Q: Dr. Crapo: I’ve had a partial upper denture for over fifty years. It has served me well, as I lost all but six upper teeth many years ago. I have a back tooth on my upper right side, then a big space, then an eye tooth with four front teeth. Four years ago, I got an implant for one of my front teeth next to the eyetooth.
My partial hasn't been fitting too well so I saw my dentist to get a new one. He said I shouldn't get a new one but should have implants. I guess the partial has been putting lots of pressure on my bone and he figures that I should get a bone buildup and then have all implants.
That was the only option that made sense he said. I know it would probably be best but I like my partial and maybe I could get a new one, or you could suggest some alternative ideas.
My dentist said my six remaining teeth are strong and can be saved but he said I should put implants in for my back teeth. He probably knows best but I like the partial denture. I think a new one would be fine. I thought maybe I could get an implant and maybe that would make the new partial fit better. I'd like more options because I feel I need something done but can't make a decision.
A: Over the years, I have seen people fall into three camps as far as partial dentures go.
Folks like yourself, who love them and have had problem-free service for years. Others, who tolerate them and try not to think about them, and those whose partials are somewhere in a drawer.
In your case, a minimalist way of solving your concern would be to add bone to your sinus (this is a relatively easy surgery and problems are rare), wait six to eight months for the graft to take, place two implants in the newly formed bone, wait six months more, then have a new partial made. You would have tremendous support and strength, with the implants acting as anchors and they would stop the bone loss as well.
Another idea would be to graft bone in both sinuses, place four implants on the left side where you're missing your eyetooth and all the back teeth, implants as needed on the right side, then have crowns made on the implants. This is the best treatment (from a strength, function, longevity and maintenance point of view) and eliminates the partial.
If the teeth are compromised, a third option would be to remove them, except the implant, add three or four more implants and complete the teeth-in-a-day procedure for immediate function. If the teeth are really solid – keep them. This third option is great when teeth are compromised.