Retention poses a significant challenge for many who use dentures. Denture retention relies almost entirely on the contact and friction between the inside surface of the denture and the gum tissue. As the amount of bone to support a denture decreases, it can become increasingly difficult to retain a denture in place while speaking or eating. This is especially noticeable with a lower denture, as the strong tongue and floor of the mouth can dislodge it during function, and prevent the suction cup effect the palate provides to an upper denture. Adhesives can only do so much, and sometimes do not provide an adequate solution for those with severely resorbed gingival ridges. The remedy for this problem lies in implant-retained dentures. This involves the placement of implants in the bone, which in turn provide firm anchors to retain and support the denture.
A lower denture needs a minimum of two implants for adequate support, while an upper denture requires at least four due to softer, less dense bone. If you suffer retention problems with an existing denture, the denture can be retrofitted to fit implants, negating the need to fabricate a whole new denture.
- Completed in 3 steps:
- CBCT image and intraoral scan: A CBCT scan is a three-dimensional x-ray of the mouth. This image combines with an intraoral scan to fabricate a surgical guide. This surgical guide helps direct the dentist to place the implants in the most ideal locations.
- Surgical placement of the implants: The implants are placed below the level of the gums to heal without the interference from any external forces.
————————2-4 MONTH HEALING PERIOD————————
- Denture portion of the process:
- If you already have a denture, at this point we will retrofit your denture to fit the implants in one appointment. The implants are uncovered, attachments are inserted into the implants, and these attachments are processed chairside to fit into the denture.
- If we are making a new denture, the process will take 4 appointments over the course of about 2.5 months.
Order and Explanation of Each Appointment in the Implant-Retained Denture Process
The following list of appointments includes every possible appointment in the process; your individual case will most likely not include all of them. Refer to the Schedule of Payments by Appointment for the list of included appointments for your case.
- First impression for immediate denture – Assuming you still have some teeth left that are planned for removal, we first fabricate the denture before we extract the teeth. Since we extract the teeth and immediately deliver the denture the same day as the extractions, the denture is called an immediate denture. This appointment is the first impression for the immediate denture using stock trays.
- Final impression and bite registration for immediate denture – The lab sends us custom trays to take more precise impressions, and we also take measurements to record your bite. We select a shade for your denture teeth as well as the pink denture acrylic that will simulate your gums.
- Extract remaining teeth, bone graft(s) and deliver immediate denture – With the denture received from the lab, we are ready to remove your teeth and deliver the denture. If your plan includes placing implants in an area of an extraction, we will need to place a bone graft and membrane to preserve the ridge of bone and prepare the site for future implant placement.
————————————–1-2 MONTHS OF HEALING————————————–
- Chairside soft reline of denture – This is an optional appointment. As the gums shift and remodel as they heal, the denture will fit less and less well over time. In some cases, this change in fit does not significantly affect the feel and function of the denture. In cases where they are compromised, a chairside soft reline involves adding a soft rubberlike material to the inside surface of the denture so that it matches the altered position of the gums.
———————————–2-3 MONTHS MORE HEALING———————————–
- Evaluation and imaging of site(s), possible guide fabrication (only sometimes necessary) – This appointment involves the evaluation of the implant sites and the capture of a 3D x-ray to aid in planning the implant surgery and fabricating a surgical guide. A surgical guide is an appliance the dentist uses in cases where the margin of implant placement error is too small for an unguided surgery. Some cases may only require a 3D x-ray to clarify the exact amount of available bone, while other more demanding cases will require a 3D x-ray AND the surgical guide to direct the precise placement of the implant.
- Implant Placement – This is the step where we place the implants that will support the denture. The implants are placed below the level of the gums so that they can heal free from any outside forces for three months.
————————————–3 MONTHS OF HEALING————————————–
- Laboratory hard reline of denture – With the gums now fully healed, we will take an impression with your denture and send it to the lab so that the acrylic can be reprocessed to intimately match the new position of the gums. If this is your only set of dentures, plan on being without it for about two weeks.
- Insertion of prefabricated abutments into implants and modification of denture to fit implants – With the implants fully healed, we can now retrofit your denture to snap into them. We first will expose the implants and insert the prefabricated abutments, which are the male connecting pieces of the implant-denture system. These prefabricated abutments will fit into the precision attachments, which we will process into the denture chairside.