Full Mouth Rehabilitation

There are several types of dentures in the market, each made from different materials and serving different purposes. That’s why it’s important to understand what the benefits of the different types are when deciding on the best type for you. Dentures could be partial or complete, fixed or permanent, depending upon tooth condition. 

Implant-supported dentures are a type of denture that is supported by dental implants. Implants are small titanium posts that are screwed directly into the jawbone. Implant supported dentures may be fixed as well as removable.

In contrast, regular dentures use adhesive and mouth muscle strength to stay in place.

WHY IMPLANT SUPPORTED DENTURE ?
If you are considering implant-supported dentures, it is important to get them placed sooner rather than later. When you lose teeth, the jawbone starts to deteriorate due to long periods of disuse. Implants are most successful when there is sufficient bone density left, so the longer you wait to get them the less the chance to succeed.

BENEFITS OF IMPLANT SUPPORTED DENTURE

• Once placed, implants help to stop the jawbone from deteriorating further, preventing the sunken facial shape that often accompanies jawbone loss. 
• Although traditional dentures need to be regularly adjusted to account for a loss in bone density and the accompanying change in jaw shape, the implants supporting the dentures encourage bone stability and do not ever need to be replaced. 

TYPES OF IMPLANT SUPPORTED DENTURES

• BALL-RETAINED DENTURES - Each implant in the jawbone holds a metal attachment that fits into another attachment on the denture. In most cases, the attachments on the implants are ball-shaped, and they fit into sockets on the denture. 
• BAR-RETAINED DENTURES - A thin metal bar that follows the curve of your jaw is attached to two to five implants that have been placed in your jawbone. This metal bar then fits into the denture.

The number of implants required for denture depends upon the condition of your jawbone. Better the condition, more implants could be put in for more stability.  However, in case of compromised jawbone, especially towards the pre-molars and molars, we are left with below options in case of full mouth dentures: 

• Cantilever near premolar/molar (quick, simple, economical) -  This is the most common type of dental implant generally used for dentures. This is the preferred option when the intention is to keep the procedure least invasive for patients with severe loss of rear jaw bone, especially the upper part. The cantilever can be stabilised by putting more number of implants in the other areas of the jaw where the bone is healthy, and by putting forward inclined implants from molar/premolar tooth towards the front healthy jaw. This stabilizes the entire denture. Since this procedure doesn't involve as complex surgeries as in other two cases, chances of its success are highest and the overall cost is least as compared to other procedures.

• Zygomatic implant near premolar/molar (quick, complex, costly, preferred) -  Zygomatic dental implants are a simpler solution than bone grafts, and can help patients with severe bone loss get dental implants. A zygomatic dental implant uses a different bone than other dental implants, which are implanted into the maxilla (upper jaw bone) or the mandible (lower jaw bone). The zygomatic bone, also known as the cheekbone, does not suffer bone loss in the same way that the jaw bones do. Since the zygomatic bone is adjacent to important structures, such as the brain, eyes, nerves and blood vessels, in order to prevent unfortunate outcomes of zygomatic bone augmentation procedures, as serious post-operative complications, these should be performed exclusively by experienced surgeons.

• Pterygoid Implant use pterygomaxillary region which provides us an excellent place for placement of implant and rehabilitation of posterior maxilla. Due to the disadvantages such as tear of sinus membrane during sinus lift procedures, seepage of bone grafts into the sinus, loss of bone grafts due to resorption during bone augmentation procedures, high morbidity seen in zygomatic implants, screw loosening or breakage in tilted implants, a simple but effective method of replacing posterior maxilla is placement of implants in the pterygomaxillary region. Pterygomaxillary implants resist all axial and nonaxial forces better than any other implants placed in the maxilla. However, these are the most expensive of all dental implants and requires a skilled Oral Maxillofacial Surgeon to get it done.

• Bone grafts (multiple surgeries, costly, rare cases) - In a bone graft, a section of healthy bone is taken from another area of the body and implanted into the damaged area. If a zygomatic dental implant is not an option, particularly in the cases of bone loss in the mandible, a bone graft can also help to restore the jawbone and make dental implants possible. A bone graft is a more complex process, but can be highly effective for restoring the health of the teeth and jawbones. In addition to making dental implants possible, a bone graft can also help to strengthen the jawbone and restore face shape, chewing and speaking comfort, and help to prevent further damage.

Only after careful evaluation of patient's condition of teeth and jawbone, along with other vital parameters,  the specialist dentist decides which of the above approach would be suitable for the case in hand.