IMPLANT SUPPORTED/RETAINED DENTURES [IRD's]:

Many patients with either partially missing teeth or fully edentulous (without teeth) experience loose or ill-fitting dentures or partial dentures.

Often the reason for the looseness is not poor fit, but that the structures that support and retain the dentures or partial denture (ridges or arches) are inadequate to give the kind of retention and stability that the patient needs to effectively support the denture for comfort and ease of speaking and function.

In these cases, simply making another prosthesis (denture or partial denture), will not provide the additional stability and retention that the patient needs.

When any individual's circumstances come to this point, there are only two options:
1) Have the new dentures made and deal with the inadequacy of the stability and retention by using adhesives or pads, or
2) Have an array of implants (minimally 2 up to as many as 8) to retain and stabilize a dental prosthesis (denture, partial denture or bridge).

Most times it is the lower arch that gives the most problem, so the majority of our scope is directed toward providing treatment that will stabilize the lower denture.

Entering into this relatively new type of dental restoration process gives the patient a wide array of options.

Of course the more implants placed results in higher treatment costs, so each treatment option must be met with a pragmatic analysis of finances.

Most frequently the upper denture can provide suitable retention and stability so that going through the treatment and cost to provide enhanced stability. By leaving the upper arch alone, the concentration of treatment and expense can then be better directed to the lower arch where it is usually more beneficial to provide enhanced stability and retention.

Of course, there are exceptions to this and each person must have an evaluation depending on their own specific and unique circumstances and needs.

Implants to restore missing teeth can vary from a single implant to replace one tooth that has been lost with a "fixed" restoration to up to 8 or 10 implants in an arch to provide a complete and fixed (cemented or screwed in) full arch of teeth. So, we can utilize dental implants to provide anywhere from a complete arch of fixed crowns to a more simple two-implant retained over-denture case.

Again, the type and style of implant case any one patient receives depends upon each individual case.

Only after evaluating a patient's physical and medical condition, needs & desires for a restored dental result, ability to commit to the necessary treatment from the aspect of time, ongoing dental maintenance, and, of course, finances, can a restoration plan be implemented.

To assist you in understanding the benefits and rationale for the IRD, click on these links:

What is a dental implant?

A dental implant is, simply stating it, a surgical titanium screw that is placed in the jawbone in the area of a missing tooth. It actually performs the same function as a tooth root and, after a suitable time for healing, provides a base for attaching anywhere from a single tooth to a complete arch of teeth.

How long do dental implants last?

Today Implants generally will last between up to 25 years, or even longer, depending on the location of the implant, the patient's overall health, both at the time of placing the implant and their ongoing health status, and the patient's compliance with oral hygiene and routine dental visits. Obviously there can be wide variables based on each individual. A thorough and frank discussion on this topic will occur prior to begining each Implant Case.

Because back teeth receive more stress and wear from chewing, implants in the back of the mouth typically will not last as long as implants located at the front of the mouth.

Examination and Dental/Medical Evaluation:

An examination with x-rays and a thorough Dental/Medical evaluation will determine if anyone is good candidate for dental implants.

Our Doctors will perform a detailed examination before deciding to undertake an implant case. We will determine the condition of your bone and tissue as well as your general health pertaining to your ability to receive an implant case. A thorough discussion of your options will occur as well as a review of the financial obligation so that you will be able to help decide what style of implant best suits your needs and requirements.

Types of Dental Implants:

There are two distinct types of dental implants used for IRD's:
1) One-piece implants. One-stage Implants -- or "Mini-Implants -- are placed and affixed to a removable denture during the same appointment. These are popular because they are generally less expensive than the other style, but they are notably weaker and often times are inadequate for providing the result that is desired, and they have a higher failure rate, generally failing within 5 years. For the most part, this style Implant is reserved for short term or temporary uses.

2) Two piece implants -- or conventional Implants.

These are 2-stage Implants where the implant is surgically placed, and after a suitable time (two to four months depending on variables of location and implant loading application) for healing (referred to as osseo-integration)the Implant has an abutment screwed in and then either a removable denture or a tooth attsched to it. After 6 to 20 weeks for stabilization (depending on the individual case and the process to be done) they are then fitted with the "abutment" (the second piece of the Implant) and restored for their intended purpose of either a fixed restorative or a removable restorative prosthesis (meaning any replacement tooth or teeth). Technology has developed to the point that now, we can provide some conventional Implant cases with a one-stage process that do not require the 2nd Stage Surgery, but it is not suitable for every case. If you can have this style procedure, you will be advised at the time of your Implant examination.

