Dentures are not usually a preferred modality of treatment by the patient. The exception is oftentimes a financial one made by the patient at the time of treatment. Initially, dentures are far less costly than implants. However, over time, implants are much more cost effective. In addition, due to a longer required treatment time with implants, patients may prefer a denture, although they may at a later date return for implant reconstruction after encountering the numerous negative effects of removable full dentures.
• Lack of security: dentures can fall out with laughing, drinking, or eating;
• Loss of taste due to upper palatal coverage;
• Continuous bone loss;
• Collapse of lower third of face;
• Continuous reline of dentures required;
• Inability to masticate and digest food properly;
• Decreased nutritional values;
• Prominence of chin and nose with increase of peri-oral lines, wrinkles, and crows feet;
• Overall premature aging of the face.
• Increased security, confidence, and self-esteem;
• No loss of taste as an upper is fabricated without palatal coverage;
• Stops continuous atrophy of the mandible and maxilla;
• No further collapse of the face;
• No further relines or remakes of the prosthesis;
• Good mastication and digestion and improved nutrition;
• Facial structures maintained or enhanced;
• Improved overall appearance.
Bone Loss Associated with Bridges Explained
Continuous bone loss is associated with both fixed and removable partial dentures. With a fixed partial denture, the teeth on either side of the edentulous space must be reduced, or ground down, in order to be able to place the crown to support the pontic. Once the bridge is placed, the area under the pontic is no longer functional and the bone in that area will continue to resorb and atrophy. In many instances, aesthetics will decrease and even cause a space to form at the cervical area of the pontic related to the gingival/mucosa soft tissues.
In regards to a removable partial denture, there is usually a more rapid rate of bone resorption as the saddle area is continuously compressed in function with no stimulation to the underlying bone. With this resorption, the clasp becomes loose and will exert forces or torque on the adjacent teeth. This sets up a trickle effect in the area initiating multiple relines and/or multiple replacements. The adjacent teeth may require endodontic treatment and/or removal over time. With these factors, aesthetics are reduced as are overall comfort, confidence, and function.
Responding to Patient Objections
The information provided above that compares implants to dentures should help you answer any questions presented by the patient.
Every concept of treatment that can be thought of related to implant reconstruction, including time, money, procedures, security, confidence, self-esteem, nutritional values, longevity, and aesthetics/cosmetics are all added up for a win-win final result for the patients we serve.
For more information, go to www.zugamedical.com/simplicity.
Dr. Babbush received his DDS from the University of Detroit School of Dentistry and his master of dental science degree from Boston University. He completed his oral surgery residency at Mt. Sinai Hospital in Cleveland. Currently he is director of the Dental Implant Center, Cleveland, and clinical professor of oral and maxillofacial surgery as well as director of dental implant research at Case School of Dental Medicine, Case Western Reserve University.