I’m Missing All My Teeth. What Options Do I Have?

The loss of your teeth can affect your life, both aesthetically and functionally. Missing teeth cause a series of general, dental, and aesthetic health problems. Problems chewing, speaking, chronic headaches, and stomach problems are all common for those missing teeth. Losing teeth can also cause changes in our face and even psychological damage that can significantly affect our quality of life and how we relate to the world.

However, you have every opportunity to get your smile back! No matter why you lost your teeth, whether you lost them in an accident, to tooth decay or gum disease, there are solutions with the potential to improve your appearance, your chewing, your speech, and your quality of life.

Here are some solutions you can choose from:

Complete dentures

Dentures generally consist of an acrylic or plastic plate with embedded ivory teeth. In full upper dentures, they cover the entire palate (roof of the mouth). The suction created by a skinny layer of saliva between the prosthesis and the gum holds it in place. Your facial muscles and tongue also help keep it in place.

Traditionally, dentures have been the most common treatment option for replacing missing teeth. Although currently it cannot be said that it is the best. Their disadvantages are that they can be uncomfortable to use. They can force you to have food restrictions, such as avoiding crunchy or sticky foods, they can be challenging to keep in place, some people cannot adapt to them, must be replaced every few years. Their advantage is that they are the cheapest solution.

Implants to restore all teeth

A dental implant is an artificial root placed in the mandibular or maxillary bone, and then an artificial tooth (fixed prosthesis) is placed on it. In recent years, implantology has focused on offering increasingly precise, comfortable, and long-lasting treatments for the patient. For this, it is currently possible to choose between two methods to recover their teeth.

Both prostheses require dental implants placement throughout the mouth since they are responsible for holding them and allowing you to speak and chew normally. These types of prostheses are fixed prostheses on implants and overdentures on implants.

Overdentures on implants

Overdentures are removable prostheses placed on dental implants, which provide greater support than traditional prostheses placed on the gums. They are very comfortable to use, and taking them off makes their hygiene easy and very effective.

Their manufacture with resin and the reinforcement they have, often cobalt, makes them very resistant.

Dietary limitations:

The overdenture is not suitable for crushing tough food because it can weaken the prosthesis’s support structure and end up fracturing it. But otherwise, the patient will be able to eat anything. It is recommended to remove the prostheses and, after each meal, to do correct hygiene of the mouth and the prosthesis, which will also help increase its durability and keep it, in perfect condition, for a longer time.

Advantages:

  • Overdentures are an extraordinary treatment for patients with false teeth (especially the lower one) that easily move and misfit.
  • Fewer implants are needed (so it is cheaper).
  • Its main advantage is that the patient can be removed after each meal facilitating hygiene and care of osseointegrated implants.
  • Improvement in phonetic aesthetics and occlusion.
  • Improves oral proprioception
  • Improved chewing performance, maintenance of chewing muscles, and facial expression
  • Reduction of the prosthesis size (the palate is eliminated); therefore, it is more comfortable.
  • Improvement in psychological health by improving comfort and aesthetics.

Disadvantages:

  • Long-term maintenance: change of retainers, relining, change of prosthesis every seven years.
  • greater accumulation of bacterial plaque on the support pillars, with the consequent increase in periodontal disease.
  • Greater home care on the prosthesis wearer, since when using overdentures, excellent oral hygiene is required for success; Thus, many patients are poor candidates for overdentures

Fixed Prosthesis on Implants

These are full-arch dental prostheses that are screwed on six or eight osseointegrated implants using the all-in-6 or 8 technique. They replace all the teeth of one or both arches with a prosthesis or “denture fixed.” Only Your dentist can remove them, and it is the closest thing to recovering your natural teeth; it does not move, you regain the chewing capacity, and the aesthetics are fantastic.

Fixed prostheses on implants are 100% personalized and usually made of materials that allow great results, such as metal-ceramic and metal-porcelain.

How many implants should be placed?

It can be all in 8, all in 6, or all in 4. It refers to the number of implants that can be used to support a denture on implants. As for which one to choose, there is no wrong answer or decision you should make.

It depends on your mouth’s topography, such as how many natural teeth are left, the quality and quantity of the remaining jaw bone, general and oral health, and other things, which only your dentist will tell you after making an evaluation.

All-on-4:

Bone loss in the jaws’ posterior regions in fully edentulous patients often makes dental implant placement difficult. This could be solved by undergoing bone graft surgeries to increase the alveolar bone’s width and height in posterior areas, but this technique has increased complications in the patient. A suggested treatment option to avoid these unfavorable posterior areas is inclined implants to allow better anteroposterior extension of the dental implants. This, in turn, favors a better load distribution. This concept, known as “All-on-Four.”

In summary, four (or more) implants are placed in the entirely toothless anterior part of the jaw. The two implants are placed anteriorly, and the posterior implants are placed at an angle to maximize implant length and avoid anatomical structures. These implants are immediately loaded with a temporary fixed dental prosthesis.

Advantage:
  • Angled posterior implants avoid anatomical structures
  • Angled posterior implants allow for longer implants anchored in the better quality bone
  • Eliminates the need for bone grafts in the maxilla and mandible
  • High success rates
  • Good biomechanics
  • Easier to clean
  • Recovery of aesthetics immediately
  • The final restoration can be fixed or removable.
  • Reduced cost due to the fewer number of implants and the avoidance of grafts in most cases
Disadvantages
  • Freehand arbitrary surgical placement of
  • the implant is not always possible as implant
  • placement is completely prosthetically
  • Length of the cantilever in the prosthesis cannot
  • be extended beyond the limit.
  • It is very technique sensitive and requires
  • elaborate pre-surgical preparation such as
  • CAD / CAM, surgical splint.
Indications:

patients with bone loss in posterior areas (molars), with no bone graft surgery availability.

Contraindications:

patients with general health problems that prevent them from undergoing implant surgery. Unfavorable oral hygiene.

All-on-6:

All-on-6 dental implant system procedure creates a permanent prosthesis through the use of six dental implants. Acts as an anchor for the bridge or overdenture. Six implants are placed in the lower or upper jaw to anchor the prosthetic teeth in place permanently. After performing a comprehensive exam, your dentist, digital x-rays, and 3D cone beam CT scan will evaluate the anatomical structures of your mouth. The dentist will then assess the bone loss and impressions to generate your smile again.

Indications:

for moderate atrophic maxillary rehabilitation

Contraindicated:

in patients with severe bone loss, general health problems, poor oral hygiene.

All-on-8:

The All-on-8 dental implant system is a variant of the all-on-four system based on the same concept. The only difference is that eight front implants are used instead of 4. Most of the All-on-4 technique uses acrylic dentures, while All-on-8 uses dental bridges with crowns, which provides teeth with a more natural look.

Benefits:
  • provide the best grip and firmness.
Disadvantages:
  • Its price is usually higher since it requires a greater number of implants.
  • Recovery and time to finish treatment are slightly longer.
  • Requires an adequate amount of bone. (otherwise, a bone graft will be necessary).
Indicate:

in cases of severe bone loss.

Contraindications:

patients with poor general health that prevents undergoing implant surgery.

Conclusion

We’ve just gone over several of the solutions out there for people missing all of their teeth. While each has their own pros and cons ranging from fit to price, there is surely a solution for you! If you have any questions or concerns, feel free to leave a comment below! 

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