Q: Dear Dr. Crapo: I have had an upper denture for over fifty years. It fits well and stays in place even though my bone has shrunk. I’ve had a number of relines but as far as eating, it’s good. On my lower I’ve had a partial denture for almost the same length of time. Over the years, the six lower front teeth that hold the partial have gone through decay, fillings and root canals. In the past year, these teeth have broken down and some are getting loose.
I saw a dentist and he said it was time to think about a denture or implants but he said I’d lost a lot of bone where my lower back teeth used to be. He said a denture would not be a great idea because the ridge, it was supposed to sit on, was gone. He also said I either have a very strong bite or I had worn my partial too much at night or I lost bone quickly after the teeth came out or a combination of all of the above.
I was kind of aware of the lost bone because my partial was fitting badly, so I was thinking implants were in my future but can I still have them? He said I’ve got good bone where my lower roots are. Will that be sufficient? When you look in my mouth it seems like the bone disappears or is much lower behind my eyeteeth.
A: To answer your question at the outset – yes you have enough bone to place implants that will sufficiently do the job. There are a number of ways that this is done but the finished product will fall into one of two categories.
The first configuration of restoring or giving you anchored teeth is to place two or three implants, wait for three months and then fit a lower denture with a snap coupling that will sit over and snap onto the implants in your mouth. This is called an “implant retained denture”. It works well enough but still relies on one’s ridges for support in the molar area. This is not a good long-term solution for one who has lost as much bone as you have.
The second configuration of anchoring teeth is called “implant supported teeth”. In this case four or five implants are placed then the teeth are either fixed permanently to the implants like a fixed bridge (not a removable partial denture) or a titanium bar is made. It is fixed to the implants and then a denture is fabricated with snap couplings that will sit over and snap onto male couplings on the titanium bar. As you can see, in both these cases your ridges, that are largely gone, will take no pressure as you chew your food.