One piece/one stage implants are generally referred to as Mini Dental Implant (MDI). Mini implants are ultra-small implants that replace the root of your tooth. MDI implants are minimally invasive and relatively painless to place. These are the ones advertised as "surgery-less" implants, but in actuality they are placed with a minimally invasive surgery. The implants can be placed and the denture is adapted to work with the implants all in one visit. Mini implants can be used in some patients with health issues, which disqualify them from conventional implant therapy. This system is also utilized frequently as short-term or temporary treatment. We utilize only the Conventional 2-piece Implants due to the limitations and short term prognosis of the Mini Implant system.

There are several manufacturers of the more conventional two-stage implants.
We generally prefer to use the Ankylos Dental Implant System but do also use both Nobel-Biocare or Straumann Implants -- these are our preferred implant manufacturers.

We have found that these implants integrate the best with the least complications and lowest failure rate due to the specialized coating of the implant surface that yields the best integration.

Ankylos, Nobel Biocare, or Straumann Implants are a broader-based more conventional implant systems that replaces the root of your tooth. These implants are placed into the jaw and remain covered to heal for approximately three to six months. Then an additional piece, called an abutment, is placed on the implant and prosthetic teeth are attached to the abutment. These implants may be used for single or multi-tooth crowns and bridges that may be fixed or removable. We use these implants to support removable dentures for patients without teeth. This style implants are most often used in very healthy patients and younger patients who need longevity for their implant.

Surgery, Stage 1
What happens during the first surgery?
After you are given a local anesthetic, your Doctor will surgically uncover the jaw bone and insert the implants into precisely measured insertion points. Very gentle, low speed drilling and extensive irrigation will be used to prepare your bone for the implant placement. Then the titanium implants are positioned and the soft tissue is sutured over the implant site to cover them. Dental implants are designed to bond rigidly with the living bone (osseo-integration) in approximately three to six months -- there are certain situations where the Implants can be placed and the denture affixed to them immediately; this is only for very specific cases -- your Doctor will advise you if you are a candidate for this process. This procedure generally results in minimal post-surgical discomfort similar to a simple extraction.

You will be given medications pre-surgically to relax you for these procedures and will not feel any pain during the procedure.

You will be given an ample supply of painkillers to handle any minor post-surgical discomfort for this procedure. It is important to understand that this procedure invokes much less surgical discomfort than the surgery to remove your teeth, and most people are able to actually go out for dinner the night of the placement procedure -- you will be sore, but strong painkillers are not needed.

Surgery, Stage 2 (3-6 months after Stage 1)
What happens during the second surgery?
The second stage surgery is the more minor surgical procedure. The gum overlying the Implants is pushed back and titanium posts, called abutments, are attached with screws to the bone anchored implants. X-rays are then taken to check the condition of the implants and to confirm the exact seating of the abutment posts.

Most cases will require a new denture, but your old denture can sometimes be utilized depending on its condition & age. The denture will be fitted with retaining devices and placed directly over the second stage posts (abutments) giving you the retention and stabilization necessary for a denture that won't move during eating or speaking.

You will be given medications pre-surgically to relax you for these procedures and will not feel any pain during the procedure.

You will be given an ample supply of painkillers to handle any minor post-surgical discomfort for this procedure.

Types of Implant cases to be considered:

1) Single tooth replacement:
This is for the patient who has lost only a single tooth and wants a fixed replacement.
2) Multiple tooth replacement:
This is for patients who have lost two, or more teeth, and wants an implant case to restore them without having to have a conventional bridge or partial denture. Implants are an excellent modality for removable partial denture elimination.
3) Full removable denture stabilization:
A full removable denture can be retained by as few as two or several implants while still being supported by your gum tissue. 
Implants can be used to support a fixed bridge by either connecting implants to natural teeth or connecting several implants together.
Complete bridge support patients with all natural teeth missing can have them restored completely with fixed bridges anchored by implants. This type of fixed (cemented or retained by screws) restoration is removable only by your dentist.

The Cost:

Since the dental implant case may be as simple as a single implant or as intricate as a whole mouth consisting of up to 8 implants per arch, prices will vary greatly. 
Cost is always a consideration and while finances may not be the only determinate for the type of implant case you decide on, it is certainly a factor that must be taken into consideration when making a decision about dental implant cases. Therefore a frank discussion of the expense related to any type of case will be reviewed with your Doctor prior to commencing any dental implant case.

If you have any further questions about the dental implant technology feel free to call the office and schedule an appointment for an examination and consultation for your implant case.
Remember, that any money spent for your examination and evaluation will be deducted from the final payment of your case.