By: Jean Johnson for Dental1“Now I can eat caramel at a party and not have to worry about my dentures sticking together and prying them apart,” said Marvin Goodwin of Buena Park, California. “Even though my partials fit, they were often uncomfortable and had a tendency to move when I talked or ate.”
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Learn more about implant-supported dentures:
An implant-supported denture is a type of denture that is supported and attached to titanium implants that are installed in the jawbone.
Look for prosthodontists or other dental specialists that have both advanced training and an established clinical background in implants.
Most implants take months to fuse to the bone to the procedure is a time-consuming one. During the process, patients always have temporary dentures or teeth in place when they leave their office visits.
Bar-clip and ball attachments are critical decisions that should be discussed carefully with your prosthodontist or other dental specialist.
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Rates of Tooth Loss in AdultsGoodwin is only one among many. The Surgeon General’s Report on Oral Health states that the rate of tooth loss or edentulism for adults 18 years old is 10 percent. As would be expected the incidence increases with age, and data shows that a third of the population over age 65 are without at least some of their teeth.
Popularity of Implant-Supported Dentures
With both partial and complete dentures a growing reality, many like Goodwin are increasingly turning to implants.
“Yes, they are very popular with people who have dentures,” said Nader M. Rassouli, D.D.S., M.S., prosthodontist in Portland, Oregon. “Securing dentures to implants gives people more stability.” Rassouli adds that people appreciate being able to rely on their dentures.
“It makes a big difference,” he said, “especially on the lower jaw because especially the tongue but also the movement of the jaw causes lower dentures to move around quite a bit when they are not secured to implants.”
Success Rates
Not only do denture wearers gain added confidence and comfort by having dental implants placed, a recent study shows the survival rate of implant-supported dentures is high.
According to results published in the Journal of Periodontology 95.4 percent of those in the study group enjoyed fully functioning implants securing their dentures at the end of a 10-year period. Success rates were somewhat higher for implants placed in the lower jaw or mandible – 99.5 percent – than they were for those in the upper or maxilla – 87.3 percent.
Physiology Considerations
Tooth loss creates enough problems functionally and cosmetically. But the accompanying bone loss can further complicate matters when it comes to fitting dentures. Implants help here as well by counteracting bone deterioration since the titanium implants stimulate bone growth and integrity similar to the way the original roots of the teeth did.
“One of the advantages of implant-supported bridges and dentures is that it replaces some of the tooth roots, which will better preserve the jawbone,” explained president of the American Academy of Periodontology, Vincent J. Iacono, D.M.D. “Dental implants integrate with the jawbone helping to keep the bone healthy and intact.”
Pain Considerations
Having implants placed is a surgical event. Nonetheless most patients report minimal after-surgery pain that they manage with cold compresses and Ibuprofen or a mild prescription pain medication. “I felt practically no pain in having them placed and am very glad that I did it,” said Goodwin.
One visitor to Dental1, however, inquired about pain and pressure surrounding an implant prior to placement of the denture or crown, so we went inquiring.
“There shouldn’t be any pain or pressure after the first one to two hours,” Dr. Rassouli said. “If there is, something is wrong.”
Rassouli adds that if implants are placed too deep in the bone, problems can arise. He explains that the art of placing implants is delicate one and that getting the angulations and depth right requires a practiced touch.
“A lot of doctors don’t do enough implants, and so when patients have some discomfort, the doctors don’t know exactly what the problem is,” he said.
Attachment Options for Implant-Supported Dentures
Instead of resting on the gums, implant-supported dentures snap onto special attachments fastened to the implants. The dentures are still removable, and those who wear them are advised to remove them for nightly cleaning as well as have them relined yearly by their dentist.
Choices come in determining which type of attachment – bar-retained, that need at least three implants, or ball-retained that require two. Bar-retained implants use a thin metal bar that follows the curve of the jaw and attaches to the implants, while ball-retained implants fit into sockets on the denture.
Bar-retained implants are generally the preferred technology since in the late 90s Canadian National Health Research Development Program found that “there was a substantial repair rate within the first year after insertion of removable implant dentures.” Over a two-year period the team monitored patients with ball attachments bar-clip attachments and found that “preliminary indications are that the mechanism of attachment may influence the incidence of repairs.”
To decipher this jargon, we again turned to the Portland prosthodontist, Nader Rassouli. “Doing a ball attachment is cheaper, but it doesn’t give you as much retention. The bar clips run around $1,500 while the ball attachments are $500 each.” Depending on how many implants the patient has, Rassouli said the total can range from $3,000 to $6,000 for the customized bar clips as opposed to $1,500 for the ball style attachment. “So it’s not fair to compare the two, really,” he said.
Editor’s note: Costs can vary by state and also by dental professional. When considering any treatment, it’s important to get more information including cost estimates from professionals in your local area.
As far as repair rates, Rassouli explained that there are replaceable O-rings in the ball attachments that start wearing down the same day the patient gets them. “As soon as you start chewing on them, they start to wear. That’s why the manufacturer made the O-ring as a replaceable part.”
Rassouli offers only customized bar clips to his patients since he thinks they are so much more successful. Indeed, patients want technology that is going to work for them so they can get on with their lives. As Marvin Goodwin said of his decision, “I can now enjoy eating food – especially steak because my teeth do not move. My implant-placed overdentures have made my life more pleasurable.”
