Prosthetics for complete absence of teeth supported by implants

Reasons for missing teeth

1-2% of the population has a genetic disorder in which teeth are initially absent or their number is abnormally small. In the vast majority of cases, the absence of lower or upper teeth is a consequence of illness or mechanical damage. Doctors at the clinic name the main reasons:

• Untreated caries or pulpitis. Tooth tissues are destroyed, in advanced cases, inflammatory processes in the gums begin, and the bone structure changes. Our dentists try to preserve every unit. But, if the process is already irreversible, then it is necessary to remove one tooth or several.
• Inflammatory processes in periodontal tissues lead to the fact that the ligament cannot hold the tooth in the socket. The crown becomes loose, destructive phenomena progress, and the gums and bone are destroyed.
• Injuries. The complete absence of teeth or partial adentia is caused by dislocations, bruises, fractures of the tooth crown or root, and other damage resulting from mechanical impact.

Sometimes teeth can be lost after suffering from somatic diseases: oncological, endocrine, and others that weaken the immune system and affect the structure of tissues.

Dentures

One of the most popular types of removable dentures are dentures. This is possible both with partial and complete absence of teeth in the patient. They are different:

• full plate plastic;
• partial;
• conditionally removable.

Dentures

Acrylic is used in the manufacture of plastic dentures. Moreover, such structures can be not only permanent, but also temporary, as well as cast and pressed. Such dentures are also divided into removable and non-removable.

Acrylic dentures

It is necessary to decide on the material, as well as the type of prosthesis, together with the doctor. He must assess the condition of the patient’s own teeth, as well as listen to wishes for the future prosthesis.

Flexible dentures

Denture for one tooth

In some cases, installing a crown on one tooth is not possible. For example, a dentist may recommend that adjacent teeth not be ground down if they are in perfect condition. In such a situation, a one-tooth prosthesis would be a good solution.

Nylon denture for one tooth

Such dentures are removable. They are attached in different ways, but the most popular are dentures with clasps, which have several locks that hold the denture at the expense of healthy teeth.

It is important to remember that just because a denture is removable does not always mean it needs to be taken out of your mouth every day. The quality of dentures today is such that they can be worn for months – you just need to take proper care of them.

When replacing teeth, you need to listen to the opinion of the dentist - he will tell you the best way to make your smile beautiful again!

Why do you need to restore your teeth?

Edentia is not only discomfort, but also early aging. The absence of teeth leads to changes in facial features, sunken cheeks, and the appearance of deep wrinkles. The person looks older, his appearance becomes sickly. In addition to visible imbalances in proportions and a deterioration in the quality of life, when there are no teeth at all, health problems

:

• The diet is reduced, the body does not receive the required amount of vitamins and minerals. The immune system suffers, metabolic processes are disrupted, and cells do not receive enough nutrients.
• Gastrointestinal diseases are provoked. Food is chopped poorly, making digestion difficult. Sometimes patients switch to eating pureed food or pureed food - this method also contributes to the appearance of dysfunction of the stomach and intestines.
• The absence of teeth in the jaws leads to improper distribution of the load on the gums and bone. Tissues atrophy and become thinner.

The bite also changes, diction is impaired - speech is slurred, most sounds are distorted. The absence of teeth affects the emotional state, lowers self-esteem, and the circle of friends narrows. Researchers have also established a direct connection with the presence of teeth and the state of intelligence and activity of older people.

Features of complete prosthetics

The clinics of the German Implantology Center in Moscow are a team of expert dentists who constantly improve their skills, participate in domestic and foreign symposiums, and introduce innovations. For more than 11 years of successful dental practice, we have been able to become a leader not only in Moscow, but also in Russia in the field of implantation and prosthetics.

Therefore, dental restoration in our clinics is as comfortable and painless for you as possible - safe anesthesia and sedation are used. The doctor tells you what symptoms may appear in the first days after surgery and prescribes medications appropriate to the case. The doctor is always in touch with the patient until complete healing.

