Complete dental prosthetics
In the classical sense, complete jaw prosthetics implies the presence of complete edentia, that is, when not a single tooth remains. Fixation of the prosthesis in the absence of teeth is carried out using implants or special suction cups located on the base of the removable denture.
Dental prosthetics in cases of complete absence of teeth are divided into three large categories.
- Removable dentures can be removed without assistance.
- Fixed - installed with support on dental implants.
- Conditionally removable - removed using professional tools by a dentist.
Expert opinion
Roman Borisovich Alekperov
orthopedic dentist
Experience: 24 years
Don't settle for removable dentures when modern dental technology offers more convenient and effective options. All-on-4 implantation will allow you to fix a complete denture on just 4 implants. And the unique basal method ensures the restoration of the entire dentition even with severe bone atrophy without first increasing its volume. In this case, prosthetics are performed the very next day after the implantation of basal implants.
Types of complete dental prosthetics
Implantation today is an advanced method of restoring teeth, including those with complete edentia. Purely theoretically, it is possible to replace every lost tooth with implants, but such a procedure will cost enormous amounts of money, which in general is not entirely justified. Specifically for the diagnosis of complete edentia, clinicians have developed a number of concepts that allow the installation of a fixed prosthesis on a certain number of implants. Complete prosthetics of the upper jaw more often require osteoplastic surgery (compared to the lower jaw), since the bone here is less dense and voluminous.
Complete fixed dental prosthetics
All-on-4 (all on four)
Concepts of complete fixed dental prosthetics on 4 implants. The technique was developed by a well-known manufacturer of implantation systems - Nobel Biocare.
All-on-6 (all on six)
Method of complete fixed dental prosthetics using 6 implants. Considered a more reliable option than All-on-4.
Complete mandibular prosthesis Trefoil
The Trefoil concept is also from Nobel Biocare. The technique involves the use of only three implants and a special beam platform. However, the technology is used only when it is necessary to carry out complete prosthetics of the lower jaw. Due to anatomical features, upper dentures with complete absence of teeth must rest on at least four implants.
ReSmile
"ReSmile®" is a comprehensive solution for restoring chewing function in cases of complete absence of teeth and severe lack of bone tissue. The concept involves the restoration of all teeth with a complete fixed prosthesis on cement or screw fixation (14-16 teeth) with the rapid restoration of all functions of the jaw (chewing, swallowing and others), as it is carried out without incisions in the gums by puncture. Re-prosthetics are not required with this method.
ATTENTION!
As a temporary option for more reliable fixation of the prosthesis, mini-implants can be used. They are easy to install and do not require large amounts of bone.
Prosthetics with complete removable dentures
The option of fixed prosthetics is only possible with the installation of intraosseous dental implants. If this is not feasible, it makes sense to pay attention to removable prosthetics. These are products with a soft base and artificial teeth that copy the gums and the visible (crown) part of the teeth.
Acrylic
Prostheses made from special plastic. Suitable for complete prosthetics of the lower jaw and upper jaw due to good load distribution. Dentures are uncomfortable, promote the accumulation of bacteria, and the material itself can cause allergies.
Nylon
Good fixation, moisture resistance, hypoallergenicity and comfort are the qualities that make nylon prostheses worth paying attention to. On the other hand, they distribute pressure worse when chewing and sag over time (the bone tissue under such a prosthesis atrophies faster).
The best removable dentures for complete absence of teeth should be hypoallergenic, distribute the load well and not cause serious discomfort when worn.
Types of removable dental appliances for the upper jaw
Products of this type are available in several types. This is a removable full upper denture and partially removable (if there are supporting teeth). Implants implanted into the jaw can be used as supporting elements. They are reliable, physiological, strong, and fully convey the aesthetics of natural teeth. The most popular dental models are acrylic and nylon.
Acrylic
Prosthetics with acrylic products have replaced structures made of rubber. They were chosen because of the attractiveness and comfort they provided. The first modifications were quite extensive and caused long-term addiction. Today this problem has been partially solved, as new technologies and materials have appeared.
Advantages:
- the most inexpensive option of all the others;
- the ability to manufacture partial dentures and complete removable appliances;
- quickly produced, can be repaired if necessary;
- has a good degree of strength, allows you to chew food normally, and does not deform.
The main disadvantage is considered to be a closed palate and lack of direct access to taste buds.
Nylon
It is an analogue of acrylic. It conveys the appearance of gums and tooth enamel well and is hypoallergenic. The main disadvantages are soft texture and tendency to deform. It is not recommended to make a full-type prosthesis from nylon. In this case, it is better to give preference to the Acri-Free composition, which is also used in dental practice.
