The advent of dental implants has been able to totally solve this problem for most patients.

The implant-supported denture is stable, very retentive and enables most patients to eat and chew the kinds of food they haven’t eaten in years. In some patients biting into an apple is now the norm rather than a wish.

Some patients may require a bone graft to create sufficient bone to place the implants, this now uncommon. The procedure for implant-retained dentures is as follows and I have included some x-rays and photos from my casebook. All of my patients who have undergone this type of treatment wondered why they didn’t do it sooner and I have no patients who have not been more than happy with the end result.

The technique is similar for both the top and bottom jaws. The bottom jaw (mandible) is usually more straight forward than the upper jaw (maxilla). The maxilla requires a minimum of four implants.

The process starts with having the implants placed in the bone. This generally done either under deep sedation or general anesthesia and consists in having precision drilled holes into the bone. The implants are placed into these and the area allowed to heal. The implants may take up to 20 weeks to fully integrate – this is the time taken for the bone to join to the implants and lock them in.

The “locator tops” are placed on the implants instead of the healing caps. This completes the surgical side of the process.

The dentures then have to be adapted with a press stud like tops so they can clip to the locator tops. Whether you need new dentures or not needs to be discussed with the correctly qualified dental technician or your dentist. Once the dentures have been fitted, the dentures will stay in the mouth unless unclipped by you. Needless to say the usual denture hygiene needs to be undertaken. Remember this type of implant retained denture is like any other denture and is not a permanent fixtures. If you want permanent fixtures this is a different process but can be accomplished. The implants should last many years if not indefinitely.

Dental implants could be considered as a third set of teeth. They feel more natural and secure than the traditional removable dentures,especially if these are loose fitting due to bone loss. Implants can also be used to “anchor” dentures into the oral cavity thereby giving denture wearers much more confidence and biting ability than they had with just their plates.
Dental implants allow for the replacement of a single missing tooth [without having to modify adjacent teeth] through to a complete set of missing teeth. These pictures show only a single replacement but multiple teeth can be replaced.

Multiple Implants placed in the jaws for full mouth dental reconstruction

Full mouth reconstruction, crowns and bridges

Dental implants as a general rule are not complicated to place provided there is sufficient bone and gum to accept the implant. Where there has been a quantity of bone and /or gum loss, dental implants may still be used but the area may require pre-implant surgery with bone and gum augmentation.

The type of implant shown in the diagram is the type typical of those that are used to help secure dentures. The “ball head” clips into a special attachment on the inside of the denture, while the rest of the structure is integrated into the bone.
These two pictures show the basic type of implants that are currently available. One has its surface covered with spheres to increase surface area. The other is of a “self-tapping” screw type. There are now many different manufacturers but their products are only variations of these.

Stages

There are really three stages of placing implants although this depends upon the type of implant and what it’s specific function is.
Stage 1.
The implant root component is placed into the bone site. This is a surgical procedure involving opening the overlying gum to expose the alveolar bone. Making the implant socket in the bone and then either screwing the implant in on friction fitting it. The gum is then replaced and the wound closed with stitches. This procedure is done under sedation and local analgesia. After a week to ten days the stitches are removed and the buried implant is allowed to heal for about 20 weeks.
Stage 2.
This is usually a simple procedure and is done under local analgesia alone. The buried, secure implant is uncovered using a small incision in the gum tissue .A “healing coping” is attached to the implant and pokes up through the gum. The gum is allowed to heal around this coping for a period of about two weeks.
THIS COMPLETES THE SURGEONS PART OF THE PROCESS.
Stage 3.
The final post is screwed into the implant and the crown made and fitted.