Prosthetics of the upper jaw on implants

Implantation in the complete absence of teeth in the upper jaw has its own nuances: osteoporosis of the bone progresses faster, there is an anatomical feature - a low alveolar ridge (its height is not enough to hold the pin), and the proximity of the maxillary sinus complicates the process.

The classic two-stage method is rarely used in this case. Bone grafting is an additional surgical intervention, and our doctors perform surgery when it is unavoidable. Therefore, preference is given to immediate implantation or gentle techniques.

All on 4 systems

"or "
All on 6
" allow you to quickly, with minimal trauma, restore the dentition when complete dental prosthetics are required in the upper jaw. These techniques are suitable for those who want to get quick and high-quality results. They are well tolerated by older people. If you replace your teeth completely, the healing time of the implants will be up to six months.

The “All on 4” and “All on 6” protocols differ in the number of supporting implants. The first method is suitable for patients with slight thinning of the bone and a small jaw, the second is acceptable for moderate and severe atrophy.

When implanting “All on 4”, two (four) implants are installed at an angle of 35-45 degrees in the lateral (sometimes distal) section, and two more are installed vertically on the front part of the jaw. Implantation at an angle allows you to bypass the maxillary sinuses. Doctors prefer to install dental implants in a minimally invasive way - through a puncture.

If it is not possible to install 4 implants in the complete absence of teeth, then it is possible to implant 2 pins, which will support a removable denture - the structure will be fixed better than the simple version with suction cups, the use of additional gels is not required.

When the tubular bone is too thin, a sinus lift will be required - this is how the volume of the maxillary sinuses is reduced and the bottom is corrected (raised). The voids are filled with synthetic material biocompatible with tissues. Implantation is possible approximately two months after the sinus lift.

If inflammatory diseases are observed (sinusitis, sinusitis), there is a cyst, or a deviated nasal septum, then bone grafting is performed only after anomalies have been excluded - treatment or surgery.

One of the features of implantation in the absence of teeth in the upper jaw is that the front teeth and part of the gums are visible when talking or smiling. Therefore, doctors solve two important problems: restore health and create an aesthetic image. Often artificial teeth turn out to be more beautiful than those given by nature and form the natural contour of the gums. The exact location of the implant is determined based on diagnostic images.

If the bone tissue deficiency is too acute and the augmentation operation is irrational, then it is possible - but at the stage of temporary prosthetics - to install zygomatic implants. In this way, it is possible to replace teeth completely with a small amount of spongy bone mass.

• Extended pins guarantee reliable fixation of the prosthesis in cases of total bone tissue deficiency, osteomyelitis and other clinical cases.
• Titanium implants from the Nobel Biocare line with a porous surface and a special coating are designed for rapid osseointegration.
• Artificial roots are implanted through surgery under anesthesia, bypassing the paranasal sinuses, into the deep cortical layer of the zygomatic bone. This is a complex operation, which is used only in special cases.

Before the operation of implantation of implants in any jaw, the doctor draws up a detailed treatment plan, because not only the beauty of the structure, but also the adequate distribution of the load on the artificial tooth root depends on the accuracy of each action and the correct selection of models of implants and prostheses.

Example #3. Prosthetics of the upper jaw on 8 implants

Our patient is quite young. I contacted the German Implantology Center with the problem of swelling, swelling, bleeding gums, discomfort, accompanied by periodic pain.

Based on the diagnostic results, it was found that all (!) of the existing teeth in the upper jaw are completely untenable due to the previously not entirely successful treatment in other clinics. Unfortunately, this problem is quite common:

The result of implantation and prosthetics of example #3 is presented below:

This clinical case is reviewed in more detail HERE.

Example # 3.1 - Upper jaw prosthetics on 7 implants

Our patient is a 70-year-old man

. I contacted the German Implantology Center with the following problem:

• There are only a few teeth left on the upper jaw,
• Some of the destroyed teeth were roots.

