Ross A. Hildebrand, D.D.S
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Learn About Dental Implant Dentures
A dental implant over-denture connects to cylinder-like configurations (called implants) that have been surgically implanted into the jawbone.
The dental implant denture appears like a traditional prosthesis. However, the part of the denture overlying the dental implants is modified to retain various semi-rigid attachments that receive dental implant extensions projecting above the gum. This arrangement helps keep a denture securely in place while eating, speaking, and during other oral activities, but still allows easy self-removal of the denture for cleaning purposes.
There are two phases to this process. The first is a surgical phase consisting of two stages, and the second is a prosthetic phase (making the implant denture).
The Surgical Phase of Dental Implants
1. Surgical Implant Insertion Stage
- Dental implants are completely inserted into precise preparations in the jawbone. While there are various dental implant configurations, they are essentially cylindrical in shape and made of pure titanium metal. After dental implants are inserted into the jawbone, gum tissue over the dental implant is closed with sutures, in most cases.
- While a minimum of two dental implants may be inserted for an acceptable outcome, a person may plan to receive three or more, depending upon individual needs and anatomical limitations. More dental implants will give additional support and retention to the dental implant denture.
2. Healing and Surgical Exposure Stage
- During healing, an existing or temporary denture may continue to be worn after adjustments have been made to adapt it to the surgical site. If the existing denture cannot be altered sufficiently, a provisional prosthesis should be fabricated.
- Dental implants are left undisturbed beneath gum tissue for at least several months as determined by the dentist. During this time, bone reorganizes and grows around the dental implant surface, anchoring it securely into the jaw (this is called osseointegration).
- At the end of the healing stage, the top of the dental implant is exposed by removing gum tissue directly over it. An extension that is then screwed into the exposed dental implant projects slightly above the gum tissue.
- After adjustments, an existing denture can be worn over an dental implant denture extension while the gum heals. However, the denture must be reshaped to conform to surgical site contours in order to avoid unnecessary pressure areas on the newly inserted extensions and the surgical area.
The Prosthetic Phase (Making the Dental Implant Dentures)
- A precision superstructure is fabricated and is screwed into the dental implant extensions. This superstructure may have various interface configurations, ranging from interconnecting metal bars to specially shaped singular extensions.
- A dental implant denture is fabricated with special provisions on the inside surface to receive various types of attachments (interlocks). Depending on the attachment, they interact in various ways with the superstructure. For example, a metal or plastic attachment may clip onto metal superstructure bars, a nylon receptacle may receive a specially configured dental implant extension, etc.
- The attachment/superstructure configuration helps to securely maintain a denture while eating and speaking, and still allows a person to comfortably and easily remove the prosthesis for cleaning purposes.
Essential Dental Implant Dentures Maintenance Needs
As might be expected, exemplary oral hygiene is essential to help prevent the development of disease around dental implant dentures that could cause their failure.
Implants, superstructure, attachments, and the over-denture must be checked and professionally maintained by a licensed dentist on a regular basis. Attachments often need periodic adjustment or replacement due to wear.
While the dental implant over-denture approach is complex and expensive, the value received by an individual usually far exceeds monetary considerations.
How Long Will Dental Implant Dentures Last?
Dental implant dentures may last for a lifetime (current reports show many dental implants lasting 20 years) or deteriorate in a few years. Many factors are involved that reduce the life expectancy of dental implants, such as oral hygiene, general health, habits such as smoking, grinding, etc. The superstructure or dental implant extensions may need to be replaced after five years. Depending on the dental implant system used, some parts may need to be replaced annually, or sooner, because of wear or deterioration. These time frames are generalities. The dental profession continues to strive for long-term durability of dental implant dentures.
by Joseph J. Massad, D.D.S.
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