K., Ayukawa, Y., Ogino, Y. et al. Clinical effectiveness of implant support for distal extension removable partial dentures: functional evaluation using occlusal force measurement and masticatory efficiency. Int J Implant Dent 7, 101 (2021).
Bandiaky ON, Lokossou DL, Soueidan A, Le Bars P, Gueye M, Mbodj EB, Le Guéhennec L. Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications. Clin Exp Dent Res. 2022 Feb;8(1):294-312.
Yen YY, Lee HE, Wu YM, Lan SJ, Wang WC, Du JK, Huang ST, Hsu KJ. Impact of removable dentures on oral health-related quality of life among elderly adults in Taiwan. BMC Oral Health. 2015 Jan 5;15:1.
Also from SupreDent:
Dental Implants: Types, Procedure, Costs, Risks, and Benefits
Dentures: Your New Artificial Teeth