dentures/implant-retained dentures

[Guest]

I haven't posted in awhile about my dentures and thank you for your help. I have my new upper and lower dentures and they are beautiful. In a few weeks I will have the two implants. I will not be moving for awhile, so that isn't a concern right now as my plans have changed. I went for an adjustment last week because I was having a difficult time learning to chew with them and I asked the dentist to please file down the top denture because the two front teeth are too long. She wouldn't file the ones that I wanted her too, just a little on the others(can't quite tell where-I think she was humoring me) and I couldn't quite get an answer from her as to why not? She did say my incisors were good. These two (need to be filed down and I asked her that when I come back after trying them for awhile, would she do it and she said no. I can bring my teeth together for a good bite, but these two hang below my lip. I also asked her to make the bottom ones not look so perfect and she said they can't be seen. She did file on them to give me a better bite, but I beg to differ, they can be seen and will be more visible after I have the implants for the secure denture. If there is a good reason for not having these two filed, then I will just have to accept it and learn to either not smile anymore or to cover my mouth when I do. Do you have any suggestions as to what I can do? Thank you, Gollilue
p.s. My old denture's teeth are just about the length I need for these to be and her assistant told her this to no avail.

 

[Guest]

Re: implant supported dentures

Hi there - this strikes me as a dentistry question rather than a support question, so if you'd like me to move it to the dentistry section (so that dentists can see it), please let me know. I really don't feel qualified to give an answer.
Could you also give some extra info on the set-up - might make it easier to get an answer (i. e. do you have a full upper and lower denture at the moment, or are you talking about a bottom partial? Is it two implants you're getting at the bottom)?

Cheers

PS: Actually, I'll try and give it a shot (no pun intended):

I went for an adjustment last week because I was having a difficult time learning to chew with them and I asked the dentist to please file down the top denture because the two front teeth are too long. She wouldn't file the ones that I wanted her too, just a little on the others(can't quite tell where-I think she was humoring me) and I couldn't quite get an answer from her as to why not?

When you have teeth extracted for a full denture, the bone that used to hold your top natural teeth begins to disappear/retreat upwards. This can cause your face to age.To prevent this facial aging from happening or slow it down, dentures should be relined every 2 years and replaced every 5-7 years. The replacement dentures need to have "longer" teeth (it's the pink plastic that is actually longer) to make up for the shrinking gums, to prevent the muscles that you use for chewing food from shortening (otherwise, the muscles shorten to accomocate the reduced space betweeen your nose and chin). If you wear the same denture for too many years, the facial muscles can change radically, which affects both appearance and function. At a guess, your dentist may trying to prevent this, hence her insistance not to shave them down.

If it's a long time since you last had your dentures replaced, this might explain why it's hard to get used to the length of the two front teeth.

That's just pure speculation on my behalf - I don't know what the actual situation is and how long it is since you last had them replaced - so I may be totally off the mark here!

Regarding making the lower teeth look "less perfect", what is it that looks unnatural about them? Colour, shape? It might be easy enough to make some adjustments?

Sorry that's all I could come up with - maybe someone else knows a bit more...

 

[Guest]

Thank you, letsconnect, for the great explanation. There will be no need to move this to a dentistry section, as I feel they will give me the same answer as you have. Now that it has been explained to me so very well, I can accept these teeth. I will get used to them and I need to be happy that they fill out my face more. As for the bottom denture, the color and shape are fine, its just that they are too perfect...I want them to look a little less perfect, but my dentist won't do it. Maybe I just need to realize that she knows what she is doing. Huh? Thank you, again. Gollilue P.S. Now if I could only chew with the bottom denture. I am only using soft foods. I have tried all types of adhesive and they don't work. She wants me to get used to these before the implants are put in, but this is a big problem for me.

 

[Guest]

Glad I could help !

I can't really give any tips for chewing with the bottom denture... did you have a bottom denture before, or is this a new thing for you?

 

[Guest]

For the last few years, I haven't had any bottom teeth, so this bottom denture is very new for me. I know it takes awhile to get used to them. I am very glad that I don't have much bone loss on the bottom, but, and this is a stupid question, is that one of the reasons I am having such a problem with this? My denture is very narrow and there is nothing for it to "grab" onto. (did that make sense?) No matter how careful I am with any type of adhesive, there is seepage? around the denture and I sure don't want to be swallowing that! Oh, well, next week, I go back for the original adjustment appointment and maybe she can suggest something more that I can do? I am only trying to chew with soft foods and I try to chew correctly, but it isn't working.
How used to these do I have to be and be able to adjust to the secured denture? She said it will be done in six weeks, but I if I don't have any improvement in my chewing by then, what can I do? Thank you, Gollilue
P.S. I just reread your post and realized that you said you couldn't help me with the chewing. Sorry. Maybe you could move this to dentistry for me? Thank you so very much for your help. I will also try your other suggestion.

