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Dental Health Library Article

Long Term Denture Use: The Final Impact



Severe Mandibular Bone Resorption

Prosthodontic Bone Loss Syndrome

Long term denture wearers run the risk of losing significant amounts of jawbone height and density, in both the upper (maxilla) and lower (mandible) jaws.

Bone Loss Photo The mandible, lower jaw, usually takes the brunt of the common physical forces of biting, chewing and eating.

The denture prosthesis typically rests on gum tissue which can eventually wear away, depending upon how often a denture patient has dental check ups and has the dentures relined. Frequent relining provides an extra cushion that slows down the wear on gum tissue.

Since non implant supported dentures rest on the gingiva - gum tissue, there is no direct stimulation of the jawbone. Implant supported dentures... and even the mini-implant retained dentures to some degree, offer the healthful benefit of bone stimulation which is critical for maintaining some degree of healthy bone.

Bone Loss Photo
Significant bone loss
Denture partials and some non-implant supported bridgework have a similar impact of friction on the gum tissues and lack of stimulation of bone.

Despite numerous advances in denture prosthodontics, many long term denture wearers are reaching the point where their mandibles no longer have sufficient bone height and/or gum tissue to adquately support a serviceable denture.

In many instances the opportunity to convert to mini implants (require less bone mass) or traditional implants is not available. It has been our experience that some patients are now being advised by denture clinics and denturists that they are no longer a candidate for dentures.

Others have discovered they can no longer use their present denture due to poor fit, denture pain or generalized jaw pain.

Advanced Diagnostics - Tissue Regeneration

Some full service reconstructive dentistry practices throughout the country keep abreast of and maintain investments in leading or cutting edge technologies that provide their patients access to the some of the newest treatments possible.

APC+ Platelet Rich Plasma Plasma Rich Proteins (PRP), as an example, were proven not too long ago to enhance and accelerate tissue regeneration, a process technology that captured the interest of all doctors involved hard and soft tissue repair and augmentation.

Many tissue grafting specialists (e.g., oral surgeons, periodontists) made investments in the PRP technologies, acquiring a specialized centrifuge that enables near instantaneous collection of proteins that has renowned tissue regeneration benefits.

Unfortunately, there are many more dentists and specialists that don't have immediate access to the technology.

3-D Imagery and Bone Assessment

The more recent developments in 3-D Cone Beam Imaging equipment (Sirona Galileos, I-Cat, Planmeca, etc) that rivals or exceeds the accuracy of hospital grade equipment enables a level of diagnostic accuracy that wasn't possible just a few years ago.

Reconstructive dental practices that have invested in advanced Cone Beam Catscan and specialized analysis software are able to conduct tissue assessments almost error free. The common experience of not discovering the need for bone grafting until surgery is underway is a thing of the past.

Cone Beam Bone Scanning
Click picture for a demonstration
Imaging science has become so precise that patients are even being trained by some dentists to read and comprehend their own scanning data. The mysteries of hidden bone or tissue loss have been all but eliminated.

The small handfuls of doctors nationwide who are becoming familiar with the new treatment possibilities brought about through their access to advanced technologies are now able to apply layered treatments of proprietary grafting treatments.

What was once thought an impossibility.... has become, for some grafting specialists... another opportunity for challenge..... and they are succeeding.....

Layered bone grafting for severely deteriorated jawbones, typically caused by long term denture use or certain types of oral health conditions, can be augmented sufficiently to support a series of implant devices and custom prosthesis that recreates what we all want to maintain.... a mouth full of teeth and a normal ability to eat, chew, speak with clarity, smile......and maybe even laugh again without the fear of embarrasment.

Cumulative Bone Grafting?

Becoming a Candidate

Diagnostics is the starting point. 3-D Imaging equipment and specialized software used by implant surgeons can assess bone quality and density with unsurpassed accuracy and clarity.

Cumulative Jawbone Grafting
Lower Jawbone Grafting - Female
The possibilities for becoming a candidate are developed as overall dental health is assessed, along with dietary habits, eating preferences, medication histories and overall patient compliance.

Patients who have been advised they may become or remain toothless with little indication of successful treatment intervention are encouraged to research nearby resources (statewide, not just locally) to locate grafting specialists (oral surgeons, periodontists and general dentists who have immediate access to advanced diagnostics and tissue repair technologies).

In general terms, those practices that have the heaviest focus on all forms of hard and soft tissue grafting will be in the best position to evaluate candidacy for layered bone graft treatments.

Patients who have experienced significant bone loss through physical trauma, congential defects, untreated orthodontic abnormalities and periodontititis may or may not be candidates. Obtaining a Cone Beam CatScan (preferred, for accuracy) or possibly a high grade Panograph would be a good starting point for some patients.

Editorial Staff

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