HSG Dental Implant Centre
Specialist Dental Implant Centre focusing on full arch and specialist implantology.
Full Arch Implants Solutions
When all of the teeth in an arch are missing, or have been diagnosed as non-restorable, traditional treatment options were limited to living without teeth or conventional complete dentures. Removable full dentures in the upper arch tend to fit well as they are held in place by suction formed from contact with the solid bone of the hard palate. A major trade-off from this improved suction in upper traditional dentures is the hard palate needs to be covered resulting in decreased comfort, taste perception, and increased discomfort.
This suction does not exist in traditional dentures for the lower arch resulting in challenges retaining dentures down. This results in trouble eating, discomfort, and issues of movement. Fortunately dental implants are excellent tools to provide retention and support for full arch prostheses and can effectively correct many of the deficiencies found in traditional dentures.
Below we have outlined some of the common problems with traditional dentures and ways in which dental implants can help to provide relief. There is tremendous flexibility in treatment options in this area. We even have the ability to improve denture retention with as few as two implants. This is simply an overview of some of the options available. Once you have a basic understanding of some of the options available, we invite you to schedule a consultation to help answer any questions you may have.
Securing Lower Dentures
Conventional complete dentures on the lower arch are designed to be retained by a combination of muscles, the tongue, and patient control. As a result they tend to move around quite a bit resulting in patients sometimes report discomfort and difficulty eating. Most of these issues come from the lack of retention.
By placing two implants in the lower jaw we can create two points of retention. This helps to make the denture more stable and eliminates major movements and improves comfort and function. This type of prosthesis is referred to as aTwo-implant overdenture (pictured).
The question of "why two, why not 4" comes up regularly when discussing 2-implant ovedentures. The reason comes down to how this type of prosthesis responds to chewing force. The implants do not actually serve to resist chewing forces, instead they are simply used to hold the prosthesis in place and keep it from rocking, lifting, and falling out. Like a conventional denture the gums are what resist chewing forces. This is referred to as implant retention. The reason no more than two implants are traditionally used in implant overdentures is that two are already able to provide adequate retention. Further implants only serve to decrease the overall strength of the prosthesis.
Implant supported prostheses are those which distribute chewing forces through the actual implant and into the bone. They are discussed in more detail below.
Implant Supported Full Arches
Available for both Upper and Lower arches
When a more rigid solution is desired an entire arch of teeth can be supported by dental implants. Amazingly, this can be accomplished with as few as three implants, but in most cases requires 4-6 implants per arch. As a result, this technique is sometimes called "All-On-4".
This procedure is similar for both the upper and lower arches, but starts with an edentulous arch (missing all teeth). With the assistance of a mock up of the desired end product and a detailed 3D x-ray a surgical plan is created. From there 4-6 implants, per arch, are placed into the bone onto which a provisional prosthesis is connected. The surgery and attachment of a provisional prosthesis is done on the same day which is why this procedure is also commonly called "Teeth in a Day". At this point we wait for 4-6 months while the area heals and bone grows around each implant. During this time we advise avoiding crunchy, chewy, or otherwise tough foods. As a general rule of thumb, if the food item can be easily cut or broken apart then it is OK to chew.
After a period of healing a definitive prosthesis is fabricated. This can come in many forms, but all usually involved a titanium substructure (bar) and either acrylic and/or porcelain overtop. This provides an esthetically and functionally secure prosthesis that is rigidly held in place by the implants. Some definitely prostheses are removable by the patient while others are only to be removed by dental specialists. The decision on which pathway to take is made through a combination of patient desires, dexterity, oral hygiene abilities, anatomy, etc. There is no clear cut 'best' option, but Dr. Hickman will work with you to educate them on the options and ultimately find one that suits each patient's needs as ideally as possible.
As you can appreciate, this is a complex procedure with many options. Dr. Hickman works with patients to educate them on the background of the procedures to help you make an informed decision and to help patients figure out if this type of treatment is right for them. If you would like to meet with Dr. Hickman to discuss your treatment options please feel free to fill out the form below.