When restoring chewing function and installing dentures, the presence of native teeth in the mouth plays an important role. Today, with complete adentia, the choice of prosthetic methods is quite wide. Before deciding on the material and type of products, it is worth finding out all the advantages and disadvantages of the available methods for restoring the dentition.
The nuances of prosthetics in the complete absence of teeth
All possible options for solving the problem of complete absence of teeth can be divided into two main groups - these are removable dentures and implantation. The first and second options have several ways of execution. In order to finally make a choice, it is important to understand what tasks are designed to solve dentures, as well as take into account lifestyle, financial capabilities, etc.
Fixed prosthetics
In order to solve the problem of missing teeth once and for all and make your smile as natural as possible, you should think about implantation. The advantages of the procedure are the aesthetic appearance of artificial teeth, comfort while eating, no need to remove the structure for cleaning, etc. The implants “sit” firmly in the bone tissue, so there is no danger that the jaw will fall out of the mouth.
Implantation
It is not uncommon for a completely edentulous patient to wish to have all of their teeth implanted. To do this, an artificial root is implanted in the upper and lower jaw in place of each missing tooth, then an abutment is put on it and a crown is fixed. This procedure is fraught with some difficulties:
- If the loss of teeth did not occur immediately, but over time, there may be a lack of bone tissue in the jaw areas. A long absence of a tooth leads to resorption (atrophy) of the bone on which it was held. This problem is solved with the help of sinus lifting procedures, bone augmentation. However, after this event, at least 6 months must pass before implantation.
- The implantation procedure is quite complicated and involves risks: bleeding, poor engraftment, infection, etc. Installing 28 implants is more traumatic than 2-3.
- A large number of implants will cost a lot. Often, patients, in an effort to reduce costs, ask to put not 28 teeth, but 24.
Before proceeding with the implantation of teeth in the upper jaw, it is recommended not only to perform an x-ray, but also to consult an otolaryngologist. This is due to the anatomically close location of the paranasal and infraorbital sinuses with the jaw bone tissue. With a high probability of perforation of the septum, it is worth abandoning the implants in this area and thinking about other methods of restoring the row.
With an implant-supported bridge
Today, there is a method of fixed prosthetics that is more accessible than full implantation (we recommend reading: how is dental prosthetics carried out in the absence of a large number of them?). We are talking about the installation of a bridge or beam structure based on implants. This means that much fewer artificial teeth will have to be implanted - from 8 to 14. Bridges and artificial teeth can be made of metal-plastic, metal-plastic or ceramic. There are several execution methods:
- installation of 8 implants on the upper and lower jaw, which serve as a support for the bridge, and help to properly distribute the masticatory load;
- implantation of 4 implants when it is impossible to use more supports.
Removable prosthetics
To date, the level of implementation of removable prosthetics allows it to compete with the highest quality fixed prostheses. The main disadvantage of wearing removable structures is the likelihood of them falling out of the mouth while talking or eating. However, this problem is solved by high-quality materials, the perfect fit of the prosthesis, as well as the use of special creams to fix the device.
Acrylic plastic structures
The most affordable and simple are plate dentures made of acrylic plastic. They are a base that is attached to the gums by a vacuum method, with artificial teeth fixed on it. Such designs can rub on soft tissues and are not always well kept in place, since their base is quite hard. In addition, in some people, wearing the upper jaw can cause a gag reflex, as the plastic arch affects the soft palate.
Soft nylon prostheses
Soft nylon prostheses that are comfortable to use and aesthetic in appearance are popular. They do not rub the gums, almost do not cause discomfort. Nylon products are made of a hypoallergenic material that does not contribute to the settlement and reproduction of microorganisms. However, due to their softness and considerable flexibility, such prostheses unevenly distribute the masticatory load, which is taken over by the gums. In this regard, nylon products are not often used: only in patients who are allergic to acrylic, as well as in children for temporary prosthetics.
Designs based on implanted implants
Removable structures can be used with implant support. This option is used for severe atrophy of the alveolar processes, when a removable prosthesis is not held on the jaw with the help of a vacuum effect.
