Technology is a wonderful thing, and never more so than when it improves your life on a very personal level. Dentures you can wear all the time are a case in point. For those people with the right clinical requirements and financial resources, implant supported dentures, implant retained dentures and single tooth dental implants, are the closest thing to having natural teeth. In this article we examine the difference between the options which allow you to wear dentures all the time. We also look at the benefits and disadvantages these options offer when compared to traditional removable dentures.
Defining dental implants
Dental implants are titanium posts surgically implanted into the jawbone to support a dental prosthesis which can be fixed, like an implant supported denture for example, or removable, as in the implant retained denture. These implanted posts function in the same way as natural tooth root, allowing you to bite and chew confidently with artificial teeth.
Three types of dental prostheses are discussed here. Firstly, there are two types of dentures that rely on multiple posts implanted into the jaw: denture supported implants and denture retained implants. In addition, there is the single tooth and partial denture secured by one or two implanted posts. All three types can be worn constantly.
What is the difference between denture supported implants and denture retained implants?
The main difference between these two options is their cost and removability. However, clinical suitability is also an important factor.
Denture supported implants
- Once the denture is attached to the implanted posts by your oral health provider, it remains fixed in place.
- Require more surgically implanted posts in the jaw to support the denture.
- Often more expensive as a result of requiring more posts, especially if bone grafts to strengthen the jaw are needed.
- The pressure and forces of chewing are borne through the implanted posts and jawbone. This is the reason more implanted posts are required than for implant retained dentures.
- Good bone density is essential throughout the whole dental arch to support the number of surgically implanted posts needed.
Implant retained dentures
- Designed to be removed, conveniently snapping on and off titanium posts surgically implanted in the jawbone, for easy cleaning and maintenance.
- Require fewer implanted posts as chewing and biting pressures are dispersed across the gums so therefore, they are a less expensive option.
- The need for fewer posts means the oral surgeon can be selective about positioning of the implant posts where bone density is optimal thus avoiding the need for bone grafts where possible.
How do I choose which dental implant option is best for me?
Sometimes the choice is made for you depending on your clinical suitability as a candidate. Not every patient has the required bone density to support the implanted posts, therefore bone grafts may have to be considered to rectify the situation. In other cases, even this is not possible due to a patient’s health status; those with chronic disease like uncontrolled diabetes or autoimmune disease, for example. Equally, your budget may also dictate the options available to you.
What are the advantages of dental implants?
It’s crucial to weigh up the risk / benefits involved before embarking on any surgical procedure. When considering the pros and cons of dental implants it must be remembered that every case is unique, therefore advice from a qualified oral health professional is essential to make the right choice for you. Below are some of the advantages and disadvantages of implant retained and implant supported dentures. Further, while dental prostheses can vastly improve your quality of life, it is important to remember they are not the same as having natural teeth so some adjustment on the patient’s part is required.
Advantages of implant retained or supported dentures
Stability and wearer confidence
One of the most important features of implant supported dentures and implant retained dentures is the stability provided, which is not always available to conventional denture wearers. Adding to this, is the ability to wear the dentures around the clock. While millions of people worldwide wear dentures successfully, there are some who struggle with conventional removable dentures. They may suffer with sore spots and rubbed gums for a variety of reasons, including from ill-fitting conventional dentures. Dentures relying on implants are especially useful for those wearers who find it difficult to keep a conventional lower denture in place. Because the implant retained and implant supported dentures are securely held by implants into the jaw, they remain stable in the mouth when chewing or speaking. Greater social confidence ensues as a result.
More varied diet
The stability offered by implant retained and implant supported dentures means the wearer has a greater variety of food to choose from. While a conventional denture may shift in the mouth if challenged by hard food like steak or nuts, the dental implant retained and implant supported dentures remain firmly secured by the posts anchored in the jaw.
No need for messy glues and adhesives
This same stability dismisses the need for expensive and time-consuming adhesives.
Greater comfort
Implant retained dentures and implant supported dentures do not need palate coverage for suction to keep them in place, therefore the denture has a smaller profile and less bulk in the mouth making it more comfortable and sensitive to temperature and taste since more of oral sensory tissues are exposed.
Bone preservation and aesthetic appearance
Missing teeth cause accelerated bone loss over time, resulting in sagging facial muscles and premature ageing of the face. Implanted posts in the jaw can slow this process and help to preserve facial structure and a more youthful appearance.
Dentures you can wear all the time
A common lament among conventional denture wearers is the concern their nearest and dearest will be repelled by the sight of them toothless. Implant retained and implant supported dentures can be worn overnight without concerns about choking in your sleep. Of course, a good hygiene regime is crucial to keep them clean and sweet smelling, just as it is with natural teeth.
