Loss of all lower teeth

Losing all of your lower teeth is not only an aesthetic and functional issue, it sets off a series of processes in your mouth that, if left untreated, can lead to serious problems such as:

  • Movement of antagonist teeth.
  • Cavities and sensitivity in the existing teeth.
  • Loss of bone and gum in the area without teeth.
  • Functional overload of the remaining teeth.
  • Accumulation of food in the spaces without teeth, which can lead to a periodontal pathology.
  • Premature ageing due to lack of jaw stop, making your jaw protrude and giving your lips no support.
An implant is a titanium anchor (that acts as the root of the tooth) with different types of surfaces that connects to a crown (the visible part of the tooth) to replace a missing tooth. The titanium oseointegrates with the bone so you can chew without any problems with the implant.

Advanced implants are treated on the surface to minimise the chances of rejection, making the tooth on the implant as strong and resistant as a natural tooth.

In order to rebuild the whole lower jaw, we recommend between 4 and 6 implants, depending on the patient (chewing power, amount of space to be rehabilitated) and the type of prosthesis we plan to use. This number of implants allows us to create a fixed prosthesis, for the most realistic sensation of having natural teeth.

We often put in the implants and load the teeth onto the implant in the same session, on the same day. This way, you will have teeth in your mouth right away. The lower jaw is one of the positions where we can frequently load the implants immediately.

It is important to note that, no matter which treatment you choose, success depends on following a regular oral hygiene plan with your dentist. All teeth need to be cared for, whether natural or prosthetic.

If you have any questions about your treatment options, please contact your surgeon or your dentist.

Removable full prosthesis: The problem is that this option requires other tissues to help support the prosthesis, which can lead to problems in the middle and long term. Lack of stability of the prosthesis, loss of bone and gum and facial ageing.

We have the best solution for your needs

Do you have missing teeth? +information

Does your jaw have a very little bone and you need implants? +information

Do you need an implant treatment without pain or discomfort and quickly? +information

Do you think that your case is difficult and you want to have the guarantee that you need? +information

There are two treatment options, and we will choose the best one for each case.

If this option is chosen, the patient will need a minimum of 4 to 6 implants in the lower jaw to build a prosthesis with 10 teeth. If the patient wants more teeth on the prosthesis, they will need more implants at the back of the jaw (which isn’t always possible due to the bone loss that is common in this area when patients have been missing teeth for a long time).

As bone loss is normally substantial, the prosthesis normally replaces both missing teeth and gums. The prosthesis is made of metal and acrylic or metal and porcelain.

Advantages

This prosthesis is anchored as far as the patient is concerned (the patient can’t remove it) but can be extracted by a dentist (if it is screwed in) if it were necessary to make adjustments. This option offers more stability and retention than a conventional full denture or overdenture supported by implants.

The patient will have greater chewing strength and the ability to eat a wide variety of foods.

It is been shown that this type of procedure stabilises bone height over time, stopping associated bone atrophy and the aesthetic effects of ageing on the face.

Disadvantages

As with other prosthesis, a fixed full prosthesis may break or the screws may come loose.  Nevertheless, it is important to note that this type of prosthesis has a proven success rates above 90% over more than 25 years of clinical studies.

This treatment is more expensive, as it requires more implants than an overdenture.

The patient may have difficulties maintaining proper oral hygiene around the denture. In general, this fixed prosthesis is more difficult to clean than an overdenture.

The treatment time is longer than with conventional dentures and requires two surgeries.

How this treatment is done

At the first appointment, photos and x-rays of the patient’s mouth are taken. Sometimes a special study is requested (CT scan), which is done in a specialised centre outside of the clinic. This study gives the doctors a precise view (even in 3-D) of the amount and quality of the patient’s bone, which is a great help in planning their treatment. It may be necessary to create a provisional prosthesis (splint) for the patient to wear while having the CT scan so the dentist can also see where the artificial teeth should go. The surgeon and the dentist, working as a team, decide how many implants, where they should go and how the final prosthesis should be designed.

The implants are put into the jaw during the first operation. The provisional prosthesis cannot be used for 7-10 days so that the gums can heal. Afterwards, the dentist will adjust the provisional dentures (soft relining of the prosthesis) so the patient can wear it while waiting for the implants to be integrated (“soldered” into the bone).

