Missing All Upper or Lower Teeth

Missing All Lower Teeth

Although many patients may tolerate wearing an upper denture without the assistance of dental implants, nearly everyone will have difficulty wearing a lower denture without dental implants. There are usually multiple implant-supported replacement options available if you are missing all of your teeth. These options are dependent upon the quantity and quality of the remaining hard and soft tissues of your jaws.

Locator Attachment Denture (minimum recommendation for the lower jaw)

One option is to have two implants placed in your lower jaw and a denture made that snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants. However, there will still be movement of your lower denture, and possible sore spots will occur as a result. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.

Bar Attachment Denture

Another option involves placing four to six implants, depending on your jaw size or shape, into your lower jaw. After healing is complete, the implants are connected with a custom-made support bar. Your denture will be made with special internal retention clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called a “fixed-removable overdenture.” The advantage of this option is that it is much more stable than the first option and allows very little denture movement. Your denture is still removable for easy cleaning and maintenance.

Screw Retained Denture

A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws that secure it to the dental implants. When used to replace teeth on the lower jaw, it generally does not touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing teeth on the jaw and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.

Individual Implants

The final option is to have all your teeth individually replaced so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires six or more implants. Separate abutments or support posts for each implant bridge will be made and crowns for each missing tooth will be placed. The teeth are joined together to span multiple sites and decrease the extent of needed bone grafting for increasing bone height and width. Overall, this is the most costly option, because it requires the most implants and individual replacement tooth fabrication. Your replacement options may also be limited by the current size and shape of your jawbone.

What if I’m missing all of my upper teeth?

A similar range of treatment options is also available for your upper jaw. However, because the bone is not as hard as that in the lower jaw, people often need more implants to support their new replacement teeth. Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature. Your denture will feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier. A common obstacle that is faced on the upper jaw is the proximity of the maxillary sinus cavity. Implants require sufficient bone width and height for proper long-term success. In situations where the maxillary sinus floor creates deficiencies in the needed bone volume, sinus grafting can be predictably utilized to provide the needed volume. This procedure may either be done at the time of implant placement (minor grafting) or will require a separate augmentation procedure prior to implant placement (major grafting).