ALL TEETH MISSING
Benefits of a fixed bridge on implants
When all teeth are missing or in such condition that they need to be replaced, a fixed bridge anchored to dental implants is the best permanent solution
Before dental implants, there was no fixed solution available for people who lost all their teeth. Today, it is possible to replace a full jaw with dental implants and a fixed bridge that results in a permanent, stable and high esthetic solution.
Lets you eat and function like having natural teeth
A solid, stable solution that will serve you for life
Preserves your facial appearance and prevents bone loss
The treatment procedure and number of visits is largely dependent on the specific conditions. But all in all, 8-10 visits should be enough to have a fixed bridge installed. Most patients report that they were much more comfortable following the procedure than they had anticipated.
INSTALLING THE FIXED BRIDGE – STEP-BY-STEP
The course of treatment described here is one of several options available. Consult your dentist to find out what the best solution is for you, given your specific condition.
1. Before the procedure
The dentist determines what needs to be done and prepares both himself and the patient for the coming treatment procedure.
2. Installing the implants
The first step is installing dental implants to replace the lost tooth roots. In this case, five implants are used. Temporary teeth are attached that enable you to eat and function like normal while waiting for the permanent bridge to be installed.
3. Attaching the bridge
The final bridge is securely installed on top of the implants. With a full jaw replacement like this, it normally takes 2-3 visits to have the bridge completely attached.
4. End result
Your new teeth should be hard to tell from natural – both for you and others. People who have had traditional dentures before getting a fixed bridge often describe this as an overwhelming and very positive experience.
ALTERNATIVES TO A FIXED BRIDGE
An alternative to a fixed bridge is a removable overdenture, which is anchored on implants. The old-fashioned denture has many disadvantages and should be avoided if possible.
Removable, implant anchored overdenture
A removable full denture that is connected to either a ball or bar attachment, which in turn is anchored on two or more implants in the front part of the jaw.
The implants help keep the denture in place and provide better function and comfort. Cost is usually the reason why this solution is chosen over a fixed bridge – although the end result can’t be compared.
Removable full denture
A denture that is loosely placed on top of the gum to cover the lost teeth. This alternative has no real advantages – except for its low price and easy installation.
The disadvantages are many: discomfort in eating, poor esthetics, affected speech, and sore gums from denture movement. Moreover, a full denture placed in the upper jaw severely reduces the sense of taste.
ALL TEETH MISSING
Sometimes all the teeth are missing in the upper jaw and there is an insufficient bone to support dental implants. This problem can often be corrected surgically with the use of Sinus Elevation (Lift) procedures to replace the missing bone. The most commonly used techniques are the Two-staged delayed approach or the Simultaneous bone graft and implant placement technique.
Two Stage Delayed Sinus Bone Graft Technique
In the upper jaw when the posterior ( back ) teeth are lost, the bone that was supporting them resorbs (disappears ) and all that is left are the large air-filled spaces (Sinuses) with no bone inside them.
The diagram shows adequate bone on one side for some implants vs insufficient or minimal bone under the Sinus cavity in the upper jaw on the opposite side.
In the most challenging cases where there are less than 3 or 4 millimeters of remaining bone in the posterior areas ( back of the mouth ), the two-stage surgical protocol is preferred. Six to nine months is needed for the new Sinus bone graft to become mature then another 6 months is required for "osseointegration" ( bone to bond to the implant ) before the implants are ready to support a bridge. In the example below, the x-ray shows minimal bone in the anterior ( front) part of the mouth and large sinuses in the posterior area.
Preoperative CT scan reveals 1-3 millimeters of remaining bone on both the right and left sides of the upper jaw. All the teeth are missing and the patient had been wearing a denture for twenty years. She is a well-controlled diabetic.
Before Sinus Graft x-ray
The Axial CT scans also revealed a severely resorbed anterior ridge which is too narrow for implant placement in the front of the mouth.
For the patient described, Sinus Elevation ( Lift ) bone grafts were performed on both sides of the mouth using the Two-stage delayed approach.
Nine months later 8 dental implants were placed into the newly regenerated bone and submerged beneath the soft tissue to be allowed to heal undisturbed. After a healing period of 6 months, the implants bonded to the regenerated bone, the tops of the implants were uncovered (exposed) and a full arch bridge was made for the patient by her prosthodontist. The bridge is beautiful,
As of 2015 this patient has been wearing her non-removable bridge for 21 years and comes into the office for dental cleanings twice a year.
Simultaneous Bone Graft and Implant Placement
In other patient situations when there is more bone available, but not quite enough to cover the whole implant, a bone graft may
Contraindications for Sinus Elevation ( Lift ) procedures
Uncontrolled diabetes mellitus
Intranasal or topical steroid use
Maxillary radiation therapy
Unrepaired oroantral fistula
Active acute sinus disease
Chronic septic sinus disease
Anti-coagulants ( blood thinners ) that cannot be stopped