Few implants are required - only 4 pieces for both jaws. Sometimes mini-implants are used, the diameter of which is 4 times smaller than usual, and the protruding part has a spherical shape. Such supports are installed relatively quickly, and due to the small diameter, they take root better.
Clasp prosthetics
To install clasp structures, which are a metal frame with artificial teeth fixed on it, a support is required. It can be represented by native teeth or implants, for which the product is attached. The metal base is covered with a material that simulates the gums, and the teeth are made of ceramic or composite.
Clasp prostheses are considered to be one of the best and most physiological, besides having an excellent appearance. They are fixed in the oral cavity using several types of fasteners:
Is it possible to use prostheses without a palate?
Most removable dentures for the upper jaw cover the palate. This is a significant drawback, it is fraught with the following inconveniences:
- violation of diction;
- overlapping of a large number of taste buds, which leads to a change in taste and loss of pleasure from food;
- in some people, a foreign body that affects the soft palate causes a gag reflex;
- salivation is sometimes disturbed;
- the tongue lacks space, which causes chafing and microtrauma.
Many new generation designs are made without a sky. Among them are clasp, as well as nylon (Kvadrotti). Such devices have a connecting plane between the two sides of the row - metal or nylon, but it is thin and does not cover the main part of the arch. Both types of prostheses without a palate are not budgetary, but their cost is fully justified.
Advantages and disadvantages of different types of prosthetics
Before finally choosing a method of prosthetics, it is worth weighing all the pros and cons. It is important to determine what the main goal of replacing teeth is - aesthetics, good functionality, ease of use, as well as assess your financial capabilities. It is difficult to unequivocally answer the question which prostheses are better. Almost every type of structure has its advantages and disadvantages. Let's look at them with a table.
| Type of prosthetics | Advantages | Flaws |
| Full implantation | Aesthetics, comfort during a conversation, eating. Implants do not rub soft tissues and do not strive to fall out of the mouth. They do not require special care. | High cost, the need for preliminary bone growth, trauma. |
| Implant-supported bridges | Relatively aesthetic appearance, do not require regular relining, prostheses are firmly held in place. | High cost, albeit lower than full implantation. |
| Removable nylon dentures | Translucent and flexible material is comfortable to use, the appearance is natural. There are designs of a new generation without a sky. | Not durable and quite expensive. Unevenly distribute the chewing load. Most often used as a temporary option. |
| Clasp structures | The most physiological, easy to use, correctly distribute the load. | They are not budgetary, they require preliminary implantation of implants. |
| Lamellar prostheses | Affordable and does the job. | Close the sky, rub due to inelasticity. May fall out of the mouth, require regular relocation. |
Against the background of chronic diseases, malnutrition, mechanical damage or old age, people can lose a large number of molars and premolars. In such a situation, prosthetics comes to the rescue - restoration of the dentition through special structures (prostheses).
Let us consider in more detail how dental prosthetics are carried out in the absence of a large number of teeth and what is the peculiarity of the techniques. See also: what are the benefits?
Types of prosthetics in the absence of a large number of teeth
To effectively restore lost functions in the absence of a significant number of teeth, various methods of prosthetics are used. The service life of the structure and comfort during wear directly depend on the correctness of its choice. To choose the optimal technique, experts take into account:
- type of occlusion;
- the nature of age-related changes in soft tissues;
- the state of the remaining roots;
- functional group of teeth.
Attachment methods are selected depending on the type, size, material of the prosthesis For a more reliable fixation of removable structures, orthopedic dentists advise using special tools (gels). In the complete absence of teeth, the fixation of a fixed prosthesis is carried out in one of three ways:
- push-button. On the surface of the implanted titanium root there are balls on which the structure is attached. The artificial jaw has a plastic matrix;
- block. An orthodontist implants several implants in the area of the front teeth, interconnected by means of a steel rod;
- on porcelain crowns. The specialist installs four implants in each jaw, which ensures reliable fixation.
Implantation
Prosthetics on implants is a worthy alternative to a removable prosthesis. In the absence of a large number of teeth, implantation is often resorted to (taking into account the absence of contraindications). This technology allows you to restore lost diction, increase self-confidence, and restore facial proportions.
