What are Denture Implants? | Implant Supported Dentures

Denture implants are used in order to support or retain a full or partial denture. They can provide a stable denture foundation for patients who have lost all of their natural teeth but have maintained adequate jaw bone mass to support implants. The use of implant supported dentures can improve significantly the quality of life for patients wearing removable dentures.

Implant supported dentures are a type of full overdenture that is secured in place by dental implants instead of simply resting on the gums as conventional dentures. Special attachments fitted on the denture are used to attach it on top of the denture implants that are securely placed in the jawbone.

Denture implants provide a level of stability and comfort that common dentures can never offer. Implant supported dentures will not move or pop off with regular movements such as eating or speaking. They can be used in either the lower or upper jaw, but generally upper jaw dentures need a larger number of implants for adequate support.

To wear the denture, the patient has to place it in the proper position with the top of implant and the denture socket facing each other and apply a light pressure fo the denture to snap securely. To remove the denture, the patient has to apply pressure in a lifting motion with the thumbs, and the denture is disengaged easily. Fixed implant dentures are permanently attached, and they can be removed only by a dentist.

There are several types of implant supported dentures based on the type of the attachment used to provide support:

• Bar-retained : A thin metal bar that follows the curve of the jaw is attached to two to five denture implants that have been placed in the jawbone. Clips or other types of attachments are fitted to the denture, so that it can be securely clipped over the bar.
• Ball-retained : A ball-shaped attachment is placed on top of each of the implants instead of the classic abutments, which fits into socket like connectors fitted at the base of the denture. Two to four implants are required for the lower jaw and four to eight for the upper jaw. This "ball and socket" type is the most popular type used today.
• Fixed : Another type are the fixed implant dentures which are permanently placed and they can't be removed by the patient. The denture has holes in the teeth positioned over the implants with small screws passing through and attaching the denture securely. The holes are then covered by the dentist. Fixed dentures require regular visits to the dentist in order to be removed and cleaned or repaired.
• All-on-4 : All-on-4, which was originally designed for patients with poor jaw bone quality, is actually a sub-type of fixed implant-supported dentures that needs only four implants. These are placed at special angles to take advantage of areas of denser bone, which means that most patients can receive these dentures without the need for bone grafts. Even some patients with severe bone loss can be candidates for All-on-4.

The cost of implant dentures is actually a combination of the cost of the dental implants and that of the full dentures. A full denture alone can cost between $1,000 and $5,000 depending on the material quality. The cost of denture implants depends on how many and what type will be used ($1,500 to $3,500 per implant). For this reason there is a huge variation at the prices of implant dentures, it can range from $4,000 up to more than $50,000.

At least two implants are required for providing a basic stability to the denture. In this case we are not actually talking about an implant supported denture but for an implant retained denture. Such an implant retained denture is the most affordable entry-level solution with a cost of $4,000-$12,000 but does not offer the full benefits regarding comfort, bone loss prevention etc.

For an implant supported denture the patient should expect the cost of at least four denture implants in the lower jaw and at least six for the upper jaw. The cost can be reduced if mini dental implants are used. In this case the number of fixtures needed will increase but the overall cost is lower.

Some patients with existing conventional dentures may avoid the cost of replacement if the old ones can fulfill some functional and aesthetic requirements. In some cases the old dentures may be modified by adding the sockets needed to support the "ball and socket" system for attachment. If modification is not possible, new dentures designed to provide implant support will cost a little more than conventional ones.

When evaluating the cost of new dentures, the patient should also consider the long terms savings of using implant supported instead of conventional dentures that have to be relined from time to time and replaced every few years. The savings from the cost of adhesives may also be significant in the long term.

Two implants are the minimum required for a ball-retained denture for the lower jaw. Bar-retained dentures require at least three fixtures. But in this case, although the retention and stability of a lower denture can be greatly increased, the patient will not get all the other benefits of implant dentures. The denture will still have to rest on the gum tissue causing irritations but the most important is that jaw bone loss can not be reverted significantly if only a few implants are used.

For a standard implant supported denture, four denture implants are needed for the lower jaw and at least six for the upper jaw. Due to the effect of gravity and the lower bone density of the upper jaw, upper dentures require a larger number than those for lower jaw. Even more will be needed if the dentist uses mini dental implants instead of standard diameter ones. For better stability up to eight may be required at each arch.

Several techniques have been developed lately to provide a solution for patients with severe bone loss at the back of the jaws. These techniques known as All-on-4 and All-on-6 are based on the placement of 4 or 6 denture implants with very specific orientation only in the front part of the jaw. They can also be used for patients without bone issues to reduce the number of implants to be placed, but they cost more.

Implant supported dentures provide several advantages over conventional dentures that worth their higher cost:

Improved Confidence

Patients can feel more confident in public because they are no longer afraid the embarrassment of a denture that might slip out of place when they eat, talk or laugh.

Improved Comfort

Implant supported dentures are much more comfortable for the patient, basically due to their secure placement that eliminates slipping or moving. The patient's comfort is also increased by:

• less irritation of gum tissue (pain and canker sores are common problems for patients with conventional dentures)
• not covering the palate allows better, more natural feel of the mouth
• better feel due to the less plastic used
• no need to use denture adhesives

Eat Better

Even with a perfectly fitting removable full denture, the patient has about 20% of the chewing efficiency of a person with natural teeth. The problem becomes worse with aging, because more jawbone is lost and dentures do not fit well, making it difficult to eat certain foods. Implant supported dentures can significantly restore the chewing efficiency over 50% and allow the patient to eat properly and follow a more normal diet without being restricted to soft foods (very hard or sticky foods should still be avoided).

Taste Better

An implant supported denture does not cover the palate of the mouth. This alone can improve the sensation of taste and let the patient better enjoy his food.

Less Bone Loss

When the natural teeth are lost, the surrounding bone loses its role of supporting them and the body starts to resorb it as useless. This can lead to massive bone loss in the jaws, seriously affecting facial integrity and appearance. Dentures start to not fit well and have to be replaced or repaired every few years. Denture implants act as the teeth roots continuing to stimulate the bone cells and help the jawbone around them to stop deteriorating and remain healthy and intact.

Improved Appearance

Implant supported dentures look more natural than conventional dentures due to the less plastic needed for retention. They can also help the patient's appearance by preventing jaw shrinkage and facial collapse. Patients using conventional dentures suffer from severe bone loss that causes the jaws to shrink and the face to have a sunken-in look. Tooth implants can delay bone loss and prevent this condition.

Improved Speech

Patients with conventional dentures have difficulty with speaking clearly. Slurred speech and clicking noises are common problems. Steady implant supported dentures help patients talk easily and relaxed with more clear and natural voice.

Maintenance cost

Less repairs (reline) are required due to less bone loss - No cost for adhesives use.