By Dr. H. Kopel
There are numerous treatment options for fully edentulous patients today. These include full upper and lower dentures, implant-assisted prostheses (overdentures), implant-supported removable prostheses (hybrids) and implant-supported fixed bridgework.
Although implant-assisted overdentures “assist” retention and stability, soft tissue and bone are still relied upon to lend support to this type of prosthesis. The overdenture will be much more stable than a regular denture and usually has 2-4 implants supporting it. The overdenture is still removable and easy to clean. It is also the least expensive implant option. Most dentures can be retro fitted with implant attachments and more implants can be added at a later date to improve stability if necessary.
With implant-supported removable prostheses (hybrids), stability, retention and support are completely provided from the implants themselves or from bars attached to the implants. The hybrid, therefore, can be much smaller than a regular denture without flanges or covering the roof of the mouth. A hybrid can be supported by 4 implants. It is screwed into place by the dentist. The patient will have no movement with this prosthesis and the patient cannot remove it. It will need to be serviced and cleaned by the dentist. Hybrids are the most affordable fixed prosthesis.
If finances permit an actual fixed porcelain bridge can be constructed on top of 8-10 implants. There will be no plastic or denture material and this will look and function as natural teeth. This will be permanently cemented in place just as any other crown or bridge. It will be maintained by the patient and dentist as with natural teeth.
The same options are available when the patient has retained some of their teeth by making a partial overdenture or hybrid or fixed bridgework. Although you cannot attach a fixed bridge to a natural tooth and an implant you may use both to support a removable partial denture. There is
controversy regarding this, but if well designed and planned this is a definite option.
Here are some of the benefits achieved by utilizing implants with dentures, partial dentures and bridges: