Patients with no Teeth in lower Jaw |
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Case 1 - Use of two implants to stabilize a lower denture
The patient has no lower teeth and has been having trouble eating without significant pain. This patient present to our practice complaining of a loose lower complete denture. After careful examination, it was determined that 2 implants with a stud attachment could be use to solve the problem.
With the help of a radiograph we can determine if there is sufficient bone height and width to then select the appropriate implant length and size
Several month after placing the implants, they are uncovered and now ready to use.
Two implants are placed into the bone and attachments are placed into the implants to snap into opposing attachments in the denture. Once the denture is fabricated, the posts are placed over the implants. These posts are the retentive parts that will help the denture stay in place during function, such as chewing, talking, etc.
A mold of the lower jaw is obtained to then make a new denture. The position of the implant is transfer to a model so the laboratory can complete the denture.
This photo shows the receptors placed into the denture which will snap into the parts in the implants. These receptors will fit very tightly over the post. The denture is now completed and ready to be placed in the mouth. This denture comes in and out of the mouth to ensure proper oral hygiene.
The new dentures allow for return to normal function for the patient.
Case 2 - Example of a patient with 5 implants and a precision milled bar to retain a new set of teeth
This model shows a precision bar secured to five implants. The precision of the bar will allow for a fixed set of teeth which can be removed by the patient for cleaning.
The precision bar is screwed into the implants. It is made under very strict controlled conditions.
The inside of the prosthesis had a metal framework which fits tightly against the precision milled bar. There are attachments which then lock it onto the bar so the teeth are fixed in position.
This picture shows the position of the attachments which willlock the teeth onto the bar.
Case 3
Fixed-Detachable Prostheses: This is a specific type of implant prosthesis. It is solely supported by implants and it does not come out of the mouth. The patient cannot remove it, only a dental professional is able to. They are specific indications for its use; please consult with our team to see if you are a candidate for this option.
This patient is complaining of a loose mandibular complete denture. His desire is to have something that does not come out of his mouth and gives him comfort and satisfaction when chewing all types of foods.
A new denture is fabricate to correct the esthetic, phonetic and functional problem. This denture is used to create a surgical template to guide the surgeon in the position of the implants.
Once the implant are placed and allowed to heal, a mold will be taken to fabricate the final prosthesis.
The final prosthesis consists of a metal substructure that contains teeth and pink acrylic that is screw to the implants.
The metal bar is kept over the gums to allow for proper oral hygiene. This space is not visible since the lower lip covers it.
Once the teeth are in placed it cannot be removed by the patient only the dentist. The screw holes are filled with tooth color fillings.
Case 4 - Replacement of all lower teeth with a fixed “hybrid” denture
This xray shows multiple implants placed into the lower jaw in a patient who had no lower teeth.
The “hybrid” denture is screwed into the implants and is only removed as necessary by the dentist.
This is a 15 year follow up photograph of the fixed hybrid denture. Note there is space to allow for easy cleaning.
Case 5 - Teeth in Three Hours, Immediate provisionalization of teeth in the lower jaw.
This patient has no lower teeth and her denture hurts when she chews.
Five implants are placed into the lower jaw and the prosthetic parts are screwed into the implants at the time of surgery.
After the gums are sutured, parts are placed into the abutments by the Prosthodontist.
The patient’s denture has holes or a slot created to fit over these parts. Acrylic is placed to bond the parts to the denture.
The acrylic is smoothed and the temporary fixed set of teeth polished.
Within 3 hours of implant surgery, the patient leaves our office with a fixed set of teeth, screwed into the implants.
After four months for bone to complete its attachment to the implants, the temporary prosthesis is removed. Note the healthy gums around the implants.
Impressions are taken. A computer is used to design and mill a perfect bar made of titanium. The bar is seen here tried in the mouth to confirm a perfect fit.
Teeth and acrylic are added to complete the final teeth. This is the undersurface which is very smooth and prevents food accumulation.
The final set of teeth are screwed to the implants and are removed only by the dentist.
A small space is left between the gums and the teeth to allow the patient to clean and maintain healthy gums.
Case 6 - Fifteen year follow up of five implants and a fixed/removable mandibular prosthesis
Five implants were placed. A precision milled bar was fabricated and secured to the implants with screws. The bar has sufficient height and strength to support a full set of lower teeth.
The xray shows excellent bone preservation 15 years after implant placement
The inside surface of the teeth have a metal structure which mates to the bar. Small plunger type attachments are pushed in to engage the bar and fixed the teeth in position.
The patient places the teeth over the bar and pushes in the plungers to secure the teeth and can chew solid foods without problems.
Case 7 - Replacement of all lower teeth using ct scanning, virtual surgery, all in one hour.
This patient required extraction of all of her lower teeth. She had the teeth removed and a temporary denture placed, which she did not tolerate.
Her lower denture was duplicated in clear acrylic for use as a guide for the imaging process.
At the time of ct scan, the patient wore the duplicated denture with a bite registration to make sure the prosthesis was perfectly positioned.
The ct scan was then converted in a computer and with the use of a special program implants were placed into the bone on the computer.
The virtual computer surgery allowed placement of the implant into the bone making sure the implants were properly oriented to the planned prosthesis.
A drill guide was fabricated using the computer virtual surgical plan, and was used to place the implants. The implants were placed without incisions and under local anesthesia.
The final set of teeth were fabricated in the laboratory using the computerized surgical plan. The framework of the teeth was milled from a solid piece of titanium, which makes the teeth very light and strong.
Immediately after the implants were placed, the new final set of teeth were screwed into the implants, providing implants and teeth in less than one hour.