Posts for: January, 2019
Dentures, removable restorations for missing teeth and gum tissue, can take a number of different forms, but are usually of two different types: complete and partial. A complete denture replaces all the teeth in a given arch. A removable partial denture (RPD), on the other hand, replaces several missing teeth while using the remaining teeth as support.
A common type of RPD formed of plastic is known as a “flipper” because it’s lightweight enough to be “flipped out” or moved around with the tongue. They serve an important purpose as a temporary appliance for use between periodontal treatment, implant placement and similar treatments before obtaining a more permanent restoration. In fact, they’re often referred to as “transitional” RPDs because they’re not designed for permanent tooth replacement.
Because of their low cost relative to other restorations, however, they often become the permanent choice for many people. While a well-constructed, properly fitting RPD in a healthy mouth can be an affordable alternative for people on modest budgets, their long-term use may increase the risk of dental disease and accelerated bone loss. Decades of research verify that people who permanently wear RPDs encounter more tooth decay and periodontal (gum) disease than non-wearers.
This is because the attachment points of a plastic RPD to remaining teeth increases bacterial growth, which can cause both tooth decay and gum disease. This doesn’t only endanger the survival of the remaining teeth, it can lead to bone loss that will affect the RPD’s fit.
While the better course is to consider RPDs as a stepping stone to dental implants or a fixed bridge, there’s an intermediary RPD constructed of cast vitallium or gold alloy that could be considered a permanent choice. These are even lighter weight than plastic and less obtrusive in their attachments in the mouth, which can reduce plaque stagnation and promote a better oral environment.
Regardless of your choice in dentures, it’s always important to maintain good consistent oral hygiene with daily brushing and flossing and semi-annual professional cleanings and checkups. Keeping a healthy mouth will help reduce your risk of dental disease and increase your satisfaction with your denture of choice.
If you would like more information on RPDs and other denture restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removable Partial Dentures.”
Some patients who wear dentures face a kind of Catch-22: their denture fit may have loosened and become uncomfortable over time due to continued bone loss, yet the same bone loss prevents them from obtaining dental implants, a superior tooth replacement system to dentures.
But there may be a solution to this dilemma that combines the stability of implants with a removable denture. A set of smaller diameter implants — “mini-implants” — can support a removable denture with less bone than required by a conventional implant.
Like all living tissue, bone has a life cycle: after a period of growth, the older bone dissolves and is absorbed by the body, a process known as resorption. The forces generated when we bite or chew are transmitted by the teeth to the jawbones, which stimulates new bone formation to replace the resorbed bone. When the teeth are lost, however, the stimulation is lost too; without it, resorption will eventually outpace bone growth and repair, causing the bone mass to shrink.
Removable dentures also can’t supply the missing stimulation — bone loss continues as if the dentures weren’t there; and due to the compressive forces of a denture, bone loss accelerates. As the jawbone structure used to originally form the denture’s fit eventually shrinks, the denture becomes loose and difficult to wear. It’s possible to adjust to the new jaw contours by relining the dentures with new material or creating a new set of dentures that match the current bone mass. Without adequate bone, fixed crowns or bridges anchored by conventional implants may also be out of the picture.
On the other hand, mini-implants with their smaller diameter need less bone than the traditional implant. A few strategically placed within the jaw are strong and stable enough to support a removable denture. One other advantage: these mini-implants can be installed in one visit with local anesthesia and usually without the need for incisions or stitches.
If you would like more information on dentures supported by mini-implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The ‘Great’ Mini-Implant.”