By Charles A. Babbush, DDS., MScD
Dentures are not usually a preferred modality of treatment by the patient. The exception is often times 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, the patient 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
- Pain on lower-compression of mental nerve
- Continuous bone loss
- Collapse of lower 1/3 of face
- Continuous reline of dentures-required
- Inability to masticate and digest food properly
- Decrease nutritional values
- Prominence of chin & nose with increase of peri-oral lines, wrinkles and crow’s feet
- Overall premature aging of the face
- Increase 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, digestion and improved nutrition
- Facial structures maintained or enhanced
- Improve 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, esthetics 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, esthetics are reduced as is 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 which can be thought of related to implant reconstruction, ranging from time, money, procedures, security, confidence, self-esteem, nutritional values, longevity, esthetic/cosmetic are all added up for a win-win final result for the patients who we serve.