A complete denture is a denture that replaces all teeth in either the upper or lower dental arch. A complete denture is considered one of the least expensive methods to replace many teeth and restore lost dental function in a timely fashion.
Complete upper and complete lower dentures have limitations due to factors such as palatal coverage affecting speech and taste, existing bone ridge anatomy and tongue position and function.
To simplify dentures have approximate 20% of full function with a convention upper and/or lower denture. (As compared with having all their natural teeth)
In many cases dentists will recommend a patient considers implant support for the denture depending on each clinical situation and patients’ particular desires and expectations.
Implant Supported Dentures (Full Arch Solutions)
For those patients that would like to achieve a higher degree of masticatory (chewing) function and achieve a results that most approximates their natural teeth, implant supported full arch solutions should be considered. Many variations of full arch solutions exist. Full arch fixed or removable options are more complex treatment options. They are considered far superior to conventional complete dentures however they have increased treatment costs and maintenance cost
Full arch “fixed” solutions refers to 12-14 teeth per arch that are retained by 4-6 implants. These are often referred to as Fixed Hybrid Dental Prostheses. These full arch tooth replacement solutions are physically attached to the underlying implants with special implant screws. These fixed full arch solutions require annual or semi-annual removal and maintenance to ensure the underlying implants remain healthy. The maintenance of a full arch implant supported solution should be considered as much or more maintenance than natural teeth.
Full arch “removable” solutions refer to implant dentures that can be removed and “clip” into implant locators. These locators can be attached to a titanium bar, referred to as an implant bar over denture, or they can attach directly to the implant locators, referred to as an implant over denture
Full Arch Removable Solutions
Full arch solutions can use acrylic material or other dental materials. When a denture is supported by implants this is referred to as an implant supported complete over-denture. Patients looking for implant supported full arch solutions will select an implant supported denture as they are more cost effective than a fixed hybrid solution. These dentures are removable allowing the patient to perform hygiene daily. In the upper (Maxillary) arch often 4 implants are utilized.
In the case of lower (Mandibular) dentures often 2 dental implants is sufficient to support the prosthesis. More implant often provide more support however many patient select 2 implant over-dentures for financial reasons. Many patients find 2 implant supported mandibular over-dentures areadequate for chewing and social function. Patient are able to add 2 additional implants later if the 2 implant solution is not providing adequate stability.
Full Arch Fixed Solutions
When all teeth are missing is an arch and dental implants are used to replace 10-14 teeth this is referred to as an implant supported full arch solution. Full arch solutions can include 12-14 unit implant bridges that are fabricated from dental materials that replicate the natural teeth and gums as close as possible. The following image demonstrates a 12 Unit (12 Tooth) full arch bridge. This is also known as a fixed hybrid maxillary (upper arch) prosthesis. These fixed hybrid prostheses are typically screw retained with 4 or 6 implants supporting beneath. The fixed hybrid must be removed at least 1 time per year to have dental cleaning performed on implant and prosthesis, as well as clinical assessment of the dental implant.
In all of these full arch solutions a specialist referred to as an Oral and Maxillofacial Surgeon is typically involved in the co-ordination and placement of the implants. Depending on the patients bone levels and complexity of medical history and clinical circumstances a dental specialist known as a Prosthodontist may also be involved.
It is best to discuss all of the options with the dentist and determine what best option for you will be. Different patients have different clinical circumstances and different clinical needs and desired outcomes.