A titanium root is implanted into the bone tissue, and after engraftment, an abutment and a prosthesis are installed. With the loss of a large number of molars, the following types of implantation are resorted to:
- complete (classical technique). Its essence lies in the implantation of the implant in place of the missing tooth;
- All-on-4. Prosthetics according to the method is carried out using four implants installed at a certain angle;
- All-in-6. The prosthesis is fixed on six implants. This technology is more reliable than All-on-4.
Prostheses on implants are characterized by reliable fixation Pros and cons
Among the main advantages of implantation:
- preventing further atrophy of bone tissue;
- no restrictions in the diet;
- high aesthetics (artificial teeth cannot be distinguished from natural ones);
- maintaining the shape of the gums;
- lack of turning the surface of the molars;
- long service life.
The disadvantages include high cost, the presence of a wide list of contraindications and a long period of engraftment of the prosthesis (about 2-6 months, depending on the chosen technology). Implant manufacturers guarantee implant healing in 96-99% of clinical cases.
However, in rare situations, rejection of the implant may occur. When choosing high-quality materials, carrying out the procedure in a proven clinic and following medical recommendations, the likelihood of rejection is minimized.
This orthopedic design completely models the dentition of the upper or lower jaw. The basis of a complete removable denture imitates part of the soft tissues of the oral cavity and serves as a fastening for an artificial dentition. The boundaries of a complete removable denture end at the point where the gum tissue connects to the mucous part of the lips. Unlike a partial denture, a full denture does not have clasps (hooks for attaching the denture to natural teeth), so the fixation of the denture is provided by a base that covers the palate. The whole structure does not have metal components, which is why among specialists such a system is called a “complete removable lamellar denture”. Do not confuse a removable plate denture, used in the complete absence of teeth, with conditionally removable dentures, which are also installed in the case of adentia. These structures are placed on implants, and only a doctor can remove them, while a conventional plate prosthesis can be removed at any time on its own for cleaning or oral hygiene.
Complete dentures for the lower and upper jaw.
Which full denture is best?
Today, there are quite a lot of such structures on the market, so the question of which complete removable dentures is better is quite reasonable. In the case of this type of orthopedic system, the main factor that determines its quality has been and remains the material of manufacture. Designs on mini-implants, which are conceptually different from other designs, stand apart. What materials for complete removable dentures are most often used, we will describe below.
| Types of complete removable dentures | Description |
| These are the best complete removable dentures that are installed after implantation. Fixation is also possible on mini-implants. They are installed not in the bone (like classical ones), but in soft tissues. Mini-implantation allows you to achieve optimal load distribution and the most reliable fixation among all types of removable dentures. | |
| Complete removable acrylic denture | The most affordable, but at the same time the least quality complete dentures, which are made of acrylic resins. |
| Complete removable nylon denture | A more elastic and comfortable prosthesis, which is superior to plastic structures in terms of aesthetics and comfort, but distributes the masticatory load worse (does not apply to all models). |
| Complete removable prosthesis Akri Free | The best removable denture in its class for total absence of teeth. The Akri Free prosthesis is hypoallergenic and comfortable to wear, however, it has sufficient rigidity for a high-quality restoration of the chewing function. |
Complete removable prosthesis supported by implants.
Full upper and lower dentures - what are their differences?
As already mentioned, the fixation of complete removable dentures has its own characteristics. Since the patient does not have natural teeth, the palate and soft tissues are used to fix the prosthesis.
Complete prosthesis for the upper jaw
A complete removable prosthesis for the upper jaw is placed on the alveolar processes, and special suction cups on the artificial palate make the fixation stronger.
Complete prosthesis for the lower jaw
As for the lower jaw, only the alveolar processes are involved in the fastening (the so-called complete removable denture without a palate), so the design on the lower jaw is less stable. That is why mini-implantation is considered the best option (if it is impossible to carry out a classic one).
