Several implant-supported replacement options are available if you are missing all of your lower teeth.
One option is to have two implants placed in your lower jaw and a denture made which snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants. However, there will still be movement of your lower denture, and sore spots will occur if any food particles, especially seeds, are caught under it. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.
This option involves placing four to six implants, depending on your jaw size and shape, into your lower jaw. After healing is complete, these implants are connected with a custom-made support bar. Your denture will be made with special clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called an “overdenture.” The advantage of this option is that it is much more stable than the first option and allows very little denture movement. This type of denture is still removable for easy cleaning and maintenance.
A third option involves placing five or more implants in your jaw and attaching a permanent denture. This denture is held in place by screws or clasps that secure it to the support posts or a bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at maintenance visits. Although cleaning under your denture without the ability to remove it can be more time-consuming and requires a bit more dexterity, many patients who desire a permanent denture prefer this option.
The last option is to have all your teeth individually replaced so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires eight or more implants. For each implant, a separate abutment or support post will be made and a crown for each missing tooth will be placed. To replace bone height strength and support, the teeth are often joined together for sinus grafting. Overall, this is the most costly option, because it requires the most implants and individual replacement tooth fabrication. Due to the current size and shape of your jawbone, your replacement options may also be limited.
There are similar treatment options also available for your upper jaw. The bone in your upper jaw is not as hard as the bone in the lower jaw, and therefore people often need more implants to support their new replacement teeth.
It may be possible to eliminate the need for covering the roof of your mouth with a complete denture depending on the number of implants that are to be placed. This option allows you to fully taste your food and gives you a better sense of its temperature thus allowing your denture to feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier.
Restoration that is similar to your natural teeth and not removable would require eight to ten individual implants placed. After healing, this is followed by the placement of the abutments and new replacement crowns.
After your tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months.
However, when the walls of your socket are very thin (referring to your upper and lower front teeth), healing is not as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. Doing this will maintain the width and volume of bone, that you will need for implant placement several months later.
If your tooth was removed many years ago and your bony ridge is extremely thin there may be inadequate bone for implant placement. In this case, a bone graft can be placed. After the graft has healed and fused to your pre-existing bone, the ridge will be re-entered and then the implant placed. Many different bone-grafting materials are available, including your own bone. It is usually a relatively comfortable office procedure for the patient.
If the sinus cavities in your upper jaw are very large, or very low, and extend into the tooth-bearing areas; you may also need bone grafting. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is sparse. A “sinus grafting procedure” is then required. This is performed in the office with local anesthesia and at times sedation. During this procedure, the membrane that lines the sinus is located and elevated. Then the bone will be added, which restores the bone height and ensures that the dental implants of an adequate length can be placed. This procedure often can be performed simultaneously with implant placement.