Before making a decision, the patient was constrained by the fact that there were 7 teeth left in the upper anterior section. They provided some (tolerable for many men) aesthetics. But when the man finally fully analyzed the situation for himself, he realized that chewing with so many teeth was, to put it mildly, uncomfortable for him and agreed to a step-by-step and rather complicated dental prosthetics procedure for him. Why was dental prosthetics difficult? Because it was done in several stages, and not all at once in one operation.

We will also not dwell on this clinical case now; we will show BEFORE and AFTER photos.

This is the situation a patient came to us

:

And this is what we have as a result of prosthetics

:

You can view this rather complex clinical case in detail HERE.

How is upper jaw teeth removed?

Before the operation, an examination is carried out, if necessary, radiography, consultations with other specialists. Typically, tooth extraction surgery is performed on an outpatient basis. Local anesthesia is most often used. Before the operation, the mucous membrane and teeth are cleaned to prevent infection of the socket. For tooth extraction, forceps and elevators are used, and in some cases, the tooth root is cut out with a bur. Special forceps are used to remove the wisdom tooth of the upper jaw.

Removing the upper front teeth is usually simple. Certain difficulties arise when removing the upper canine, since it has a long, massive root, the apex of which is very often curved, as well as when removing molars, since they have three roots.

When removing the upper teeth, the patient sits in a chair with a slightly reclined back and headrest. The dentist is positioned to the right and in front of the patient.

Stages of tooth extraction:

• Separation of the gums from the edge of the alveolus and the circular ligament from the neck of the tooth (with a raspatory or a trowel);
• Applying and advancing forceps under the gums, fixing them;
• Rocking or rotation of the tooth, during which the periodontal fibers that connect the tooth root to the walls of the socket are torn;
• Extracting a tooth from the socket;
• Inspection of the surgical site, extraction of small pieces of bone and tooth roots.

The success of the operation does not depend on the physical strength of the dentist, but on the correct execution of all stages of the procedure. Minor bleeding from the hole stops after 2-5 minutes, the hole is filled with a blood clot, which protects the wound from infection. To avoid damaging the clot and causing bleeding, the patient is advised not to rinse the mouth or eat food for several hours. On the day of surgery, you should not consume hot food or drinks, or take any thermal procedures; it is recommended to refrain from heavy physical activity. If all recommendations are followed, the tooth healing process will proceed quickly.

Prosthetics of the lower jaw on implants

The structure of the lower jaw is different - the bone mass is denser and thicker, the installation of a lower prosthesis in the absence of teeth, and the implantation of implants have other features.

“All on 4” protocols, as mentioned earlier, in most cases allow for complete restoration of teeth. The healing process is faster - the vast majority of patients forget about the presence of artificial teeth after three months. This is possible due to the increased density and sufficient height of the bone. The method is recommended for lack of volume (short length, thickness), atypical location of the mandibular canal.

Example #4 - All on 4 implantation with lower jaw prosthetics

Our patient is 82 (!) years old

. For the last 10 (!) years I have been trying to carry out treatment - restoration of the dentition with the help of implants. But, unfortunately for him, it was not successful - the implants were lost for a number of reasons - they did not take root, they became inflamed. But we must give our patient his due - he did not lose hope. A man of very progressive thinking, he understood that the problem was not in his body, but that something else was happening that was preventing him from becoming the happy owner of a high-quality denture on implants.

The result of “All on 4” prosthetics is presented in the photo below:

More details about this interesting clinical case can be found HERE.

Features of implantation and prosthetics on the lower jaw

The artificial root is more firmly fixed in the tissue, so the risk of rejection tends to zero. The mandibular bone atrophies more slowly after the loss of units, which reduces the likelihood of osteoplasty. For complete dental prosthetics on implants, we use the “All on 6” technique more often in most clinical cases. This guarantees the patient reliability and ease of use of the orthopedic construction, primarily in the long term.

The aesthetic side is important, but when working with the dental row below, more attention is paid to restoring functionality. There is a nuance: the surgeon’s work will require precision, since the trigeminal nerve passes at the base of the jaw and there is a risk of damage to it if the intervention is careless.