Longevity
Implant retained and implant supported dentures last longer than conventional removeable dentures. Depending on how well they are maintained and your health, implanted posts can last around 25 years and sometimes longer. The denture component may need to be replaced during that time – between 10-15 years - as it wears down, or if it is damaged. According to one study dental implants have a success rate of ‘97% at 10 years and 75% at 20 years.’ i
Disadvantages of implant retained or supported dentures
Risk due to surgery
Oral surgery and anaesthetic are required to implant the titanium posts. There is a risk associated with any surgical procedure. Your surgeon will require full disclosure of any underlying health issues you may have. It’s important you ask questions of your surgeon to understand how the risks might impact on you. Follow all post operative instructions carefully to avoid infection which may compromise your dental implant’s integrity. Although not common, damage can occur to surrounding mouth tissues or nerves which can cause pain or discomfort.
Risk of implant failure
While relatively low, the risk of implant failure should be one you discuss with your oral health professional before you commit to dental implants. The most common cause is infection causing inflammation of the gums and bone structure into which the posts are implanted. ii If deemed serious enough, this may necessitate the posts being removed. One long term study cited a 3.3% failure rate iii with diabetes, and cigarette smoking found to be positively correlated for implant failure. iv
Lengthy procedure
The overall process from surgery to completed denture is lengthy, with healing taking place over months.
Suitability
Not everyone is a suitable candidate for dental implants with chronic health issues excluding some patients. In other cases, gum disease or extreme lack of bone density can rule out bone augmentation, thus excluding the dental implant option. Lifestyle factors like smoking tobacco can disrupt the integration of the implants into the bone, increasing the risk of failure. v
The expense
Implant retained and implant supported dentures cost more than conventional dentures with the involvement of several different oral health professionals. When measured against overall health related quality of life (OHRQoL), one study found that the dental implant options were superior to conventional dentures, especially for those patients with low tolerance for conventional removable dentures. vi However, budgetary concerns may overtake this consideration if the wearer is well adapted to conventional removable dentures. vii In which case, the conventional removeable denture may suit better.
Can I have a partial implant denture?
Replacing a missing tooth with a single implant supported crown, or a couple of teeth with a fixed partial denture, can be the perfect solution for the most natural restoration of your smile. The pros and cons listed above for full dentures with implants, also apply to partial dentures. In addition to the noted advantages, there are no metal or plastic retentive clasps essential to secure the partial implant denture. The partial implant denture wearer can continue their pre-edentulous lifestyle with confidence and little awareness of the replacement.
What if I am not a candidate for dental implants?
When your budget, or clinical conditions like lack of bone density, gum disease or chronic health conditions, rule you out as a candidate for dentures relying on implants, what other options do you have?
Alternative options to dental implants
All is not lost if you are not a candidate for implant retained or implant supported dentures because conventional removeable dentures offer a wide variety of choice, although without the option to wear them all the time. Nevertheless, many people adapt well to the basic and most common acrylic denture with its entry level price. If this is not the case for you there are other options. The old adage, ‘you get what you pay for’ can apply, with the quality of your conventional removeable denture making a difference to its comfort, appearance and longevity. Price is relative to a denture’s profile in the mouth, its appearance, and lifespan. The materials from which dentures are made, and the work involved in their making, also factor in the cost. Metal dentures for example, are lighter, less bulky in the mouth therefore more aesthetically pleasing, and they last longer. They are also more expensive than the common acrylic denture. See here for a range of conventional removeable dentures including cost.
A final word on dentures you can wear all the time
If you are interested in dentures that you can wear all the time, then the latest implant technology for dentures is your first port of call. However, it’s essential to be aware of the pros and cons of the options available and the factors that may exclude you from some choices. Discussing your health history and your expectations with your prosthetist and dentist will help with your decision, guiding you to the appropriate dental specialties. Looking at the risks and benefits of getting an implant denture will also include budgetary considerations. If implant dentures are not an option for you, there are other good alternatives.
References
[i]https://www.jomos.org/articles/mbcb/full_html/2022/02/mbcb210065/mbcb210065.html#:~:text=is%20properly%20cited.-,Introduction,to%20loss%20of%20the%20implant.|
[ii]https://www.jomos.org/articles/mbcb/full_html/2022/02/mbcb210065/mbcb210065.html#:~:text=is%20properly%20cited.-,Introduction,to%20loss%20of%20the%20implant.
[iii] French D, Ofec R, Levin L. Long term clinical performance of 10 871 dental implants with up to 22 years of follow-up: A cohort study in 4247 patients. Clin Implant Dent Relat Res. 2021 Jun;23(3):289-297. doi: 10.1111/cid.12994. Epub 2021 Mar 25. PMID: 33768695; PMCID: PMC8359846.
[iv] French D, Ofec R, Levin L. Long term clinical performance of 10 871 dental implants with up to 22 years of follow-up: A cohort study in 4247 patients. Clin Implant Dent Relat Res. 2021 Jun;23(3):289-297. doi: 10.1111/cid.12994. Epub 2021 Mar 25. PMID: 33768695; PMCID: PMC8359846.
[v]https://www.jomos.org/articles/mbcb/full_html/2022/02/mbcb210065/mbcb210065.html#:~:text=is%20properly%20cited.-,Introduction,to%20loss%20of%20the%20implant.
[vi] https://www.nature.com/articles/s41432-020-0118-2
[vii] https://www.nature.com/articles/s41432-020-0118-2
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