At the Dental Clinic Crooke & Laguna, we like to inform our patients of all the treatment options and recommend the most suitable for their case. When we have lost or are about to lose all the dental pieces, we have a very wide range of possibilities to restore the lost function and appearance. Without going into detail of all options possible, we would like to explain the most common options for treatment.
The most basic and affordable option is what we know as overdenture, which is a removable prosthetic held up by 2-4 implants but it is supported by the gums. The advantage if compared with a permanent, complete denture is that it avoids the movement of the prosthetics while chewing and talking. The disadvantage is that it is still supported by the gums, which means that it would have to be periodically adjusted to avoid wounds and cankers.
The next option would be a permanent prosthetic made out of a metal-resin hybrid material. Ideally this prosthetic would have to be held up by 5-6 implants.
They do not have a palate piece, the patient is not able to remove it by themselves and it is not supported by the gum. It displays teeth and a pink gum, which means it is not advisable for patients who show their own gums when smiling, as the joint between the fake and real gum would be visible and would be aesthetically unacceptable. The inconvenience is that they wear out with time and are made in a single piece.
The ideal option, due to its bio-compatibility, duration, appearance and hygiene convenience, is to create a prosthetic piece out of metal-porcelain or zirconium on top of 8-10 implants. This represents the advantage of being able to carry out a prosthetic in stages, distributing the weight and reducing tensions. Just as a large table needs a higher number of legs, when restoring a whole maxillary area, it is better to increase the number of implants to have more supports and divide the structure in different stretches. In addition, ceramics are more bio-compatible than resin, which means that the gums will adapt better. In any case, depending on the bone availability, on which pieces are in the opposite maxillary area and depending if the patient grinds their teeth, a kind of prosthetic or other will be chosen. Especially important is to plan these before surgery, so that the implants are put in the right position and angle.
In some cases, there is no bone availability and a bone regeneration procedure is needed. In severe cases affecting the superior maxillary area there are two basic options: carrying out an external sinus lift (grafting bone in the cavities of the maxillary sinuses), or adding zygomatic implants. The first option gives us the advantage of being able to put a larger number of implants and create the prosthetic in several stages. The zygomatic implants are a faster option, as the permanent prosthetic and the implants can be put in on the same day. However, it forces the piece to be made in one piece, and the surgery has more risks due to the anatomic structures it goes through.
In the inferior maxillary area, if there is not enough bone, the patient can undergo a bone regeneration with membranes and bone grafts, combining bones from the patient (from his or her mouth, as there is no need to take them from the shinbone or other areas) together with a xenograft.
Due to the great complexity of this condition, it is very important to have good counselling and putting yourself in good hands before getting a brand new smile.