Implant-Supported Dentures

Dental implants can be restored with both fixed crown or crown and bridge-work (teeth that the patient does not remove) or they can be restored with removable snap-on dentures. As explained in other sections of this site, the type of teeth that can and will be used for each individual patient is determined during the initial diagnostic and treatment planning stages.

We believe it is important for every patient to have some understanding of the “behind the scenes” processing that is required for both types of fabricated teeth. Not only does the laboratory technician require education and in depth knowledge of the human anatomy and the masticatory (chewing) function, but they MUST also have artistic talent to produce teeth that have a natural look and are cosmetically pleasing to the patient, their family and friends. To produce a quality product it is necessary to use quality materials and invest the time to correctly follow all steps required for fabricating and processing man-made teeth.

At the present time, all removable prostheses, whether regular or implant-supported dentures, are fabricated by our in-house laboratory. This gives us a high degree of quality control as well as eliminates the travel time (between every processing step) to and from the lab. In many repair cases, it also gives us the ability to give same day services, meaning the patient has minimal time without their teeth.

Restoration of upper and lower sub-periosteal implants with snap-on removeable upper and lower implant supported dentures.

After implant surgery has been performed and the healing period has elapsed, the restoration phase of treatment can begin. When only a lower sub has been placed, in most instances the restoration phase can begin about six to eight weeks after surgery. If a case includes an upper and lower implant or upper only, the upper arch will be allowed a full three months of healing time before the restoration phase is started.

The following picture series outlines the patient’s appointments and the step-by-step process of fabricating both upper and lower implant-supported dentures. In order for the dentures to snap-onto the implants, an “attachment system” must be processed into each denture.

The upper implant will generally have 8 posts that extend through the gum tissue. Each post ends with a hitch-like ball. This is the female portion of the attachment system.

The upper denture will be fabricated with o-ring housings. This is the male portion of the attachment system. Small rubber o-rings will be placed into these housing which will expand as the denture is snapped onto the implant and then contract around the neck of the ball.

The lower implant will have a bar as the female portion of this attachment system.

The lower denture will be fabricated with three to four gold clips which is the male portion of this system. These clips will snap onto the bar making the denture secure and stable.

To begin, the doctor takes an impression of the upper implant using impression material.

The doctor also takes an impression of the lower arch using impression material.

Parts for the attachment system:
plastic pattern ball posts which represent the implant ball posts,
o-rings for the upper denture,
clips for the lower denture, gold clips.

Plastic pattern posts which represent the ball posts of the upper sub are inserted into the positions left in the impression material.

Powdered dental stone mixed with water is then poured into the impression while carefully eliminating all air bubbles.

The same dental stone mixture is poured into the lower impression.

When the dental stone has “set-up” (hardened), the resulting stone model is separated from the impression material. (Note that the plastic balls have transferred to the upper stone model.)

The lower stone model is separated from the impression material.

Using the stone models, the lab tech will now begin to make “wax bite rims”.

Upper and lower rims have been adapted to fit onto the upper and lower implants to help the doctor to establish the correct positioning of the bite (the way the teeth will come together).

Rims are tried into the mouth, seating (placing) them onto the upper implant balls and lower implant bar.

A “bite” is then taken giving the doctor and the lab tech the information needed to determine the positioning of the teeth for the final implant-supported dentures.

The front (anterior) teeth have been set into wax.

Completed wax set-up of full upper and lower dentures which will be supported by implants.

Upper and lower wax set-up tried-into patient’s mouth. At this time, the patient has the opportunity to critique the cosmetic aspects of the dentures and have changes made if desired. Once the patient has approved the color, shape, length and positioning of teeth the dentures will be processed for final delivery.

Processing the final teeth

The following picture series will show the steps in processing the final teeth. (The process is the same for both upper and lower dentures, but only the upper will be shown.)

The upper wax set-up is placed in the top half of a processing flask. A combination of dental stone and plaster is filled in around it. (The same procedure would be followed with a lower wax set-up). The halves of the flask are put together and immersed into boiling water. This step softens the wax so that it can be separated and removed from the teeth (same for lower.)

Wax has been removed leaving the acrylic teeth cradled in the dental plaster.

Stone model of the upper jaw with pattern posts in place.

The female housing attachments which will allow the denture to snap onto the ball posts of the upper implant have been installed onto the pattern ball posts in the stone model. During processing these attachments will be transferred to the underside of the upper denture. (At this time, the clips for the lower denture will be snapped onto the bone model so that they will be transferred to the inside of the denture during processing.)

Acrylic material which matches the patient’s gum tissue is inserted over the teeth cradled in the dental plaster (same for lower.)

The flasks are assembled and compressed.

After compression, the flasks are separated to inspect and determine if more acrylic needs to be added.

During processing the female attachments installed on the upper stone model will be transferred to the depressions seen here in the acrylic.

Flasks for upper and lower re-compressed after inspection and ready for processing.

Both flasks are placed in 160 degree water and heat processed for 9 hours.

After the 9 hours of heat processing the plaster is removed from the flask halves and broken away revealing the final denture within.

When the denture is fully removed and turned over, the o-ring housings which were processed into the denture from the upper bone model can be seen. (Clips can be seen in the lower.)

Upper implant-supported denture before finishing touches.

Upper implant-supported denture after finishing touched.

Side view of upper implant-supported denture showing teeth and inside attachments.

Final delivery of upper and lower implant- supported dentures the the mouth.

Before: regular upper and lower dentures.

After: implant-supported upper and lower dentures.