If several natural teeth are preserved on one of the jaws, then clasps or attachments provide a more reliable fixation, however, in this case, the prosthesis will be already partial, not complete. It should not be forgotten that partial and complete removable dentures have a different principle of attachment, so the latter will lose in terms of stability and stability in any case.
Complete dentures for the upper jaw.
Making a complete removable denture
The manufacture of a complete removable lamellar denture is quite fast. The design itself does not have complex elements, and the patient does not need a preparatory period (with the exception of the installation of a prosthesis based on implants). Modern methods for the manufacture of complete removable dentures imply the receipt of a finished structure 10-14 days after the initial visit to the clinic.
Stages of manufacturing a complete removable denture:
- Initial consultation. X-ray of the jaw and choice of prosthesis.
- Removal of casts.
- Model casting.
- Making a wax base.
- Determination of the ratio of the patient's jaws, correction of the prosthesis in the articulator.
- Making the final model after a successful wax fitting.
- Correction and processing of the finished prosthesis.
- Installation of a complete removable prosthesis.
The manufacture of removable dentures in the complete absence of teeth is usually not accompanied by big mistakes on the part of doctors, however, if at the fitting stage the design gives you severe discomfort or pain, immediately report it.
How much does a complete removable denture cost?
Prices for removable dentures in the complete absence of teeth are considered quite attractive, so prosthetics with complete dentures are in demand. At the same time, one should not forget that such structures only partially restore functionality and aesthetics, and they serve for a relatively short time (on average, up to 5 years).
The complete absence of teeth (dentia), which occurs mainly in the elderly, is a common problem. Regardless of the reasons, adentia is a complete and unconditional indication for urgent prosthetics. What are the best dentures for the complete absence of teeth? This article will help you understand the many dental services aimed at restoring the dentition.
Several factors contribute to the occurrence of adentia: natural wear of enamel and dentin, periodontal disease, untimely access to the dentist, ignoring elementary hygiene requirements, injuries, and chronic diseases.
The lack of even 2-3 teeth is very noticeable and unpleasant, and when it comes to their complete absence, it can be said without exaggeration that such a condition is a serious pathology that entails many negative consequences:
Adentia can be the result of injuries, as well as various diseases.
- Disorders of the gastrointestinal tract (GIT), as a result of poor chewing of food and malnutrition.
- Negative changes in appearance - a patient with a complete absence of teeth acquires a characteristic elongated oval of the face, a protruding chin, sunken cheeks and lips, pronounced nasolabial folds.
- Significant violations in colloquial speech: teeth are the most important and integral part of the articulatory apparatus, and their lack, and even more so the absence, leads to the appearance of diction defects that are very noticeable to the ear.
- Bone tissue degeneration of the alveolar processes (gums), which, in the absence of roots, become thinner and smaller in size, which in the most advanced cases makes it difficult or impossible for high-quality implantation (prosthetics).
The cumulative result of all the above problems is significant psychological discomfort, communication disorders, limiting oneself in vital needs: communication, work, good nutrition. The only way to return to a quality life is to get dentures.
Contraindications for prosthetics
Cases in which dental prosthetics are prohibited are rare, and nevertheless, a qualified dentist must make sure that his patient does not suffer from one of the following ailments:
- individual allergic reaction to the chemical components that make up the material;
- intolerance to local anesthesia (important for implantation);
- any viral disease in the acute stage;
- severe form of diabetes;
- oncological disease;
- mental and neurological disorders during the period of exacerbation;
- blood clotting disorders;
- severe lack of weight and depletion of the body (anorexia, cachexia).
Obviously, many contraindications are temporary, while others lose their relevance with the right choice of restoration method.
Removable dentures in the complete absence of teeth: difficulties and features
Another negative point with adentia is a very small selection of possible ways to restore teeth. Existing methods are either expensive or have many disadvantages. A nylon prosthesis is in great demand in the complete absence of teeth. But when choosing the optimal method of prosthetics, it should be remembered that a complete removable restoration of the entire dentition has a lot of features:
The main feature of complete dentures is that they do not have fasteners.