On the lower arch, the bone should heal around the implants for 3 months, after which the patient has the second operation, to make sure the implants are integrated (“soldered” into the bone). In the second operation, the surgeon exposes the implants and inserts a second component that sticks out through the gum (called a healing abutment) and checks that the implants are completely fixed and no bone has been lost.

After waiting 7-10 days, during which time the patient cannot wear the prosthesis in order to allow the gums to heal, the patient must visit their dentist to readjust the provisional prosthesis.

After that, the dentist starts making the permanent prosthesis. These procedures include preliminary impressions, final impressions, wax moulds, metal tests, tooth tests and inserting the prosthesis. After all of the adjustments have been completed to the patient and the dentist’s satisfaction, the patient can start with regular maintenance and re-assessment appointments.

Many patients with fixed prostheses on implants say they are very comfortable and that the replacement teeth feel and function like their own natural teeth.

These dentures are very similar to a conventional full lower denture, except that it is supported by 2 or more implants on the lower arch. The patient can remove and replace this denture. The implants are connected by a metal bar to help stabilise the implants, which has a clip-like mechanism to keep the dentures in place.

Advantages

These dentures are removable and the bar and dentures are accessible for daily oral hygiene.

Implants give the denture greater stability and increase chewing power.

More affordable. Requires at least 2 implants

The implants are put into the front of the jaw, where bone quality is normally good enough to accommodate the implants.

The site of treatment allows the dentist and patient to change lower lip support and facial profile to fit the aesthetic needs of patients with severe atrophy of the lower jaw.

Disadvantages

It is best to remove the prosthesis when sleeping When patients remove the dentures, their face changes greatly in appearance (sunken lower lip and profile).

Occasionally, the denture must be repaired or the clips replaced. The dentures or the teeth on the dentures may also break. The screws on implants may break or come loose, and sometimes the implants fail.

Continued bone loss in the area for this back on the lower jaw where there are no implants and where the denture is supported. For this reason it may be necessary to readjust the prosthesis relining periodically.

The treatment time is longer than with conventional dentures and requires two surgeries.

How this treatment is done

At the first appointment, photos and x-rays of the patient’s mouth are taken. Sometimes a special study is requested (CT scan), which is done in a specialised centre outside of the clinic. This study gives the doctors a precise view (even in 3-D) of the amount and quality of the patient’s bone, which is a great help in planning their treatment. The surgeon and the dentist, working as a team, decide how many implants, where they should go and how the final prosthesis should be designed.

The implants are put into the lower arch during the first operation. The provisional lower prosthesis cannot be used for 7-10 days so that the gums can heal. Afterwards, the dentist will adjust the provisional dentures (soft relining of the prosthesis) so the patient can wear it while waiting for the implants to be integrated (“soldered” into the bone).

On the lower arch, the bone should heal around the implants for 3 months, after which the patient has the second operation, to make sure the implants are integrated (“soldered” into the bone). In the second operation, the surgeon exposes the implants and inserts a second component that sticks out through the gum (called a healing abutment) and checks that the implants are completely fixed and no bone has been lost.

After waiting 7-10 days, during which time the patient cannot wear the prosthesis in order to allow the gums to heal, the patient must visit their dentist to readjust the provisional prosthesis.

After that, the dentist starts making the permanent overdenture. These procedures include preliminary impressions, final impressions, wax moulds, bite registration, wax tests, and inserting the bar and prosthesis.  After all of the adjustments have been completed to the patient and the dentist’s satisfaction, the patient can start with regular maintenance and re-assessment appointments.

Many patients with overdentures on implants say they are very comfortable and that they have gained in comfort, confidence and chewing ability.

Maria Villacampa, patient at the Birbe Clinic: “I had pyorrhea, I was missing teeth and those I had were loose…and I was afraid of the dentist! Dr Birbe gave me several dental implants and the experience was excellent. I walked out of the Birbe Clinic with teeth.

I’m so happy because I can smile and eat like before.

But I’ve put on several pounds…!

Equipo Clínica Birbe

Contact us: Ease and options

At your first appointment, we explain the different treatments available and the best option for your specific situation. You will deal directly with Dr Birbe, one of the most world-renowned maxillofacial surgeons in Barcelona. You will get:

  • Personal diagnosis after oral and facial exploration
  • Firm quote, along with different financing options
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