What to do if all our teeth are missing?

¿Qué hacer si nos faltan todos los dientes? In Crooke & Laguna Dental Clinic we like to advise our patients, inform them of all treatment options and advise the most appropriate for your mouth.

When we have lost or are going to lose all our teeth we have a wide range of possibilities to restore the lost function and aesthetics. Without going into all the possible variants, we would like to explain the most common treatment options.

OVERDENTURE

It is a removable prosthesis retained by 2-4 implants but resting on the gum. The advantage compared to full dentures is that it avoids the mobility of the prosthesis during chewing and speaking. The disadvantage is that it still rests on the gum, which means that adjustments must be made periodically to avoid canker sores and wounds.

FIXED PROSTHESIS WITH METAL RESIN HYBRID PROSTHESIS

These prostheses should ideally be supported by at least 5-6 implants. They do not have a palate, the patient cannot remove them and they do not rest on the gum. They always have teeth and pink gum, so they are not suitable for patients who show their own gum when smiling, since the union between the false gum and the real one would be seen and it would be aesthetically unacceptable. The disadvantage is that they wear out over time and are in one piece.

This has the advantage of being able to make a prosthesis in sections, dividing the loads and reducing tensions. In the same way that if we have a long table we want a greater number of legs, when rehabilitating a whole jaw, it is better to increase the number of implants to have more supports and divide the structure into sections.

In addition, ceramic is more biocompatible than resin, so the gum will respond better. Even so, depending on the availability of bone, which teeth are in the opposite jaw and whether the patient is a bruxist or not, one type of prosthesis or another will be chosen. What is very important is to plan it before the surgery, so that the implants are placed in the right location and with the right angulation.

BONE REGENERATION

In severe maxillary cases there are 2 basic options: sinus lifts (bone grafting in the maxillary sinus cavities) or zygomatic implants. The former gives us the advantage of being able to place a greater number of implants and thus be able to make prostheses in sections. The zygomatic implants, on the other hand, are a faster option, since a fixed prosthesis is placed the same day the implants are placed, but it requires a one-piece prosthesis, and it is a surgery with more risks due to the anatomical structures it crosses.

In the lower jaw, if we lack bone, we can resort to bone regeneration with membranes and bone grafts, combining the patient’s own bone (from the mouth itself, it is no longer necessary to resort to the tibia or other areas) with a xenograft.

Given the complexity of the matter we are dealing with, it is very important to get good advice and put yourself in good hands before putting on a new smile.

The ideal option, for biocompatibility, durability, esthetics and ease of hygiene would be to make a metal-porcelain or zirconium prosthesis on 8-10 implants.

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