Cosmetic Dentures Goodlettsville

An implant-supported denture is a type of overdenture that is supported by and attached to implants. A regular denture rests on the gums, is not supported by implants, and tends to fit less firmly in the mouth. This is especially true of the lower denture.

An implant-supported denture is used when a person doesn’t have any teeth in the jaw, but has enough bone in the jaw to support implants. Having enough bone in the jaw is a limiting factor in the placement of dental implants. An implant-supported denture has special attachments that snap onto attachments on the implants.

Implant-supported dentures usually are made for the lower jaw because regular dentures tend to be less stable there. Usually, a regular denture made to fit an upper jaw is quite stable on its own and doesn’t need the extra support offered by implants. However, you can receive an implant-supported denture in either the upper or lower jaw.

You can remove an implant-supported denture easily. Although, some people prefer to have fixed (permanent) crown and bridgework in their mouths that is cemented and is not taken in and out of the mouth .The permanent crown and bridgework is a great option, but can be very expensive. We can consider your particular needs and preferences when suggesting fixed or removable options.

How Does It Work?

Locator retained dentures (button-attachment dentures) – Each implant in the jawbone holds a metal attachment that fits into another attachment on the denture. In this type of system, the denture snaps on to the denture very much like a button on a jacket snaps together. There are other types of systems available, but this system works so very nicely, it is the only system I use in my office. You can find additional information on the locator system at www.locators.com.

The Implant Process
The implants usually are placed in the jawbone at the front of your mouth because there tends to be more bone in the front of the jaw than in the back. This usually is true even if teeth have been missing for many years. Once you lose teeth, you begin to lose bone in the area of the extraction(s). Also, the front jaw doesn’t have many nerves or other structures that could interfere with the placement of implants. If you are interested in dental implants snapping your denture in place, then you need to consider having the dental implants placed during the extraction procedure, or shortly after the extractions.

The time frame to complete the implant depends on many factors. The shortest time frame is about four months in the lower jaw and six months in the upper jaw, though there are exceptions to this. This includes surgeries and the placement of the denture. However, the process can last up to a year or more, especially if you need bone grafting or other preliminary procedures.

Two surgeries usually are needed – one to place the implants in the jawbone under your gums, and a second surgery to expose the tops of the implant. The second procedure comes three to six months after the first.

A one-stage procedure is what I prefer to use. In this procedure, we can place the implants one step, and avoid a two step surgery procedure. The success rate of this procedure is high, and ultimately more comfortable for you.

Initial consultation
Before any work is to be started, you will visit my office to discuss your treatment options, wants, and needs. It is important to realize what can be done for you, and even more importantly, the limitations of what I can deliver in your situation. I really try to convey the limitations and what you should expect prior to starting any work with you. I find that if I try to explain the limitations after we have started your treatment, they tend to sound like excuses. I do not care for excuses, and neither do my patients.

During the exam, I will review your medical and dental histories, take X-rays and create impressions of your teeth and gums so that models can be made. Our panoramic X-ray machine is digital and has very low radiation emission, about 90% less radiation than our old standard film based machine. This is typically the only X-ray we will take of you, and yes we must take this X-ray. The standard of care requires me to have this X-ray prior to any treatment by me, even if you have no teeth. It is a great screening tool for abnormalities in the jaw bone.

In some cases, we may order a computed tomography (CT) scan of your mouth (very rarely do I order this, but it is really neat, high tech stuff). This allows me to see the exact position of your sinuses (located above your upper teeth) or nerves, and to make sure they will not be affected by the implant placement. A CT scan also may be done to see how much bone is available and to determine the best locations for the implants.

CT Scan showing placement of implants

If you are not already wearing a complete denture to replace your missing teeth, we can make you one. You will use this temporary denture until the implant-supported denture is placed in your mouth. Remember, implants take time to integrate with the jaw bone. It will take several visits, to complete this denture. By making this temporary denture, we are able to determine the best position for the teeth in the final denture. The temporary denture also can be used as a backup if something happens to the final implant-supported denture. It is always good to have a backup denture.