Does this mean that it is better not to resort to this method of restoration? Certainly not. Despite the fact that the best restoration method for completely missing teeth is, the use of a covering prosthesis also makes sense. It will help those who do not have the financial ability to put implants, as well as patients whose bone tissue is loose, which is a contraindication to implantation.
Types of complete dentures
Orthopedic products used to restore completely missing teeth have approximately the same design. These are arched prostheses, which on the lower jaw are held only on the gums, and on the upper jaw they also rest on the palate. The teeth in dentures are almost always plastic, and the base can be made of different materials. It is on this basis that they are classified.
Expert opinion. Dentist Yanovsky L.D.: " named after the name of the polymer from which their basis is made. Nylon is a translucent, strong, flexible and elastic material with good wear-resistant qualities. Its advantages include good aesthetic performance and hypoallergenicity, which favorably distinguish this type of dental structures from others. Considering that two out of ten people on the planet suffer from allergies to acrylic or various types of metals, for many, a nylon prosthesis in the absence of teeth is a panacea in terms of convenience and quality.
Made of acrylic - a more modern and perfect variety of plastic. It is distinguished by resistance to wear and aggressive acid-base environment, which makes acrylic a fairly popular material in dental practice. However, he has a number shortcomings, which put it an order of magnitude lower than nylon:
Both nylon and acrylic prostheses do not have any attachments - this causes difficulties in fixing them. The use of special glue, which lasts for 3-4 hours, can slightly improve the situation, but this also brings only temporary comfort. The only way to get rid of discomfort is to install polymer prostheses on implants.
Prosthetics on implants in the complete absence of teeth: advantages and types of procedures
The main advantage of implantation is reliable fixation, thanks to which the patient does not have to worry that the prosthesis will fall off at the most inopportune moment. Chewing food is also greatly facilitated: there is no need to limit oneself in taking solid and viscous foods, and this has a positive effect on the state of the gastrointestinal tract and intestinal motility.
One of the first questions of interest to people who decide on implantation is the required number of implants. In each specific clinical case, this is decided individually, and the decisive factor is the condition of the patient's bone tissue. On average, at least two implants should be installed on each jaw to hold the entire structure.
If the patient is determined to undergo surgery, and the condition of the alveolar processes does not allow it, he can undergo a sinus lift - a technique for building up bone tissue using special materials. Modern dentistry has several methods for implanting implants, however, in the absence of teeth, it is rational to use only two of them - beam and push-button.
Button implants- a fairly reliable and relatively inexpensive method of restoration. During the operation, two implants are implanted into the gums, which end in a ball that looks like a clothes button. On the side of the prosthesis, there are holes, which are the second part of the attachment. This device allows the patient to remove the prosthesis daily for thorough cleaning.
Implantation on beams provides for the implantation of 2 to 4 implants interconnected by metal beams that increase the support area for a more thorough fixation of the prosthesis. Just like button implantation, it requires periodic removal, but at the same time pleases with good functionality.
Fixed dentures, in comparison with removable structures, have a longer service life, are more comfortable to wear, are better fixed, and have an aesthetic advantage. In addition, they allow you to keep the bone tissue healthy and prevent its atrophy.
The non-removable option of orthopedic treatment is suitable for young and middle-aged people, as well as for anyone who suffers from intolerance to removable structures. It is optimal for public people due to its aesthetic qualities and the absence of speech problems.
Types of fixed dentures
In dental practice, several types of fixed structures are used, which differ in their design, purpose and method of fixation.
Micro prostheses
Overlays. We are talking about veneers (from the English. Veneer - to give an external gloss, mask), which serve to change the shape and color of the teeth. High-quality onlays are made of ceramic and fixed to the surface of the tooth with cement. Their thickness is from 0.2 to 1.5 mm.
Tabs. They replace light-polymer fillings and, in comparison with them, are more reliable and aesthetic. Like veneers, inlays serve to restore the shape and color of partially destroyed teeth, but are fixed not on the surface, but directly inside the crown. The most popular tabs are ceramic. But they are also made of gold, chromium-cobalt alloy, zirconium dioxide.
