Affordable Replacement for Dentures
The “Bar Attachment Denture” procedure is being advertised as an affordable option for complete tooth replacement, but there are more affordable treatment options for replacing dentures.
Lower dentures are rarely comfortable. In fact, studies show that at least half of all lower denture wearers are not satisfied with the comfort, or stability, of their dentures. Fortunately, patients who decide to replace their lower dentures with implant- supported over-dentures experience an improved quality of life, with more comfort and the ability to eat healthier foods.
There are many advertisements about affordable dental implant treatment to replace all of the teeth in one day with only four implants in each jaw. The “All-on-4” concept is based on the theory that a full arch of “fixed” (non-removable) replacement teeth can be supported by four implants when two of the implants are placed at an angle (see illustration), thereby avoiding critical anatomical structures like the sinus cavities and the nerve that runs through the lower jaw, and eliminating the need for bone grafting.
While the “All-on-4” procedure can be considered affordable compared to some treatment options, it is not the most economical implant treatment to replace your lower denture. In addition, if you have worn your denture for several years, you have lost not only a significant amount of bone, but also lip and cheek support, which would make it difficult to achieve a truly esthetic result with the “All-on-4” procedure.
Immediately following tooth loss, the supporting bone deteriorates or resorbs fairly rapidly. Dentures fabricated at the time teeth are removed will loosen quickly, and continue to do so over time. As the bone continues to resorb, there is less bone to support the lips and cheeks, resulting in changes in facial appearance. Dental implants function as substitute tooth roots and prevent additional bone resorption.
Often, a fixed prosthesis on several implants, or even the “All-on-4” procedure, fails to address all of the deficiencies caused by tooth loss and bone resorption, or satisfy patients’ esthetic concerns. If a significant amount of bone has been lost, the mouth will appear flattened without additional procedures to add bone for more tissue support. Also, for many people, these treatment options are simply too expensive.
For those patients who have lost all of their teeth, as well as significant bone, facial, and lip support, a removable overdenture, which fits “over” the implants, will often be the treatment of choice. Additionally, the two-implant lower overdenture (implant retained denture) is much more economical than a fixed prosthesis. Two dental implants, strategically placed, instead of the four or more needed to support a fixed prosthesis, are sufficient to comfortably support a lower denture, which is modified to fit on the two implants.
Studies over the past two decades have demonstrated the significant benefits of lower overdentures supported by two implants. In fact, back in May 2002, the McGill Consensus Statement on Overdentures stated “As a minimal treatment objective: the mandibular (lower jaw) two-implant overdenture should be considered as a first choice standard of care for the edentulous (missing all teeth) patient.”
The overdenture represents a simple, effective and predictable solution to the problem of loose, uncomfortable lower dentures. It results in a significant improvement in comfort and stability, and more importantly, patients report a consistently high level of satisfaction compared to their regular lower dentures. And since the lower overdenture usually requires only two implants, this is a treatment option that is much more economical than a fixed prosthesis, or even the “All-on-4” procedure in many advertisements.
It is also important to understand that advertising is designed to sell a particular product or service; in this case “All-on-4” implants. Additionally, this treatment option is not appropriate for all patients. It is a suitable treatment option for those patients who are missing all of their upper and/or lower teeth, only when they have adequate bone conditions to support a complete arch of teeth with only 4 implants supporting a fixed (non-removable) prosthesis.