Implant-supported dentures represent a significant advancement in prosthodontic technology, offering a more stable and permanent solution than conventional dentures. Unlike traditional dentures, which rest on the alveolar ridge (the thick bone that surrounds and holds the roots of teeth in place) and may require adhesives, implant-supported dentures are anchored directly into the jawbone, providing enhanced stability and functionality. This makes them a desirable option for patients looking to improve their oral health and quality of life.
The variety of implant-retained prostheses available today—including locator-retained overdentures, fixed screw-retained dentures, and single- or multiunit implant restorations—allows for customized treatment plans to accommodate a wide range of dental needs. This personalized approach requires patient-specific consultations and careful planning to ensure optimal outcomes.
Types of dentures to consider
Snap-in dentures: These tend to be a more affordable option when compared to other more “permanent” implant-supported dentures. The locator attachment system allows them to stay securely in place while still being removable for care and cleaning, making maintenance more convenient for many patients with overdentures.
Screw-in dentures: This is a more permanent solution, though they are still removable by a dentist or oral surgeon for cleaning and maintenance. These dentures provide enhanced stability and masticatory function, with options ranging from fixed screw-retained systems to screw-retained zirconia prostheses.
Single- and multiunit implant restorations: For patients requiring the replacement of only a few teeth, there is a wide range of dental implant options. These work in conjunction with a bridge or crown to replace individual teeth or small segments. Compared to other implant-retained prostheses, this represents a permanent solution.
Important considerations for treatment planning
Patient history: Not everyone is a candidate for implant-supported dentures. Dentists must assess patient history and overall health. Common contraindications include:
- Suppressed immune system
- Untreated bruxism (teeth grinding)
- Uncontrolled diabetes or gum disease
- Cancer
- Radiation treatment to the jaw, head, or neck
- Habitual smoking or alcoholism
Esthetic expectations: During the first consultation, the dentist will discuss esthetic outcomes, including the color, morphology, and alignment of the prostheses. Traditionally, screw-in dentures offer a more seamless esthetic result as they don’t move, providing more stability and precision.
Strength requirements: The dentist will assess functional needs based on occlusal load and chewing patterns to determine the prosthetic’s functional requirements. Screw-in dentures offer more durability compared to snap-in dentures for patients with higher occlusal loads. Patients with bruxism will most likely require screw-in dentures, as snap-in dentures have a higher chance of discomfort if you grind your teeth.
Maintenance considerations: Screw-in dentures require specialized tools, such as water flossers, to thoroughly clean them. Snap-in dentures can be removed and soaked in a cleaning solution. While screw-in dentures require more frequent professional cleanings, snap-in dentures require patients to be more diligent regarding their home care. If you have trouble keeping up with daily oral hygiene routines, snap-in dentures may be a better option.
Additionally, fixed implants will require more professional cleanings to ensure the surrounding tissue health remains sound. Routine checkups are a must. Similarly, snap-in dentures will also need adjustment visits to check for wear and tear and optimize comfort. The risk of peri-implantitis increases greatly if patients are not given the resources or proper treatment follow-up to maintain their dentures.
General process for denture treatment
While individual treatment plans vary, there are several steps involved for implant-supported dentures:
Consultation: This appointment will cover an overview of the patient’s health and suitability for the different forms of implant-secured dentures, as well as the anatomical positioning and number of implants that are required. The dentist will obtain a complete medical history for the patient as well as all pertinent records, especially if they were referred from another practice. Up-to-date diagnostic imaging, such as CBCT scans, will be used for precise assessment.
Impressions and molding: An accurate impression of the dental arches will be made to facilitate the fabrication of a prosthesis that fits best in the mouth. Dentists use 3D modeling and CAD/CAM software to create molds and models, ensuring an accurate and comfortable fit.
Implant placement: This may involve multiple visits, especially if extractions or bone grafting to address bone deficiencies are required. Once that is addressed, the dentist will place the implants. Following successful bone grafting and sufficient healing, implants will be placed according to the treatment plan formulated during the consultation. Osseointegration (anchoring of a surgical implant by growth of bone around it) periods vary, typically requiring a healing phase of several months before the final prostheses can be placed. Placement of the dentures, whether locator-retained or fixed screw-retained, is less invasive and involves a shorter recovery period compared to the initial implant placement.
Aftercare: Follow-up visits will be scheduled as needed to monitor healing and health. These appointments offer opportunities to make any required adjustments or reline the prostheses to ensure optimal function and comfort.
Unique circumstances and individual health will affect additional steps or changes to increase the chances of success with the new dentures.
Importance of follow-up care
The patient must listen and follow instructions for aftercare, as these steps are vital for continued oral health with new dentures. It is important to attend follow-up appointments so the dentist can monitor healing and address any potential complications promptly. Some patients may require additional surgical interventions or treatments for other underlying dental issues; referral to a specialist may be needed.
A proper cleaning routine—even after the initial healing period—is critical to maintain dental health. Even if teeth are no longer attached, lingering food and bacteria left from improper cleaning can affect the gum tissue and jaw, causing damage to the places where dentures are anchored.
A transformative solution
Implant-supported dentures can be a transformative solution for many people seeking to restore their smiles and improve oral functionality. While not everyone may be an ideal candidate due to specific health conditions or habits, advancements in dental technology offer a range of options that can cater to different needs. From more affordable snap-in dentures to the stability of screw-in options and tailored single or multiple-tooth implants, there’s a suitable solution for each patient situation.
The journey to getting implant-supported dentures involves several critical steps, including consultation, precise molding, implant placement, denture fitting, and diligent aftercare. Your dentist can guide you throughout the process to ensure the success and longevity of your new dentures. With proper care and regular checkups, implant-supported dentures can significantly enhance your quality of life, providing you with a functional and confident smile.
