No Teeth (fully edentulous)
Edentulous is a dental term, used to describe a state in which a patient has no teeth at all. This may sound strange but there are a great many people who do not have any teeth, either as a result of an accident or illness.
If you are in this position then dentures are often the only solution. This means having to use a messy ‘glue’ to fix their dentures in place which can be awkward and off-putting.
Dentures are a tried and tested answer to the problem of missing teeth but they are not without their problems which include the tendency to become loose, soreness and irritation.
These problems will resolve themselves over time as you become used to wearing dentures but there are some patients who never come to terms with denture wear. For that group of patients, dental implants are the answer.
There are several treatment options available to the patient:
- Crown and bridge restoration
- Fixed/detached restoration
- Implant overdenture
- Mini implant overdenture
Crown and bridge restoration
This involves the use of restorations or crowns (artificial teeth) and a special bridge (a temporary denture). The crowns are attached to this bridge and are a permanent fixture unlike the usual removable restorations.
Fixed restorations (teeth) are more realistic looking than the removable type of restoration but are also more expensive.
And, they are more difficult to clean and generally, care for.
A crown and bridge restoration can be carried out as part of a major reconstruction or as a means of converting from a removable restoration to a fixed restoration.
This is an extensive process which includes initial diagnostics, the taking of an impression of your jaw – for purposes of casting, and the insertion of the implants. The second stage includes the fitting of the abutments and the final replacement teeth (crowns and bridge).
They are more realistic looking and feel like real teeth rather than the removal type.
They are more difficult to clean and are expensive as well. They tend to be more expensive than the removable type.
What is the procedure?
It still involves the insertion of dental implants in the usual manner. Once these have been inserted, abutments are placed over them, ready for the attachment of the restorations.
The denture itself will be created via a special cast. Your dentist will take an impression of your mouth by fitting a special ‘tray’ over your teeth. This tray is filled with a soft material which the patient bites into in order to leave an imprint.
This tray is left to set and is then filled with a casting material. A good way of thinking about this is like this:
The mould is formed from clay and left to harden. Once it has done so, the plaster material can be poured into it and left to set. As soon as it has done so, the mould can be chipped away to leave a plaster cast ‘impression’.
It is very much the same procedure with dental casts. They can be formed out of wax and allowed to harden. Once they have done so, the dental technician will pour in a casting material. Dental casts can be made from ceramics, resins or metals such as gold or silver.
Basically, a cast is an artificial model of your teeth.
This cast is used as a guide when creating the dental restorations. Plus wax models can be created from this cast for the purposes of crowns, bridges and partial dentures.
A crown is a device which looks identical to a real tooth and is fixed in place. It behaves in exactly the same way as a natural tooth.
A bridge is a device which can hold a crown or crowns together by means of a thin metal bar. This is often called a partial denture.
These are as the name says: they are a type of restoration which is fixed in place by a series of screws. It is a permanent fixture and can only be removed by your dentist.
These tend to appeal to those patients who find dentures to be awkward or plain unattractive.
Fixed restorations are harder to keep clean than removable ones.
This restoration takes the form of a metal framework, dentures (teeth) and an acrylic resin.
This form of treatment combines dental implants with an overdenture and so may appeal to those patients who want a cheaper yet effective dental treatment.
An overdenture is made to fit over existing tooth roots or dental implants. This is supported by the natural tissue of your mouth and is designed to work as a working alternative to natural teeth.
One advantage of this over conventional dentures is that this stays firmly in place. This means no risk of ‘slippage’ or any other problems associated with a conventional denture; plus it is easy to look after.
It is also cheaper than other types of hybrid restorations such as crown and bridge restorations.
How does it stay in place?
This is due to a connection between the dentures and the implants. There are two types of connection:
- The attachment of a gold bar which is screwed onto the implants and then fixed to the denture via a special connector.
- A series of individual attachments each screwed into an individual implant and a separate attachment in the denture.
The aim is to find an attachment which you will find easy to use. These attachments tend to be ‘self-locating’ which means that they make it easy for you to insert your denture after a cleaning routine.
There are several types of overdentures which include:
- A Bar Overdenture
- A Slant-Lock Overdenture
- A ZAAG Bar system
- Hader Bar system
- Maxillary Clip Bar system
These are just a few types of overdenture which your dentist will discuss with you.
Bar overdentures are as the name says. They are comprised of a thin metal bar (usually gold) which is attached to the dentures (false teeth). There are a variety of different designs which include:
- A Maxillary Bar Overdenture
- A Mandible Bar Overdenture
- An ERA Bar Overdenture
The maxillary bar overdenture is used to replace missing teeth in the upper jaw (maxillary).
The mandible bar overdenture is used to replace missing teeth from the lower jaw (or mandible).
The ERA bar overdenture is a newer and less expensive form of overdenture.
Slant Lock overdenture: manufactured by Pfisterer Auderer Dental Laboratory, this overdenture is marketed as being as stable as a fixed bridge. It is supported by a series of abutments and two slanted wedges and sleeves.
The patient will find this easy to insert and remove.
ZAAG bar system and attachment: this stands for Zest Anchor Advanced Generation and is a reliable form of bar system which features a universal joint design. This prevents undue pressure or stress on any parts of the attachment.
It is available in three versions: standard, mini and ‘cast-to’.
Our ‘links’ section contains a link to the manufacturer and other related sites.
Hader bar system: this is another bar and clip system which attaches the denture to the implants in the same way as the maxillary clip bar. It is known for its good clip rotation, flexibility and adaptability.
Maxillary Clip Bar system: this is viewed as one of the most popular forms of an implant overdenture as compared to the keeper and magnet, stud and cap, coping, cone and bar and sleeve varieties.
There are different varieties of bar system with either plastic or metal clips that connect the denture to the implants.
It works by the clip snapping over the bar which then forms a connection between this and the denture.
ERA bar system: this is marketed as one of the most popular attachment systems in the world. This bar system is sturdy and durable and includes a metal bar and two attachments – male and female. The ‘male’ attachment fits into the denture whereas the ‘female’ attachment is inserted into the implant.
Whichever overdenture you choose, there are various factors to take into account such as ease of use, cost and durability.
Mini Implant Overdenture
This is very similar to the normal sized overdentures: the only difference being that mini dental implants are used instead. Mini implants are cheaper than the standard sized ones and easier to insert but have usually been seen as a temporary measure.
But, they have proved to be useful in situations where patients don’t want the full implant, are unable to pay for a full implant or just need something to secure a loose denture.
There are still ongoing discussions about mini implants as compared to the normal, full sized implants. Some sources view them as a suitable form of treatment if there are no other choices, or if normal implants are not an option.
Other sources see them as providing a good, solid foundation for bridges, crowns and overdentures.