• Before implantation begins, during diagnostics the exact location of the branch of the trigeminal nerve is established, the structure of the tissues and the localization of nerves and vessels are clarified.
• Surgeons at the Research Center clinics are highly qualified, carry out diagnostics and know everything about the anatomical features of each patient, so implantation takes place without complications.
• The doctor selects not only the location of the implant, but also its size, which is especially important in the absence of teeth. If the location is too close, then the nerve trunk will need to be docked.

Example #5 - Lower jaw prosthetics on 6 implants ALL ON 6

Our patient is a woman with fairly progressive views on dental treatment and prosthetics. But a rather serious problem in her life is an allergy to antibiotics. Since she categorically did not want a removable denture, considering it archaic and uncomfortable, the patient began her independent attempts to improve her smile. And she did this at her own peril and risk in several clinics.

At first, she installed the implants without “covering up”—the subsequent use—of antibiotics. Some of the implantation went well, some not so much. Having suffered, the patient concluded that she still needed to turn to professionals and then, even without antibiotics, she would get the reliable and aesthetically beautiful result that she dreams of and really wants to achieve.

The photo shows a view of 6 implants installed on the lower jaw:

Photo after prosthetics

:

You can read more about this interesting clinical case HERE.

How to insert a dental implant

Indeed, it can take six months for an implant to heal. But if prosthetics are done in the smile area, then the patient is given a temporary orthopedic structure that covers the defect. It turns out that the proposal to insert teeth in one day actually means eliminating an aesthetic problem rather than returning a person to the ability to chew food as before.

To be fair, it is worth noting that the installation of the implant is done in one visit. This operation is performed under local anesthesia, so the question of whether it is painful to insert a dental implant is unnecessary. How long does it take to insert teeth if you need to replace several lost units in a row? It is better to install implants right away, so as not to drag out the prosthetic process for a long time. However, if the patient has already had an implant installed, but then there is a need for prosthetics for another tooth, then each of these units can be treated separately. It all depends on the specific case.

Which prosthetics for the lower jaw is better?

Patients are often interested in which prosthetics are best for restoring lower jaw teeth. Progressive experts believe that implantation and installation of structures today is the optimal and gentle option to maintain quality of life at any age. Root-shaped implants for the lower units are selected taking into account the upcoming high chewing load.

We use the basal method of prosthetics on implants extremely rarely and only at the stage of temporary prosthetics in the distal part as part of the “All on 6 implants” protocol in the absence of teeth, severe tissue atrophy and the inability to install 2 classical artificial roots. Then the elongated implants are introduced into the deep layers of the jawbone during the formation of bone in the distal section after bone grafting. After the bone tissue has formed, the basal implants are removed and normal classical implants take their place. And after this, the patient undergoes permanent prosthetics on 6 implants.

Modern implant designs are characterized by directional threading; some models have a porous surface with a coating that accelerates the integration of the artificial root into the bone. Fixed dentures in the absence of teeth are installed on a larger number of supports, minimum 6-8. One- or two-stage protocols are warranted. In the first option, until complete engraftment, the patient wears a traditional removable denture; in the second, a temporary option with artificial gums attached to pins is installed.

The fixed structure consists of metal-free crowns (usually zirconium dioxide), there is no artificial gum, and there is no need to remove the denture for cleaning. It is enough to follow standard hygiene procedures.

The “All on 4” protocol is ideal for restoring missing teeth in the lower jaw, if it is small, and allows, in most cases, to avoid bone augmentation. This is usually a one-stage implantation with immediate loading. Primary stabilization is high, there is an orthopedic stage. Within a week after the implants are inserted, a temporary prosthesis is put on.

If the bone has atrophied and for some reason it is decided to give preference to classical implantation, then bone grafting will be required. Special membrane materials are used that are embedded in the bone and stimulate its development. After osteoplasty there is a rehabilitation period of 4 months. up to six months.

What teeth can be inserted to make them look like real ones?

