In this the last of our series on Implant Supported Dentures (ISD’s), we will discuss:
1) Ideal locations within the jaw to place the implant and other important facts related to implant location.
2) Time frame from placing the implants in the jaw to getting the denture.
3) Radiographic imaging involved with implants.
4) Advantages of ISD’s.
Location of implants in the jaw
Implants are usually located near the front of the mouth. The reason for this is:
– There is usually more bone to support the implant in this area of the jaw.
– There are less nerves and anatomical areas i.e. maxillary sinuses that may
interfere and be problematic for implant placement. Please see the blog, “Sinus Lift…..Really?” posted on March 25th, 2012, for a brief review of the maxillary sinuses.
The minimal number of implants to support a complete lower denture is two:
These would be placed near the front of the jaw. Two implants would work for the ball-type of ISD, not bar-type. Please review the last blog for an explanation of both the bar and ball type of ISD’s.
With two more implants (four), a bar can be added which would provide additional retention. Two implants in front where the canines are and two more in the premolar area.
Time frame from placing implants in the jaw to getting the denture:
This can range from 6 months to about 1 year.
At the time of the first surgery, the implants are placed into the jaw bone. They are left to sit undisturbed in the bone for up to 6 months.
At times there is a second surgery (about 5 months after initial placement), to
‘expose’ the implants. Let me explain: This ‘exposure’ occurs when the implants are placed and they are buried in the bone and covered up by the gum. This second surgery is performed about 5 months after the implants’ initial placement, because in this amount of time, they have fused irreversibly with the bone.
Then 1 month after the buried implants have been exposed (at about 6 months of initial placement), the implants are secure enough to be ‘loaded’ with the denture.
Please note: Often a two stage process is not necessary. The implant is buried
in the bone, but instead of the top of it being covered up by the gum, a structure
called a ‘healing cap’ is placed on top of it. We will discuss the concept of healing caps in a future series of blogs dedicated to dental implants.
Longer Duration of Time than Six Months
The duration of time from the initial placement of the implants to loading with the denture can take longer than 6 months if a procedure called a ‘bone graft’ is required. This procedure is indicated if there is insufficient bone in an area where we would like to place the implant. This can stretch the procedure out to the one year mark.
At times it may be frustrating to have to wait several months to get your ISD, but the general consensus of patient’s is that it is well worth the wait.
3-D imaging is necessary as opposed to the conventional (x-rays) 2-D imaging which is routinely taken in the dental office. 3D imaging is most routinely done with a CT scanner.
Imaging is important to determine:
1) If there is enough bone at a particular site in the jaw to place an implant.
2) The angle in which the implant gets inserted into the bone.
3) The size of the implant that can be used i.e. width and length.
Advantages of Implant Supported Dentures:
1) More stable than a regular denture…They don’t move around when speaking or eating.
2) No need for sticky dental adhesives that is often ineffective. Also ends the cost of buying adhesives.
3) Healthier gum tissues.
Well there you have it….the end to our series on ISD’s.
Please note that we have just touched the surface in each category that we discussed. A general overview has been presented to introduce you to these concepts.
Again, if you would like any more information on the topic or have any questions, please do not hesitate to contact our office. You’ll be glad you did!
Dr. F. Keshavarz Dentistry