First surgery
Month 1 (if no denture needs to be made)
Month 2 (if denture needs to be made)

The first surgery involves placing the implants in the jawbone. During the first surgery, an incision is made in the gum where the implant will be placed. A hole is drilled in the bone, the implant is placed into the hole, and the incision is stitched closed. Amazingly, almost every patient I have performed dental implant surgery on, experience little to no pain after the procedure. Taking teeth out seems to be far more painful for my patients than dental implant surgery. After this surgery, you should avoid putting pressure on the implants. Occasionaly you will not be able to wear your temporary denture for about four weeks. I try to avoid this situation as much as possible. You should avoid eating hard foods during this time. After four weeks, you will be able to wear your temporary denture again. The temporary denture will, however, need to be modified, to make sure it fits properly. It will also be given a soft reline (new lining next to your gums) to help to reduce the pressure on your gums.

After the first surgery, I will typically wait three or four months if implants were placed in the lower jaw, and five or six months if they were placed in the upper jaw, before scheduling the second surgery. During this time, the bone and the implants integrate (attach and fuse).

Second surgery
Month 4 or 5 (no denture needed to be made)
Month 5 or 6 (denture needed to be made)

Once the implants have become fused with the bone, the second surgery can be scheduled. We will confirm whether the implant is ready for the second surgery by taking a digital panoramic X-ray. This surgery is easier than the first. A small incision is made in your gums to expose the tops (heads) of the implants.

A healing abutment (collar) is placed on the head of each implant after it is exposed. This encourages the gums to heal correctly. The collar is a round piece of metal that holds the gums away from the head of the implant. The collar will be in place for 10 to 14 days. We will adjust your temporary denture again and it may be given another soft reline. The reline material will secure the denture to the healing abutments.

About two weeks after the second surgery, the healing abutments will be replaced with regular abutments. Your gums should now be healed enough for you to make an impression of your gums and implants. The impression is used to make a working model of your implants and jaw, which is used to make the denture framework and teeth.

Denture Try-In and Insertion

This picture shows locator attachments immediately before they are to be inserted into a new lower denture. This patient has four locators, making her denture very, very stable and tight fitting. You can get by with only two locators, but the results are not as great.

You will have to return for another visit to have the completed denture inserted. When the denture is inserted, the denture is snapped onto the locator attachments.

At this point, your temporary denture will be given a new reline. This will allow it to be used as a backup denture in case you lose or break your new overdenture. It is always good to have a back up denture.

Caring for Your Implant-Supported Denture

You will need to remove the denture at least twice a day for cleaning. You also should carefully clean around the implants and attachments. You must brush the implants and attachments everyday! I recommend purchasing a WaterPikâ„¢ from Walmart or Amazon.com to keep your implants clean. You must keep them clean, as they can develop infection around them just as natural teeth can become infected from bacteria in your mouth. Use that WaterPik every day, you have invested too much time and money to have your dental work fail due to poor oral hygiene habits.

For the first year, following dental implant placement(s), you should schedule follow up visits every three months for a cleaning and checkup. We will test all the parts of your new denture to see if they are secure. Even though your denture is stable, it still can move slightly when you chew. This slight movement can cause the denture to rub against your gums, which can cause sore spots. We can check your gums and also will check the way your top and bottom teeth come together (your bite).

The attachments on the locator retained denture usually will need to be replaced every 6 to 12 months. They are made of a plastic material (nylon) and will wear after continued use.

What Can You Expect From Your Implant-Supported Denture?

Your implant-supported denture will be more stable than a regular denture. You will find it easier to speak and you won’t have to worry about the denture becoming loose or falling out of your mouth. You generally will be able to eat foods you could not eat before. The difference is HUGE! Patients who have been tolerating a regular, non implant supported denture, see and feel the difference once their new denture is snapped into place. We have pictures and testimonials on our website for you to research.

If you have an implant-supported denture in your upper jaw, it will feel more natural than a regular denture because the denture will no longer cover the

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