Today, dentists have practically abandoned metal crowns and dentures in the visible part of the dentition. Among the materials from which dental crowns and dentures are made are zirconium dioxide, ceramics, metal ceramics, and plastic. Ceramic and zirconium dentures are most similar to real teeth, but they are expensive. Plus, porcelain (ceramics) does not have the proper strength for a chewing tooth. Typically, those artificial teeth that bear high loads are made of metal ceramics, metal or zirconium dioxide. Metal is used where teeth are not visible in the smile area, and the patient should not be allergic to this material. Zirconium crowns are expensive and therefore not available to everyone. That is why metal ceramics are the most common at the moment. It has one drawback: the necks of the teeth have a metal strip, which can be noticeable, especially if it oxidizes. Overall, this material is durable and aesthetically pleasing. So, if you have a relatively small budget, it’s worth choosing it.

If you have very little money, then which teeth are best to insert so that the prices do not seem exorbitant? In this situation, you can count on temporary plastic prostheses. They can be made either as removable ones, or as full-fledged crowns on stump inlays or a bridge. The service life of plastic is short, but while wearing such prostheses you can save up for a better option. This is especially true when you need to completely insert teeth.

We insert the teeth completely: prosthetics of two jaws

Which prosthesis should I choose if I have no teeth at all? Contact the German Implantology Center - the doctor will choose a way to restore your health. Preference is given to implantation. The statement that it is expensive is outdated. Today you can get an installment plan. Implants are installed once and with a lifetime guarantee - clinic dentists work only with the premium segment from well-known manufacturers, and expensive traditional removable structures wear out and require replacement after 7-10 years.

Our Center is a certified partner of top-rated implant brands, which is why patients all over Russia and abroad trust us. If it is necessary to restore the dentition on two jaws, the treating doctor will prescribe an examination and draw up a detailed action plan for dental prosthetics on implants. A tomogram is performed, a 3D model or surgical template is created, providing a predictable result. We use the best tomograph models in the world – cone versions of the Planmeca line.

The dentist chooses the priority of actions and introduces implants according to the “All on 4” or “All on 6” protocols. These are ways to carefully, avoiding unnecessary trauma, improve the quality of life.

Dental implantation is completely performed in most cases without bone grafting.

• For total rehabilitation, sometimes 4 implants are enough to fix the prosthesis on the lower jaw - this is 20% of all requests.
• The bone of the upper jaw is more porous, so 6 supports may be needed to secure the structure - the need to use one of the methods will be discussed by the doctor during a consultation after the examination.

The treatment plan must be discussed with the patient.

Example #6 - Prosthetics of both jaws with implantation ALL ON 6

Our patient is a 49-year-old man. I came across the following difficult situation:

• severe periodontitis,
• partial absence of teeth,
• numerous caries, incl. deep
• bone tissue atrophy.

The situation was more than serious, look for yourself at the photo BEFORE the start of treatment

:

The result of the prosthetics exceeded all the patient’s wildest expectations, see for yourself:

And with a smile, the result of ALL ON 6 is simply fantastically beautiful:

You can read this clinical case in detail HERE.

Full implantation for edentulous patients is the optimal method of tooth restoration

You can restore chewing function with complete edentia using:

• removable acrylic or clasp dentures fixed on the gums and upper palate using a vacuum method or a special corrector cream;
• conditionally removable or fixed dentures supported by dental implants.

Removable dentures are relatively inexpensive, but they create a lot of inconvenience, ranging from mobility of the denture during chewing to increased sensitivity and an increased feeling of nausea.

Prosthetics of all teeth on implants completely solves these problems. Moreover, implantation improves the patient’s quality of life, since:

• prevents further bone tissue atrophy;
• improves chewing function, protecting against diseases of the stomach and duodenum;
• restores the aesthetics of a smile;
• provides reliable fixation of prostheses;
• returns a feeling of naturalness and makes you forget about these problems for decades.

In the absence of contraindications, such as diabetes, tuberculosis, oncology and hemophilia, implantation is the best way to restore teeth in completely edentulous upper and lower jaws.