Fixed alternative to loose worn denture
This 65 Year Old retiree had a full upper denture for many years. In the lower he still had some of his own teeth but they were so badly deteriorated with advanced gum disease that they became mobile and had to be splinted together.
The upper denture was very worn and have become loose. This is a common phenomenon with dentures where bone atrophy occurs over time, which causes the denture to loose its support. The way dentures are retained in the upper jaw is through a cupping of the entire palate and bare gums by the plastic plate and the suction effect that this creates.
In the lower jaw because of its horse-shoe shape there is no effective suction effect like in the upper. As such, looseness, movement and discomfort are a far bigger problem.
In treatment planning for this retiree cost was a major consideration. He initially said that he was not able to afford to do both upper and lower implants, and wanted to have a lower denture and implants in the upper only. It is a common request for patients to prefer to do the upper first, but it is not the best way because of the particular problems with lower dentures described above.
Instead, we recommended as a cost-saving exercise to have the LOWER dental implants first, and an upper denture. As an upper denture is typically more stable than a lower, this course of treatment is typically the most efficacious and provides better overall function.
As it turned out, this gentleman’s children helped him to do both the upper and lower All-On-4 dental implants at the same time, and by doing them together we had the flexibility to restore both the appearance and bite to ideal.
This picture illustrates the worn upper denture and the lower teeth that were splinted together because they were loose from periodontitis.
The lower teeth were removed along with the infections and gum disease, and four implants were placed in each jaw at the same time. Note that the gums have been flattened and the implants adequately spread to provide the required support for the subsequent bridges.
The final upper and lower All-On-4 prostheses are permanently fitted to the fixtures with screws. Note the flat interface between the natural gums and the prostheses for ease of cleaning.