Dental Implants and Dentures

A dental implant is a form of tooth restoration procedure used to replace a missing tooth. It is a screw inserted into the jawbone to serve as an artificial tooth root. The jawbone to which the implant is inserted provides solid support and anchorage. An implant may either be topped with a porcelain crown or several of them can be used to support an entire denture.

A denture, on the other hand, is a removable prosthesis that has been around for a very long time. Like dental implants, it is used in cases of missing teeth although dentures are more ideal if the patient has lost almost all of his/her teeth. Dentures rest directly on the remaining jawbone and gums. They are typically kept in place by suction against the soft tissue. For added retention, some dentists recommend the use of dental adhesives to keep the dentures from falling off the patient’s mouth.

CANDIDACY

Patients who have lost only a single tooth are the most ideal candidates for a dental implant. There are other factors that must be considered when determining if an implant is appropriate for a patient. Such factors include the patient’s oral hygiene and the amount of remaining bone that can support the implant. Putting an implant on a patient with poor oral hygiene will only cause the implant to fail. The same can be said if the remaining bone support is not enough. In such cases, the patient would be better off with conventional dentures.

If the patient has multiple missing teeth but does not want a removable denture, then he can get the best of both worlds by opting for a combination of implants and dentures. Such technology is known as an implant over denture. In this type of prosthesis, the dentist puts the implants into the jaw and then attaches the denture to the implants. The implants will help support and keep the denture in place.

A patient who has lost all of his teeth may opt for either conventional dentures or an implant over denture. Most dentists will recommend the dentures but patients may choose to have implants. An implant over denture costs more but the main advantage is these implants will restore function as close as possible to that of natural teeth. For example, a patient that has missing teeth replaced by implants will experience 90% of the original chewing power they had with a full complement of healthy teeth. On the other hand, someone who has a set of conventional dentures will see their chewing power cut down to about 30%.

TREATMENT COMPARISON

Dental implants and implant-supported dentures have a lot of advantages over conventional dentures. Both provide more permanent results and help restore the patient’s chewing ability. Patients can enjoy a normal diet with implants while those who have conventional dentures are required to switch to a diet consisting of softer foods. When it comes to esthetics, dental implants produce the most natural looking results. Implant-supported dentures and conventional dentures are more or less similar in terms of appearance.

Another thing that makes implants better than conventional dentures is the amount of coverage required by the latter. To be retentive, dentures must cover as much area as possible. This is especially true in cases of upper dentures, which require coverage of the entire palate (the roof of the mouth). The palate contains lots of taste buds and if the upper denture covers these taste buds, the patient’s ability to enjoy the full flavor of food is tremendously reduced. However, if the patient has implants or implant-supported dentures, the roof of the mouth does not have to be covered. In turn, the taste buds will not have to be covered and eating will be a more enjoyable experience for the patient. 

LIMITATIONS

As long as the patient qualifies for an implant there are virtually no limitations with the implant itself. The limitations pertain more to conventional dentures. The number one limitation of this type of prosthesis is stability. Even a properly made denture becomes less stable over time due to the shrinking of the bone. There will also be diet limitations because there are some foods that are too hard or too sticky for dentures. Hard foods may cause dentures to crack while sticky foods might displace it.

Another limitation of conventional dentures is that applying too much pressure will cause the bone underneath to shrink. Over a period of time, the denture will sink deeper and deeper into the jawbone as the jawbone wears down. When you put an implant into the bone, the implant will preserve the bone and prevent it from shrinking. The function of the bone is to hold on to the roots of the tooth. If a tooth goes missing, the bone that used to support it no longer has that function so it just shrinks. Implants preserve the bone by serving as an artificial root. The bones function to support this artificial root and therefore do not have to shrink anymore.

RISKS

Patients who receive an implant, an implant-supported denture, or a conventional denture are at risk for infection if they do not practice good oral hygiene. Implant and implant-supported denture patients may be at risk for a condition called peri-implantitis, which refers to the inflammation of the tissues around the implant. If left untreated, peri-implantitis may worsen and eventually cause the implant to fall off. Patients with conventional dentures may develop denture stomatitis caused by infection with Candida albicans fungus. Denture stomatitis is characterized by redness and a slight inflammation of the soft tissue beneath the denture. Peri-implantitis and denture stomatitis can be prevented by brushing, flossing, and rinsing as normal with dental implants or removing the dentures to clean them thoroughly. The idea is to keep all of the bacteria and fungi from building up.    

RECOVERY

Patients who receive a dental implant require a much longer recovery period compared to those who have conventional dentures. The placement of implants requires surgery. After surgery, there will be soreness for a day or two. The complete healing process takes about three to six months. Since implant-supported dentures involve putting dentures on the same day the implants are placed, the recovery time is a bit shorter. The denture somehow serves to protect the implants underneath it so the surgical site will not be disturbed as much by other forces as when only implants are placed.

Regardless of what type of prosthesis is used, the patient will be placed on a softer diet for three to four months. Overall, patients who wish to have any of the three are looking at three to six months of recovery time for everything to heal.

MAINTENANCE

Patients with implants usually have no special instructions given to them. As long as they brush and floss regularly, they will not experience any problems. The same goes for those who have implant-supported dentures. Special instructions for maintenance are usually given for conventional denture patients. They are advised to take off their dentures at night and clean them using soap and a soft cloth. Brushing their dentures using a stiff toothbrush with toothpaste is not recommended, as doing so will abrade the denture. Soaking the dentures in a mild cleaning solution is also advised to prevent the buildup of bacteria as well as keeping the dentures moist to retain their shape.

RESULTS

The average lifespan of dental implants, according to the American Dental Association, is 25 years. Implant-supported dentures can last anywhere from 12 to 30 years while conventional dentures will require some refitting after 5 to 7 years.

FINAL THOUGHTS

Dental implants are becoming more mainstream as more dentists undergo training for the procedures. Consulting with an experienced and trained dentist gives a patient a better understanding of their options. A complete evaluation of the condition of the teeth helps the dentist determine which dental implant is the right choice for a patient.

Written by Cosmetic Town Editorial Team - AA

Based on an exclusive interview with Dr. Edward Camacho in San Antonio, TX