Dentures at Implant Dentistry Northwest
Hi, this is Keith Phillips from Implant Dentistry Northwest, and today I'm going to talk about what a denture is.
What is a denture?
A denture is a generic term for any replacement of teeth, but when people say denture, they typically think of a full removable plate, such as what we have here. A complete denture replaces all of the teeth. This is a representation of someone who's missing all their teeth. All we have left is the ridge of the jawbone to help hold a denture in. We make an impression of the jawbone, take some bite records, and start to fabricate a prosthesis that replaces all of their teeth.
In the upper jaw, we rely on our denture acting like a suction cup. We must get a good impression and ensure that when we fabricate it, it is true to the form of the jawbone. That helps the upper complete denture stay in. It acts like a big suction cup. Some people who have severe resorption of their bone may have to rely on denture adhesives to keep it in place. Our goal is to ensure we get a good impression, that it adapts to those tissues well, and that the bite against the lower teeth or lower denture is designed to help stabilize the denture while the patient is chewing.
Unfortunately, a lower denture is more of a horseshoe shape. For the lowers, we tend not to get the same kind of suction we would with an upper. We rely on the patient learning how to stabilize this with their tongue, cheeks, and lips while chewing. For most of our lower dentures, we try to utilize implants to help stabilize them. That's what dentures are.
Implant Overdentures
There's one in particular called a bar overdenture, where a special bar is fabricated on the implants with special clips that a denture will attach to. This is for the upper arch. When we make a typical complete regular denture, we cover the palate to get a suction cup effect. Since we're using implants to hold this denture in place, we can leave that palate open, making it much more comfortable for patients and enhancing their sense of taste because there are taste buds in the palate too. These are the components of the bar clip overdenture.
How is the bar attached to the implants?
We have a patient's upper jaw where you can see the implants were placed. An impression is made, and then we fabricate the bar, which gets screwed into the jaw and the implant. Special small screws hold that bar in place. This patient has five implants in the upper jaw. We insert a few screws, and we use special torque drivers to ensure they're tightened to proper specifications. All screws are torqued down to secure the bar. This bar is now fixated to the dental implants, holding it in place.
How do the denture clips work?
On the bar, there are little ball attachments. Inside the denture, there are clips that attach to those balls. This then goes on top. Here's a closer look: these are the ball attachments on the bar, and inside the denture, you can see the reddish clips that attach to the balls. It snaps on securely, allowing the patient to function well with this prosthesis.
Can this be done on lower jaws too?
That's for the upper jaw. We use implants on the lower jaw as well. Here's a patient with two implants and a bar. Inside, there's a special clip that snaps onto the bar, providing excellent retention to keep the denture from moving while the patient functions.
Removable Partial Dentures
In the past, we talked about complete dentures, which are used when somebody is missing all of their teeth. Then we can make a denture that replaces all their teeth. With a removable partial denture, a patient may not be missing all of their teeth. They could be missing anywhere from one tooth to most of their teeth, and we can make a prosthesis that utilizes the remaining teeth to help hold it in place.
Examples of Removable Partial Dentures
I have some examples here. As you can see, this is a model of a patient who's just missing the teeth on their lower left back area. A partial denture can be made in different ways, whether it's all plastic, but probably the most durable type is when we make this metal framework and then attach the dentured teeth where that part is missing. The patient can remove this by pulling on the clips that hold it in, and as you can see, it does a pretty good job. I've got that off, and you can see how this patient is missing teeth in just this one area. This is the partial denture, where we have our metal framework, and then we have the denture teeth set in the plastic attached to that partial denture. These clasps go around some of the remaining teeth to help it stay in place.
Advantages and Design Considerations
The advantage here is that we still have good stability by utilizing the patient's remaining teeth. It can be a little unsightly with these clasps, so we try to design and place them in areas where they're not very noticeable. Many patients can be missing different teeth, so there is always a variation on the theme. This is a patient who's missing just their back teeth, so the partial denture is designed just to replace the back teeth. It will snap in and be pretty secure. This is one made for a patient missing their front teeth in the upper jaw, along with a few other teeth. They can be designed in many different ways to fit your particular situation.
Attachment Retained Lower Overdentures
The reason why we like to place implants in the lower jaw for dentures is because a lower denture notoriously doesn't stay in very well. With the upper denture, we can design it to have a good suction cup effect. But with the lower, we have this thing called a tongue, and it's like putting a hole in your suction cup. You're not going to get the same kind of retention with a lower denture as you would with an upper denture. By placing at least two implants, two to four implants, let's say, and then placing special attachments on them, we can make that lower denture very stable.
Model Showing Four Implants
This is just a model showing four implants placed into the jawbone here. You can see there are what's called ball abutments. There are many different types of abutments that can be used depending on your situation. Inside the denture, you can see there are little clips. The great thing about that now is that we have a little snap of those attachments over the implants, and we have a very stable prosthesis. Typically, just two of these are more than adequate to help retain your denture in place.
Existing Denture Compatibility
The other nice thing is if you have an existing denture already, you don't necessarily have to have a new denture made. We've had many patients where we just placed a couple of implants and retained their existing dentures to those implants. It's what I call the best bang for your buck in dentistry. If you have a denture, we can place a couple of implants and secure that denture in place for you.
If you’re searching for quality dental care, we’re here to help. Call (253) 600-2621 or email [email protected] to schedule your visit. Our team is committed to keeping your smile healthy.