Full Mouth Hard and Soft Tissue Rehabilitation
Dentures, or removable prosthetics, are a popular treatment choice for patients of all ages who seek basic dental function and acceptable cosmetic value. The economics or affordability issue involving denture treatments, however, can often cause tissue problems that are not anticipated by today’s younger patients.
For young adults, since we are all living longer compared to 30 years ago, a critical period can arise in older adult years were hard and soft tissue loss reaches catastrophic levels.
Ordinary denture products rest on the gum tissues that are supported by underlying jawbone or the “bony ridge.” Without the stimulation of teeth or implants, the bone tissue will slowly resorb or disappear that causes a similar effect of disappearing gums.
Representative Case History Example
The adjacent pictures show the cumulative effects of about 25 years of denture use (upper jaw) and denture partials (lower jaw).
The 2nd picture shows the extreme loss of the bony ridge and gums. The anchor points for the partials provided a crude level of stimulation that maintained a small amount of bone health…. which is good.
There are cavern-like gaps of lost bone between the remaining teeth and rear-most areas of the mandible, or lower jaw.
Comprehensive Bone and Tissue Augmentation
Extensive bone grafting procedures consisting of patient donated (autogenous) bone blocks harvested from different areas of the jaw and chin provided a superb foundation for regenerating new bone and gum tissue that competes nicely with what Mother Nature once provided.
To fortify the upper jaw for multiple implants, bone block grafts and sinus lift procedures placed bone graft material along the floor of the sinus cavity on an as needed basis that would provide an optimal depth of bone.
Assessing for minor differences in upper jaw bone dept is critical for assuring no breaches (perforations) of the sinus cavity floor occur…. a common issue for all upper jaw implant surgeries.
The porosity differences are substantially different for the upper and lower jaws. The mandible, or lower jaw, is quite dense.
The increased porosity of the upper jaw, which is Mother Nature’s method of providing a shock absorber requires close review to assure a consistent quality of bone from one end of the arch to the other.
Bone Augmentation: Depth – Width – Porosity
The adjacent photos reflect the amount of augmentation that was created along the entire upper jaw ridge of bone.
Depth, width and especially the porosity of the bone has been modified to assure a rock solid foundation for the fixed bridge prosthetics desired by the patient.
Note how leveling and filling in of low spots develops an idealized implant environment that will provide the best advantages for thorough osseointegration.
Temporary prosthetics were provided during the grafting surgery stages to assure the patient he would not be toothless during any phase of the treatment plan.
4 – 6 – 8 Implants
The adjacent photo reflects healthy integration of eight (8) dental implants. The concept of having an entire arch of teeth replaced on a foundation of 4 implants is becoming popular.
While four implants for a fixed bridge are considered the bare minimum it is important for patients to understand that more implants preserve more bone and distribute biting forces more efficiently that can eliminate the problem of implant failure due to a “too strong” of a bite.
To summarize… 4 implants are better than none, 6 are better with 8 or more being the best.
Premium Reconstruction: 8 + 8 + Titanium and Porcelain Fixed Bridgework
Going from 2 natural teeth to a full complement of 24 new “integrated” porcelain teeth produces an increase in dental function and cosmetic result that defies description.
A discriminating patient who “went without” for so many years while he focused on raising a family, finally took the opportunity to rebuild and replace what was lost long ago.
The dental products, technologies and procedures selected by the patient represent what many dentists would call the best of the best. He simply wanted the treatments that would deliver not only “exactly” what he wanted…. but with the best possible long term endurance that is possible with today’s dentistry.