Loss of all upper teeth

Losing all of your upper 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. Appearance of wrinkles along the lips.

This is why it is important not to wait to replace missing teeth. There are many options for replacing lost teeth nowadays. We believe dental implants are often the best choice. They improve the function and aesthetics of your mouth and no one can tell you have them.

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 upper jaw with a fixed prosthesis of at least 12 teeth, we recommend between 6 and 8 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 implants in the same session, on the same day. This way, you will have teeth in your mouth right away.

There are three types of prostheses that we can use in patients that have lost all of their upper teeth:

  • Fixed full prosthesis with artificial teeth, supported by implants.
  • Fixed full prosthesis with artificial teeth and gums, supported by implants.
  • Removable full prosthesis on implants (overdenture).
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.

Full removable prostheses. 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.

Fixed full prosthesis with artificial teeth, supported by implants

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 treatment offers the best stability and comfort.
There’s no artificial palate, which can be uncomfortable and interfere with the patient’s sense of taste.
It has 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.

The disadvantage of this option is that the implants can occasionally fail or break, the screws can become loose or the prosthesis can break.  The implants may break due to fatigue of the material (titanium), overloaded over years of use. The fewer the implants supporting the load of the prosthesis, the greater the risk of overloading the material. This is why we normally opt to substitute each lost tooth with its own implant, except in the incisor zone (where 2 implants can substitute 4 incisors).

This treatment is expensive.

The patient may have difficulties maintaining proper oral hygiene around the fixed denture. This is due to the shape of the prosthesis, which aims to create the most aesthetically pleasing result for the patient or hide metal components.

Some patients have noticed difficulties in speaking with the full fixed prosthesis on the upper arch. This is due to air escaping out from under the prosthesis when pronouncing some words or letters. Most patients adapt to this after a while and their speech goes back to normal.

This procedure cannot be used in cases with skeletal malocclusion (if the upper jaw is further in than the lower jaw). The treatment time is longer than with conventional dentures and requires two surgeries.

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 upper arch during the first operation. The upper jaw cannot be used for 7 days to 2 weeks 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 upper 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, ceramic 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.

This is a good treatment option for patients with no teeth at all on the upper arch who don’t have any serious bone loss, which means they can have a prosthesis with only teeth, no artificial gum, without the teeth looking too “long”.

It is made of metal and porcelain. The number of teeth depends on the number of implants that can be put in.

This prosthesis is fixed (not removable) and is supported by 8-12 implants in the upper jaw (depending on the length of the prosthesis and the available bone).

Fixed full prosthesis with artificial teeth and gums, supported by implants

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 treatment offers the best stability and comfort.

There’s no artificial palate, which can be uncomfortable and interfere with the patient’s sense of taste. If the patient’s lip rises a lot when they smile, the artificial gums may be visible, which is a good imitation of the papilla between the teeth and normally looks quite good. Using artificial gums in cases with a lot of bone means the teeth on the prosthesis don’t have to be too long.

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.

The implants can occasionally fail or break, the screws can become loose or the prosthesis can break.  The implants may break due to fatigue of the material (titanium), overloaded over years of use. The fewer the implants supporting the load of the prosthesis, the greater the risk of overloading the material. This is why we normally opt to substitute each lost tooth with its own implant, except in very elderly patients or the incisor zone (where 2 implants can substitute 4 incisors).

This treatment is expensive.

The patient may have difficulties maintaining proper oral hygiene around the fixed denture. This is due to the shape of the prosthesis, which aims to create the most aesthetically pleasing result for the patient or hide metal components.

Some patients have noticed difficulties in speaking with the full fixed prosthesis on the upper arch. This is due to air escaping out from under the prosthesis when pronouncing some words or letters. Most patients adapt to this after a while and their speech goes back to normal.

This procedure cannot be used in cases with skeletal malocclusion (if the upper jaw is further in than the lower jaw). The treatment time is longer than with conventional dentures and requires two surgeries.

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 upper arch during the first operation. The upper jaw cannot be used for 7 days to 2 weeks 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 upper 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, ceramic 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.

This is a good treatment option for patients with no teeth at all on the upper arch who have any serious bone loss that means the teeth would look too “long” if the missing bone and gums weren’t also replaced with a prosthesis.

The prosthesis is made of metal and acrylic or metal and porcelain. This prosthesis is fixed (not removable) and is supported by 6-10 implants in the upper jaw (depending on the length of the prosthesis and the available bone).

For patients with serious bone loss, in which a prosthesis with only teeth, no artificial gum, can make the teeth look too “long” and unattractive.

To avoid the sensation of “long” teeth, the prosthesis has pink gum on the top, replacing the missing teeth, gums and bone.

Removable full prosthesis on implants (overdenture)

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 approximately 4 implants Good pronunciation

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

The patient can remove and replace this denture. It isn’t a fixed prosthesis and it may be a bit loose when chewing (move around a bit, but not come out.)

It is best to remove the prosthesis when sleeping. When patients remove the dentures, their face changes greatly in appearance (sunken lip and profile, no smile, etc.).

The screws on implants may break or come loose, and sometimes the implants fail. The dentures or the teeth on the dentures may also break.

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

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 upper arch during the first operation. The upper jaw cannot be used for 7 days to 2 weeks 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 upper 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 dentures and bar. These procedures include preliminary impressions, final impressions, wax moulds, bar tests and inserting the dentures. 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 say that with the new prosthesis they feel more stability, greater chewing power and are more comfortable in general.

These dentures are very similar to a conventional full denture, except that it is supported by four or more implants on the upper arch.

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.

Why should I have the operation at the Birbe Clinic?

  • We are leaders and pioneers in modern orthognathic surgery.

  • We strive for excellence in care and service, all of which can be seen in our top-notch results.

  • We are honest, when we recommend a treatment is always because we believe it is what is best for your health and wellbeing.

  • Our facilities were designed for optimal hygiene and sterilisation, and to ensure our patients’ comfort. We have an on-site scanner and operating room, with sedation and out-patient treatments.

  • Quality, trust and experience. Our professional team is led by the world-renowned Dr Birbe, who is the only Spanish maxillofacial surgeon certified by the American Board of Oral and Maxillofacial Surgery 2001.

  • Dr Birbe will see you personally, you will have his mobile number before and after the operation.

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

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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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