Implants: A Realistic Denture Alternative

Dr. Joseph Worthington, D.D.S.

by Dr. Joseph Worthington, D.D.S. | August 17, 2010 @ 10:00AM

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According to a recent survey by the American Academy of Implant Dentistry (AAID), the use of implants in dentistry has grown by over 200% in the last five years. The reasons are simple. Implants are among the most versatile of dental procedures. They can be used to replace one tooth, several teeth, or a full set, offering patients who have used partial or full dentures an alternative that comes very close to replicating their natural teeth. Dental implants can help individuals who, with traditional dentures, have suffered from chronic ailments such as hyper-gag reflex. They can be used cosmetically to enhance facial appearance. Finally, today's dental implants are extremely predictable.

An Accidental Discovery

Dental implants are biocompatible substitutes for lost natural teeth. Although the use of dental implants actually dates back to the ancient Egyptians, only in the last 30 years have they become really reliable. The real breakthrough in implant dentistry occurred when Swedish anatomist P.I. Brandemark accidentally discovered osseointegration, the process by which bone will grow up to and fuse to undisturbed titanium. Today, using Titanium, we have an 89% success rate in the upper jaw and a 92% success rate in the lower jaw, where the bone typically is denser and stronger.

There are several types of dental implants However, the most common is the endosteal implant, one placed in the bone. Endosteal implants come in many sizes and shapes, and are chosen depending on the condition of the patient's bone and the particular application for which it will be used.

A typical implant procedure is done in two stages and takes between four to six months. In the first stage, the implant body is inserted into a carefully prepared opening in the bone, and the gum is sutured closed. A temporary cap is placed in the area for esthetic considerations. Over a period of four to six months, the bone will grow up to and fuse to the undisturbed implant body.

During this time, the doctor will request periodic visits in order to insure that the site remains infection free. After the osseointegration phase, the dentist carefully reflects the tissue and attaches a titanium abutment to the implant body. The tissue will be allowed to contour around the abutment and the implant will now be ready to support the dental restoration that will replace the temporary restoration and return the patient to function.

Advantages of Implant Dentistry

As long as it is properly inserted, most patients will consider their dental implant a significant improvement over either full or partial dentures. Quite often when weighing the pros and cons of implants versus fixed bridgework when replacing a single tooth, an implant is considered more conservative. This is because preparing a bridge requires two teeth on either side to be ground down in order to support it. With a dental implant, no other teeth are compromised.

Anyone who has struggled with the fit and comfort of lower dentures, or the gag reflex commonly associated with upper dentures, will appreciate the changes effected by implant dentistry. Patients will experience a dramatic difference both in their ability to chew food and the confidence level they will gain from not worrying about slipping dentures.

In order to support a full compliment of teeth in any given arch, you will need between 6 and 8 implants, depending on their placement locations. Not every patient has the available bone or necessary financial means to do this. In these situations, the implant born overdenture may be the treatment of choice.

An overdenture is a removable appliance that can be clipped on to a bar supported by two or more implants, giving the denture wearer infinitely more chewing ability and confidence. In the upper arch, the overdenture can be designed in the shape of a horseshoe so that a patient with a hyper-gag reflex can more readily tolerate the appliance. Any new denture wearer will tell you that food does not taste as good as it did before dentures. That is because we have taste buds on the roof of our mouths that get covered by the denture. This horseshoe shape, or "open palate." design of an overdenture allows the patient to not only better taste foods but also to have a better sense of where the food is in their mouth.

Something that most people do not realize is that when an individual loses teeth he/she also loses the bone that houses the teeth. In restoring an individual with a fixed bridge supported by implants, the dentist may not be able to replace all the natural lip support that the patient lost, leaving the patient looking far older than he/she is. In these situations, the overdenture again can come to the rescue and adequately replicate the original lip support the patient had when his or her natural teeth were in place; in some cases, it can remove the wrinkles of age giving the patient a more youthful appearance.


There are some people for whom dental implants are not appropriate. Among the difficult cases are those individuals suffering from diabetes as the healing process in these patients is frequently compromised. Nonetheless, in situations where we had little alternative, we have successfully treated several diabetic patients. Another contraindication is for those patients who have lost substantial bone, not leaving adequate support for the implants themselves. In these situations we have had some successes with bone augmentation using artificial bone.

Post-Restorative Care

Although your dental implant will not decay as your natural teeth will, having implants does not alter the requirement for good oral hygiene, which includes brushing, flossing, and regular visits to the dental hygienist. In fact, the greatest cause of implant failure is poor oral hygiene. Debris that collects around dental implants can increase bacteria, which in turn can lead to inflammation, infection, swollen gums, and consequently, bone loss. Sometimes the same apathy that caused a patient to lose his or her natural teeth can cause the demise of their dental implants. We recommend that an implant patient visit the dental hygienist a minimum of four times per year. These hygiene visits are the most inexpensive insurance against potential disaster if bone loss or infection goes undetected. Infections around implants are different than those found around natural teeth and quite often don't elicit the same level of pain we use as a natural alarm clock.

Qualifying your Doctor

When determining whether or not a particular dentist is qualified to restore ones mouth to function, we find that experience is most often the primary rule of thumb. Don't be afraid to ask the dentist how many implant patients he or she has restored or how many years they have spent performing implant dentistry. You can also ask the dentist if you can talk to one or more of his or her patients that have gone through the procedure you are considering and have had their implant dentistry in place for several years. Being an educated consumer just makes smart sense. Your implant dentistry is an investment that you want to get the most out of.

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