Dentures are somewhat difficult to adjust to, and the challenge can be even greater when you do not have sufficient bone structure. Bone loss can affect the stability and retention of dentures, leading to discomfort and difficulties with chewing and speaking. It can also cause your face to sag, giving you an aged appearance.
Since bone loss is likely to occur eventually from wearing conventional dentures, your dentist may recommend various solutions to address these issues and provide a better denture experience.
For instance, implant-supported overdentures (removable) or hybrid dentures (permanent) can be your best option if you’re suffering from the effects of diminished bone structure, especially with the help of zygomatic implants.
Alternatively, you can opt for a bone grafting or bone augmentation procedure to buildup the lost bone tissue and overcome the challenges of wearing dentures with bone loss.
The challenge of dentures with diminished bone structure
Dentures can be an effective option for replacing missing teeth when bone loss is present, although the extent of bone loss and the type of dentures used can impact their fit and stability.
Partial dentures are a suitable choice for patients with localized bone loss, as they rely on the support of the patient’s remaining natural teeth. If the remaining teeth are healthy and strong enough, replacing a few teeth with a partial can be a relatively easy and cost-effective solution. However, it’s important to address receding gums and periodontal disease promptly and maintain regular dental checkups to prevent further bone loss and ensure the longevity of the tooth replacement.
Full dentures, on the other hand, are used when a person’s teeth have been extracted. Without the natural teeth to provide stimulation, the jawbone can start to resorb or deteriorate. Wearing dentures can help slow down this process compared to being completely toothless, but the bone loss still occurs.
Traditional full dentures rely on the remaining gum tissue and jawbone for support, but advancements in technology have led to the development of digital dentures, which can fit more snugly even in cases of significant bone loss. But for a more stable restoration, your dentist may still recommend implant-supported dentures as discussed below.
These are temporary dentures provided immediately after tooth extractions. Patients who have already experienced bone loss tend to have faster bone resorption and tissue shrinkage following extractions. As a result, immediate dentures may become loose once the bone resorption occurs. Temporary relining may be necessary to ensure the best fit during the healing process, as the gums adapt to the changes. Custom dentures can be created to fit securely on the healed gums once the jawbone has stabilized, typically after several months.
Implant-Supported Dentures for bone loss
Implant-supported dentures offer a revolutionary solution for individuals with bone loss. Dental implants, which are titanium posts, are surgically placed in the jawbone to provide a stable foundation for attaching the dentures.
This approach offers several benefits:
- Placement of Dental Implants for Stability and Support: By anchoring the dentures to dental implants, they gain stability and support that traditional dentures lack. The implants serve as artificial tooth roots, effectively integrating with the jawbone and providing a strong base for the dentures.
- Prevention of Further Bone Loss: Implant-supported dentures help prevent additional bone loss in the jaw. The implants stimulate the jawbone, just like natural tooth roots, promoting bone growth and preventing resorption.
- Increased Stability and Retention of Dentures: Implant-supported dentures offer superior stability and retention compared to traditional dentures. The dentures are securely attached to the implants, eliminating concerns about slippage or discomfort while speaking or eating.
Types of Implant-Supported Dentures
There are two main types of implant-supported dentures:
a. Removable Overdentures
Removable overdentures are a popular choice for patients with more significant bone loss. They require fewer implants, typically two to four, to support the dentures. This makes them a more affordable option for individuals with limited bone structure. Removable overdentures can be easily cleaned and maintained by the wearer, providing convenience and ease of use.
b. Permanent Hybrid Dentures
Permanent hybrid dentures offer a more solid fit and function, closely resembling natural teeth in appearance and cleaning methods. They require more implants, typically four to six, for increased stability. Hybrid dentures are a permanent fixture in the mouth that you can wear all the time, providing a long-term solution. However, they are more costly due to the additional implants and the need for professional maintenance.
Bone Grafting and Bone Augmentation
a. Bone Grafting
Bone grafting is a procedure that involves adding bone material to rebuild the jawbone. It is an effective treatment option for individuals with insufficient bone support for dentures. The bone graft material, which can be synthetic or natural, provides a foundation for dental implants or enhances the stability of traditional dentures. The healing process allows the bone graft to integrate with the existing bone, creating a stronger structure to support dentures.
Bone grafting typically utilizes existing bones in the patient’s body to create a stronger and more reliable foundation for dentures or other oral appliances.
Here’s what to expect:
- The process begins with the dental team creating 3D images of the mouth and jawbone to assess their condition and determine their ability to support dentures. This evaluation helps determine the need for additional bone support.
- During the bone grafting procedure, the dentist will lift the gums and place synthetic or natural bone material in the area where the dentures will be placed. This added bone material serves as a scaffold for new bone growth and integration.
- The body then gradually adjusts to the new bone, allowing it to become a natural part of the patient’s anatomy over the course of several months.
Once the graft has fully healed, the mouth is ready for dentures, dental implants, or other oral health procedures.
b. Ridge Split Bone Augmentation
Ridge split bone augmentation is a specialized technique for rebuilding the jawbone in cases of severe bone loss. The procedure involves splitting the ridge of the jawbone and adding bone graft material to create a wider base for implant placement.