 

[Guest]

I can't imagine it's due to LACK of bone loss... as far as I know, the "nothing for the denture to grab on to" problem is pretty normal with lower dentures, and that's why they're harder to adapt to... I came across this piece of advice, but you've probably tried that already: "Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the denture from moving. As you become more used to your denture, add other foods until you return to your normal healthy diet."

I thought the whole point of implant-retained dentures was that the dentures are held in place so that chewing doesn't pose a problem. I don't really know why you have to get good at chewing with the denture first

Are the implants in already? (I'm assuming they are, if the denture is going to be attached in 6 weeks time, or did I pick that up wrong?)

Anyways, I'll move this to the dentistry questions section - someone else might know more !

 

[Guest]

You've covered it all pretty well I think. I'm also a bit confused about learning to wear a bottom denture when it's about to be made utterly obsolete by the implants. Maybe it's just another way of making the time pass quicker waiting for the implants to osseointegrate

 

[Guest]

Thank you, letsconnect and Gordon.
Nope, I don't have the implants, yet. I get those the end of July. I am supposed to get used to the bottom denture first. I go back for another adjustment next week, but with the diffifulty I am still having chewing with them, I don't know if it will be satisfactory for the dentist.
I think that's why I am having to wait for the implants. Maybe? I am confused........
I chew just the way she told me to, with only soft foods, of course, but as I have said before, no matter what adhesive I use, it is difficult. This must be a test and I am miserably failing it! Ya think?
Gollilue

 

[Guest]

Are these mini-implants? What's the actual "plan of action" (the time-frame you've been given for placing the implants and attaching the bottom denture)?

 

[Guest]

I meant to get back on here sooner and I want to thank you for your replies. These are mini-implants and the dentist will be doing the procedure the end of this month. The steps will be completed in 3 months time. I am supposed to remove the bottom denture now when I eat, and gradually wear it again for eating. My dentist is on vacation this week and I asked her what she would be doing while on it. She replied, "Learning how to use the laser." This is a two day seminar. (if that's the correct word.) I am a little slow, so this information didn't register with me. While setting up the appointment with the receptionist, we were talking about the implants and she offhandedly mentioned about the minimal amount of bleeding I would have because the dentist would be using the laser. I had a nervous chuckle bubbling in my throat. Now I know why I was given the half off price on these implants. I don't mind being the guinea pig; I just would have liked to have known ahead of time. Gollilue

 

[Guest]

Thanks for the update ! What I don't get (but maybe it's something I picked up wrong) is the thing about 2 implants (usually with mini-implants, you need at least 4, as far as I was aware - so I'm a bit puzzled)

 

[Guest]

My dentist had at first said she would do four implants and then she changed it to two. Now, I am very concerned. Should I be? I don't have much bone loss on the bottom, could that be why I am getting only two? If my memory serves me correctly , the sample? secure denture she showed me had only two implants on it, but I have no idea if they were the mini ones. I had pulled it apart , per her instructions, to test how well it held together. Yikes! I suppose this means I should call her and find out? I made a point at my last visit to ask her if these are mini and she said yes. Maybe she found out at her seminar that she needs to do four instead? But then she would have to contact me with this information. I'm nervous enough already!
Thank you, Gollilue

 

[Guest]

Is it at all possible that when you asked her if they were mini and she said "yes", she was not referring to them in "technical" terms but in layman's speak ("mini" as in "small")? This might just be a miscommunication , but it's best to clear this up beforehand for your own piece of mind. With "ordinary" implants, 2 or 3 are usually all that's needed, whereas with mini implants, the general consensus is 4-6 (as far as I can figure - so far!).

I'll try and get some expert opinions on the matter and post back !

 

[Guest]

Thanks, letsconnect. I'll be looking forward to the expert's opinion on this, even though you have been very informative. [image] I found my note of some questions to ask the dentist on my last visit and I had asked her about mini implants. I found this while searching today........while a minimum of two dental implants may be inserted , a person may receive three or more, it depends on certain things. More will give additional support to the implant denture. I didn't want to copy this verbatim-didn't know if I should- , but it explains it somewhat. I was going to call her today, but decided to wait until I had more information about it before I do. Thanks, again.
Gollilue

 

[Guest]

OK, below is the low-down on implant and mini-implant retained bottom dentures, as far as I could make out (bear in mind that dentist's clinical opinions may vary):

Most dentists feel that a bottom denture with 2 mini-implants won't last (due to excessive lateral forces). 4 (or 6) minis are required. 2 minis are sometimes done when this is all the patient can afford - it's a financial decision. The use of 4 minis is indicated to decrease the rocking on what would otherwise be 2 minis causing a 'teeter totter' effect with the denture. 4 minis placed on an arch with at least 5 mm between the most anterior (frontal) mini and the most posterior (furthest back) mini will greatly reduce this rocking (see picture at bottom of thread - TRIGGER WARNING: do not scroll down if upset by graphic pictures)

The advantages of mini-implants are that they're cheaper, minimally invasive and very fast to place (4 mini-implants can be placed and the existing denture retrofitted in little over an hour by a fast operator).