Crowns
Crowns are single prostheses for teeth, the crown part of which is destroyed by more than 50%. With their help, damaged teeth become strong again, perform their chewing and aesthetic functions. Crowns are made from the following materials:
- metal (chrome-cobalt alloy, gold);
- cermets (with a base of precious metal alloys, chromium-cobalt and chromium-nickel alloy);
- ceramics (porcelain, zirconium dioxide).
Bridges
Bridge structures consist of three or four crowns. One or two crowns in the center of the bridge serve as prostheses, and two crowns at the edges are used as a support. They are used in the absence of one or two adjacent teeth, provided that there are supporting teeth on both sides.
Prostheses for the entire jaw on implants
In the complete absence of teeth, the best option is prostheses for the entire jaw, which are attached to implants (four or six). Such structures are also called conditionally removable. They consist of two such parts:
- non-removable (implants with a base for a crown);
- removable (artificial teeth with built-in ceramic-metal crowns, which are put on bases fixed on implants).
The removable part can only be removed by a dentist.
Such modern designs of the new generation are also called telescopic prostheses, because the features of the docking of their parts resemble the principle of the structure of a telescope.
Pros and cons
Fixed structures are characterized by the following advantages:
- high aesthetic effect (they look more natural than removable ones, they also do not have any fasteners that are visible to others);
- long service life (removable structures serve an average of 5 years, while ceramic microprostheses and crowns - 10, 15 and some even 20 years, and implants - throughout life);
- strong fixation (unlike removable options that may fall out);
- ease of care (they do not need to be removed several times a day, like removable ones);
- prevention of bone tissue atrophy (fixed prostheses take on the masticatory load, preventing a decrease in bone tissue).
Flaws:
- Tooth preparation (removal of hard tissues of the tooth, if necessary).
- Creating an impression of the prepared tooth.
- Fixation of a temporary prosthesis (made of plastic, filling material).
- Fabrication of a permanent prosthesis.
- Fitting.
- Installation.
Prostheses on implants are installed differently:
- Insertion of implants.
- Making a prosthesis.
- Fixation of the prosthesis on implants.
Fixation features
Features of fixation of fixed dentures are that for the installation of some of their types, grinding of supporting teeth is required.
We are talking about veneers (the only exception is very thin Hollywood veneers, which do not require any enamel processing), crowns and bridges. In the last two cases, it is often necessary to remove the nerve and seal the canals of the supporting teeth.
After such preparation, the teeth will no longer be able to function fully if the veneer, crown or bridge is removed from them.
Care
Fixed dentures require the same care as real teeth. To maximize their service life and maintain aesthetic qualities, it is recommended:
- give up bad habits (the habit of biting nails and hair ends, cracking nuts, peeling seeds);
- protect artificial teeth from mechanical damage (mouth guards for the night with bruxism - pathological grinding of teeth, for the duration of traumatic sports);
- limit the use of products with dyes (cements on which onlays, inlays, crowns and bridges are fixed can change color);
- don't miss prof. check-ups at the dentist (every six months).
Prices
The average cost of fixed structures is as follows:
- overlays - 12,000 rubles for one veneer;
- tabs - 5,000 rubles per unit;
- crowns - 4,000 rubles for metal, 8,500 rubles for ceramic-metal and from 13,000 rubles for ceramic;
- bridges - the cost of the crown, multiplied by three or four (depending on the design);
- prostheses on implants - from 100,000 rubles.
In terms of cost-quality ratio, non-removable prostheses with metal-ceramic crowns are leading. They are quite durable and quite aesthetic.
For single crowns, however, metal-free ceramics are a better option, albeit relatively expensive. One and a half times more expensive than ceramic-metal ones (8,500 and 13,000 rubles, respectively), they provide the maximum aesthetic effect - ceramics look just like a real tooth.
In addition, metal-free ceramics are hypoallergenic, which cannot be said about metal-ceramic structures. Otherwise, their differences are insignificant: the service life and installation process are the same.
The result of orthopedic treatment largely depends on the qualifications of the orthopedic dentist. On our website you can find information about all the clinics that effectively practice the restoration of the dentition with the help of fixed structures.
Loading...