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I spotted a thread entitled "Implants vs Dentures" on the Dental Twins Message Board, and because it's a frequently asked question, thought I'd post it here (slightly abridged) 
:
QUESTION:
I am in my mid 50's and my mouth is in very bad shape. My question, is it possible to extract and have dentures fitted and then go back and have implants? From what is described, would I be a candidate for implants in any event given the bone loss?
ANSWER:
First, allow me to dispel a common misconception that is suggested by the subject of your question-- "implants" versus "dentures". This is somewhat akin to comparing apples and oranges, because although the term "dentures" refers to a particular class of dental prosthetic device, the term "implants" does not. Implants are best conceptualized as representing artificial tooth roots that are surgically implanted in the gums; what you do with those "roots" includes a wide variety of different approaches. You can attach a single crown to an implant fixture, or you can place several implants distributed around the upper or lower jaw and create a removable denture that snaps onto those implants with attachments, or you can place many implants and fabricate a fixed bridge. In other words, the question is not whether you will have a denture OR implants, but whether you will have a conventional denture or an implant supported denture, or whether you will have a conventional fixed bridge or an implant-supported fixed bridge.
The exact sequence of treatment depends on so many factors that there is no point in speculating what is appropriate for you. Suffice it to say that if you require multiple extractions, it is almost a given that you will need to wear a conventional denture for a while even if you do choose to utilize implants, so the implications of whether you intend to "go back" to implants is irrelevant. However, it is best to make provision for the use of implants at the time of tooth extraction, because there is normally a significant loss of bone when teeth are removed. This is best done by the use of a bone graft in each extraction socket, which will better maintain the geometrical topography of the potential implant recipient sites.
Whether or not you are a candidate for implants is something that cannot be determined without more in-depth diagnostic efforts. The best and most accurate way of making this determination is to have your prosthetic dentist order a CT imaging study and analyze it with implant planning software, such as Simplant. In this way, your dentist can plan the logistics of where implants are needed and whether there is enough bone available to accommodate those implants. This is a critical step, because the selection of implants as an option is definitely inadvisable if compromises need to be made. For example, if an implant is selected that is shorter than an ideal length because of inadequate bone, that implant is doomed to loosen and fall out. Likewise, if an implant is tipped over at an improper angle to avoid hitting the sinus or a nerve bundle, any prosthesis attached to it will either not be any better than a conventional prosthesis, or the attachment may repeatedly break-- well, you get the idea. This is a particular consideration with implants, because the entire concept has been over-sold. Dentists and patients are so desirous of implants that sometimes they are used when they shouldn't be used, and that's when one gets into trouble. Implants are simply one more tool in the toolbox, nothing less, and nothing more. When using implants is inappropriate, they shouldn't be used-- period.
:QUESTION:
I am in my mid 50's and my mouth is in very bad shape. My question, is it possible to extract and have dentures fitted and then go back and have implants? From what is described, would I be a candidate for implants in any event given the bone loss?
ANSWER:
First, allow me to dispel a common misconception that is suggested by the subject of your question-- "implants" versus "dentures". This is somewhat akin to comparing apples and oranges, because although the term "dentures" refers to a particular class of dental prosthetic device, the term "implants" does not. Implants are best conceptualized as representing artificial tooth roots that are surgically implanted in the gums; what you do with those "roots" includes a wide variety of different approaches. You can attach a single crown to an implant fixture, or you can place several implants distributed around the upper or lower jaw and create a removable denture that snaps onto those implants with attachments, or you can place many implants and fabricate a fixed bridge. In other words, the question is not whether you will have a denture OR implants, but whether you will have a conventional denture or an implant supported denture, or whether you will have a conventional fixed bridge or an implant-supported fixed bridge.
The exact sequence of treatment depends on so many factors that there is no point in speculating what is appropriate for you. Suffice it to say that if you require multiple extractions, it is almost a given that you will need to wear a conventional denture for a while even if you do choose to utilize implants, so the implications of whether you intend to "go back" to implants is irrelevant. However, it is best to make provision for the use of implants at the time of tooth extraction, because there is normally a significant loss of bone when teeth are removed. This is best done by the use of a bone graft in each extraction socket, which will better maintain the geometrical topography of the potential implant recipient sites.
Whether or not you are a candidate for implants is something that cannot be determined without more in-depth diagnostic efforts. The best and most accurate way of making this determination is to have your prosthetic dentist order a CT imaging study and analyze it with implant planning software, such as Simplant. In this way, your dentist can plan the logistics of where implants are needed and whether there is enough bone available to accommodate those implants. This is a critical step, because the selection of implants as an option is definitely inadvisable if compromises need to be made. For example, if an implant is selected that is shorter than an ideal length because of inadequate bone, that implant is doomed to loosen and fall out. Likewise, if an implant is tipped over at an improper angle to avoid hitting the sinus or a nerve bundle, any prosthesis attached to it will either not be any better than a conventional prosthesis, or the attachment may repeatedly break-- well, you get the idea. This is a particular consideration with implants, because the entire concept has been over-sold. Dentists and patients are so desirous of implants that sometimes they are used when they shouldn't be used, and that's when one gets into trouble. Implants are simply one more tool in the toolbox, nothing less, and nothing more. When using implants is inappropriate, they shouldn't be used-- period.