The disadvantages are that they may not withstand the lateral forces (I assume that's biting forces, but not sure) as well as "standard" (root form) implants, and that long-term studies as to their success (how well they hold up over a longer period of time) are missing. No real independent research into the durability of mini-implant retained dentures is available. Mini implants are designed to stop the denture from falling out, but don't really "retain" it in one spot, according to some dentists (apparently, they will move around a little).

Some implantologists would argue that they are not viable long-term and advocate 2-3 root form (standard) implants instead of 4-6 mini-implants. Some say the failure rate is relatively high longer term. Others say they hold up well and swear by them. General dentists who also place implants appear to be more keen on minis than implantologists. But because the technology is relatively new, only anecdotal evidence is available and it's impossible to tell. Still, the general consensus is that 2-3 standard implants would have a better long-term prognosis. But it can also be argued that mini-implants are relatively easy to replace even if they fail. Still, the failure rate of mini-implants appears to be quite a bit higher than for standard implants.

The disadvantages of standard implants are that you should wait 8 weeks minimum before attaching the bottom denture to them (to make sure that complete integration with the bone has occurred). They are more expensive, and the procedure is more invasive. Sometimes bone grafts may be necessary. If there's not enough bone structure, mini-implants can often be used without the need for a bone graft. The general consensus is that if the patient has the money, isn't medically compromised, and doesn't mind the more invasive procedure, then standard implants are the preferable option. Mainly because longevity is more predictable than with minis.

Having said that, minis have the best chance in the anterior mandible (lower jaw) due to better bone quality - and this is where they're placed for mini-implant retained bottom dentures.

So there are pros and cons to both systems, but you do need at least 4 minis or 2 standard implants. If a dentist recommends only 2 mini implants, this is usually due to financial considerations (if the patient can't afford 4 minis). It's sort of better than nothing, but there would be great concerns about longevity with only 2 minis. Having to redo them might work out more expensive than getting 4 in the first place (although even then no guarantees for longevity can be made - as with any implant system, but standard implants are "tried and tested" and generally hold up very well).


I hope the above isn't too confusing

 

[Guest]

Click on the link below to see the mini-implant setup. The horizontal lines sort of illustrate how 4 minis will prevent a 'teeter totter'/rocking effect. Simple physics, apparently - but even for someone with absolutely no knowledge of physics like myself, it's easy to see how the denture would be more stable:

http://img315.imageshack.us/my.php?image=mini15aa.jpg


You can read more about mini-implants here: http://www.doctorspiller.com/mini_implant_retained_dentures.htm
(warning: contains explicit images)

 

[Guest]

Thank you, letsconnect. I found your great explanation of the implants very informative. Before my dentist even knew my financial state, she changed her mind from four to two implants, so it couldn't be that. On my first visit, I paid for all of the services rendered that day in cash. The next visit I paid in full for the implants and financed my dentures through CareCredit, so it isn't a matter of a financial problem , as I can finance more, so I don't understand why she has decided to do only two. Perhaps after her laser lessons (& talking to the instructors?), she will change her mind and do four. I certainly hope so and I am wondering if I should have been so eager to pay for them that quickly until I educated myself about them. Thank you, again. Gollilue

 

[Guest]

Might be an idea to have a chat with your dentist again, just to clear up exactly what she has in mind - it's very difficult to take in all the relevant information (esp. if it's done verbally and you haven't had much written communication and pictures). She should be happy to explain to you some more (and clarify if she's indeed talking about two minis and the reasons why she suggests this option). It might just be some minor misunderstanding.

Please let us know how you get on - and any questions, just ask (everyone's back from their holidays and/or working holidays now, so it'll be easier to grab hold of our dentists, lol ).

 

[Guest]

I want to ask the dentists their opinion on my receiving only two mini implants for a secured denture and the use of the laser that my dentist has just learned to use. I'm afraid it's going to end up costing me more in the long run, plus the time involved, if only two are done and I don't know if I have any recourse, as I agreed to this and the implants are paid for. I should have educated myself on this before agreeing to anything. Thank you, Gollilue

 

[Guest]

I have a number of Q's that will help me advise you as best I can:

Is this an upper or lower denture? Or both?
How long have you had this/these dentures?
Do you have a problem eating?
Do you have a problem speaking?
Do you have a problem with the appearance?

Why was it recommended to you that the mini implants be placed?

In what manner is the laser to be used?

These mini implants and laser use is the latest "hot" thing here in the US for all the "high tech" "upscale" Docs......

I'll keep an eye on this thread, and will try to help you when I know a little more about the situation.

Thanks......Glenn