The best dentures for complete absence of teeth
Many patients ask the question, which dentures are better for complete absence of teeth? On the one hand, the answer here is obvious. The best dentures for complete absence of teeth are placed on implants. It is titanium roots that prevent bone tissue loss, provide the necessary stability of the structure, distribute the chewing load as efficiently as possible and allow you to achieve good aesthetics. However, implantation cannot be performed in all cases, since the procedure has a list of contraindications and is not cheap. The cost of complete dental prosthetics can cost more than half a million rubles, and this is far from the limit. The Trefoil concept will be cheaper, but it has a significant limitation (it is impossible to carry out complete prosthetics of the upper jaw teeth).
Advantages of nylon prostheses
- Soft and pliable material, adheres to the jaw,
- The prosthesis does not rub;
- The product does not require long-term habituation;
- The prosthesis can be made in the shortest possible time;
- A high-quality nylon denture is invisible in the mouth and adequately performs the chewing function;
- There are no metallic inclusions, which means it is suitable for patients with allergies to metals;
- To secure the product in the oral cavity, a special adhesive composition or design can be used
- Fixed by suction to the mucosa.
Examples of work “Before” and “After”
Basal implantation of both jaws with complete edentia
Case: the patient complained of missing teeth in the upper jaw, in the area of chewing teeth in the lower jaw, as well as mobility and pain when chewing in the area of the front teeth in the lower jaw.
Basal implantation of ROOTT with complete edentia
Case: destruction and absence of chewing teeth, destruction of frontal teeth under crowns, atrophy of bone tissue and gums due to periodontitis.
Prosthetics on implants
If the patient’s budget and health condition allow for minimally invasive surgery, it is better to opt for implant prosthetics.
There is no need to install 28 units of titanium rods separately. In some cases, patients are offered the installation of 4-6 implants on each row and fixation of solid prostheses on them. Advantages of installing dentures on implants
- Reliability – the prosthesis on the implant is held as firmly as your own living tooth with roots.
- Aesthetics – dentition restored in this way pleases with its natural appearance and beauty.
- Ease of chewing
- Durability – the guarantee for implants is determined by the manufacturer at the level of 10-50 years. It is enough to choose the right prosthesis and forget about problems with missing teeth for several decades.
- Possibility of replacing dentures - if the coronal part is destroyed, you can always install a new denture on the metal root.
The disadvantages of the method include the presence of contraindications and higher cost compared to prosthetics without implants.
How to replace implants on front teeth
The frontal elements are not involved in chewing food, but high aesthetic demands are placed on them. As an alternative to implantation, a dental bridge is suitable for restoring teeth in the front row.
Metal-ceramic structures are not used in the smile area: the metal base darkens in the light; upon contact with metal, the mucous membrane may darken. Solid ceramics is a durable material, characterized by natural translucency, and looks like “your own” tooth. The most accurate, aesthetic and durable option is a zirconium dioxide prosthesis.
Materials for the production of prostheses
Prostheses that are installed on an implant and bridge structures can be made from various materials that have their own unique performance characteristics.
Metal-ceramic structures
A metal-ceramic prosthesis is a metal base, onto which a special ceramic mass is subsequently applied in layers. After each layer is applied, the structure is exposed to high temperatures in the oven. This production method allows us to obtain a finished prosthesis that is highly resistant to various negative external factors and mechanical loads. In this case, the prosthesis will look aesthetically pleasing and visually indistinguishable from the patient’s natural teeth. If the patient, after prosthetics, strictly follows all the dentist’s recommendations, observes the rules of hygiene and care of the prosthesis, the installed structure will be able to last 10-15 years.
Ceramic dentures
They are the best option for people with an allergic reaction to metals and their alloys.
The design does not use a metal base, but the prosthesis has excellent strength and high aesthetics. Thanks to this latter quality, ceramic crowns are actively used for prosthetics of teeth included in the smile area, but they can also be used for the restoration of lost chewing units. Another advantage of installing ceramic dentures is the ability to avoid preliminary pulp removal of supporting units. Metal structures made from alloys of various metals can also be used in prosthetics. The main advantages of this type of prosthesis are their high strength and affordable price, but at the same time they have the lowest aesthetics.
Experts recommend choosing metal dentures if you need to restore a lost chewing tooth that will not be noticeable to others.
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Which method is better to choose?
Implantation is a privileged way to restore lost elements in the absence of financial and clinical restrictions. Advantages of the method:
- Implants are durable. When installing a dental bridge, a replacement will be required after 5-7 years. The service life of implants is at least 25 years .
- Adjacent elements remain untouched. Implants do not require support. When installing a dental bridge, the supporting units are pre-ground, which leads to their destruction.
- Stopping bone atrophy. Implantation guarantees an even chewing load on the jawbone - the bone is not destroyed.
- Preservation of taste sensations. Removable structures dull the sense of taste due to the massive base blocking the receptors.
- Reliable fixation of prostheses and installation of various options for orthopedic structures.
Author of the article Voznyuk Vladimir Aleksandrovich Maxillofacial surgeon-implantologist of the highest category
Experience more than 30 years