This technique is particularly suitable for patients with extensive bone loss who require dental implants to support their dentures. Ridge split bone augmentation allows for successful implant placement and improves overall oral function and aesthetics.
It is performed under local anesthesia, and:
- A specialized dental saw is used to split the jawbone along the ridge.
- The space created is then filled with bone graft material.
- After several months of healing, a dental implant procedure can be carried out, utilizing the newly regenerated bone.
What happens after rebuilding the jawbone?
After the recreation of the jawbone, patients are provided with temporary implants that can be used to attach temporary dentures. This ensures that you do not have to go without teeth during the healing period following permanent implants or bone grafting procedures.
Once the dental implants have fully healed, patients can be fitted with cantilever bridge frames, which will eventually be replaced with the final porcelain bridge.
Throughout the process, temporary teeth replacements are provided, and regular fittings and adjustments are made to achieve the perfect bite and natural-looking appearance.
Once the final porcelain dentures are fabricated and delivered to the patient, their teeth’s normal appearance and function are fully restored.
Regardless of the chosen technique for recreating the jawbone, patients can expect to achieve a permanent solution for their missing teeth. The expertise of dental professionals ensures that the reconstructed jawbone provides the necessary support for long-lasting and aesthetically pleasing dentures.
Zygomatic Implants for Severe Bone Loss
In cases of severe bone loss in their jaw, such that you are unable to receive standard dental implant treatment, then zygomatic implants provide a viable solution.
Zygomatic implants are longer than traditional dental implants and are anchored in the cheekbone (zygomatic bone) instead of the jawbone. This approach eliminates the need for invasive bone grafting procedures, making it suitable for individuals with minimal bone structure.
Zygomatic implants offer stable and secure denture support, allowing patients to regain oral function and confidence.
When to consider zygomatic implants
Many individuals who have worn dentures for an extended period of time find that their dentures no longer stay in place properly. This can lead to discomfort and difficulty with daily activities such as chewing.
Additionally, some people have naturally less bone in their jaw or may have experienced bone loss due to certain medical conditions or illnesses. These individuals may have been previously ineligible for dental implants without undergoing invasive bone grafting procedures, which can significantly extend the treatment time.
How it works
Zygomatic implants help to address the challenges faced by individuals with severely atrophic maxilla and minimal jawbone. This innovative approach combines computer-guided implant surgery with precision screw-retained fixed prosthodontic rehabilitation.
- During the procedure, the zygomatic implants are strategically placed in the upper jawbone, anchoring the fixed prosthodontic restoration securely.
- The computer-guided implant surgery ensures precise placement and optimal results.
- The screw-retained fixed prosthodontic rehabilitation provides stability and comfort for the patient, enhancing their ability to chew and improving overall oral function.
This approach has revolutionized the treatment options for individuals with minimal bone in the jaw. By avoiding invasive bone grafting procedures, the treatment time is significantly reduced, allowing patients to achieve a healthier and more functional mouth in a shorter period.
The implant-supported non-removable teeth provide improved stability, greater comfort, and easier chewing ability. Furthermore, these implants can contribute to a healthier jawbone by stimulating bone growth and preventing further bone loss.
Patients who undergo this treatment experience a significant improvement in their oral function and overall well-being.
Cantilever bridge tooth replacement
For patients who do not have sufficient bone mass to support dental implants, a cantilever bridge can be an alternative solution. Unlike traditional bridges that require two dental crowns or abutments on both ends to hold the bridge, the cantilever bridge is designed to anchor the appliance on one end.
This allows the implant to be strategically placed in areas with sufficient bone mass, making the bridge appear longer than the remaining bone structure. The cantilever bridge provides a secure fit and restores normal biting and chewing function, resembling natural teeth.
Tips to Prevent Bone Loss with Dentures
1. Proper Fit of Dentures
Maintaining a proper fit of dentures is crucial to minimize bone loss. Regular adjustments by a dental professional are necessary to ensure optimal fit and function. These adjustments stimulate the gums and jawbone, reducing the risk of bone resorption. Patients should prioritize dental check-ups and promptly address any discomfort or looseness in their dentures.
2. Allowing for Proper Rest
Giving the mouth a break from denture wear, especially at night, is essential to prevent excessive irritation to the gums and bone. Removing dentures allows the oral tissues to rest and promotes blood circulation, reducing the potential for bone loss. Denture wearers should follow their dentist’s recommendations regarding the duration of rest periods and appropriate wear schedules.
3. Maintaining Proper Nutrition
A well-balanced diet plays a vital role in supporting bone health. Denture wearers should focus on consuming foods rich in protein and calcium, which are essential for bone maintenance and regeneration. In cases where dietary intake may be insufficient, the dentist may recommend vitamin supplements to support optimal bone health. Despite the challenges faced with dentures, individuals should strive to maintain a varied and nutritious diet for overall well-being.
While bone loss can present challenges for denture wearers, there are viable solutions available. Implant-supported dentures provide stability, prevent further bone loss, and improve overall denture experience. Bone grafting and bone augmentation techniques offer reconstructive options for individuals with inadequate bone support.
Consulting with a dental professional is essential to determine the most suitable treatment approach based on individual needs and oral health status.