Lower Implant Over Denture……. AKA Snap On Denture

Mandibular Implant Over Denture

Dentures can be incredibly problematic for many denture wears. They slip and slide. They pinch and gouge soft tissues. You really can’t chew hard foodstuffs with them. Are you getting the hint? They are difficult to eat with, even the “best of them”. Quality of life can suck!

The lower denture tends to be worse that the upper denture. The upper denture is self retained via simple suction onto the roof of the mouth.  A seal of the soft palate is created upon insertion of the prosthesis. The lower denture has no such luck. The tongue and floor of the mouth always wants to lift the lower denture out of its stability. The bone of the lower jaw tends to be thinner while the overlying tissue is more so fragile than the upper jaw gum tissue. The lower jaw also has two major sensory nerves called the Inferior Alveolar Nerves that can at times become compressed by the hard merciless overlying mandibular denture acrylic creating a tremendous amount of pain; a feeling of shooting electricity thru the lip. This adds to the everyday misery of the wearer.

A simple affordable life changing procedure which I routinely deliver in my office is the Implant Over Denture. This is a fabulous solution which simply remedies all of the aforementioned problems that lower denture wears suffer with everyday.

The procedure requires a Cat Scan of the lower jaw. This scan is most beneficial because it allows me to choose the most appropriate sized implants and relative positioning to be best supported by the jaw bone. Also, there are several areas of anatomic concerns for me as a surgeon that I need to respect. Knowing where not to place my implants is equally important as knowing where to place my implants. It’s advantageous to have a road map before the journey begins and the Catscan offers that.

On the day of surgery, I usually place 3-5 implants in the lower jaw in one surgical event. This takes me about an hour appointment. After placement of implants, tissues are approximated and the surgical site is closed tightly with numerous sutures of  both resorbable and non resorbable types. One of my assistants takes the existing denture and temporarily relines it with a medicated packing to aid and accommodate the post surgical tissue changes. The patient is given 600 mgs. of Advil in the chair, instructed in the basic post operative care by another of my qualified assistants, appointed to return for a 15 minute suture removal appointment in 12-14 days, leaves the office with their existing lower denture in place and an ice pack on their face. Total appointment time takes about 90 minutes completed with simple local anesthetic only.

It is important that the patient is instructed to wear the denture overnight and everyday as they normally do after surgery. The denture in place keeps compression on the surgical site and facilitates the healing process. It’s okay. The implants will be fine  submerged below the gum line beginning the process of osseointegration (fusing to the bone). For the first two weeks, until the wound seals closed,  I emphasize wearing the denture, without denture adhesive paste for the obvious concerns of wound contamination.

At the two month mark after surgery, I dremel  divots out of the patient’s existing acrylic denture base to create space for future female housing attachments that are engineered to accept the male counter component of the previously placed implants.

A chair side cold cure acrylic process of fusing the female attachments is done with in 10 minutes time.

The “Snap” is the sound of the male and female components engaging. A First Snap always garnishes a smile from me and a bewildered look of curiosity by the patient.

The patient is free to leave an enjoy a slip free lower denture. Inevitably, patients return for follow-up, happier, more enthusiastic about life and 10 pounds heavier. I am most satisfied everyday knowing that my staff and I are responsible for improving the quality of life of one human at a time.

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Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com

My Implant is Loose

A  hygiene recall patient came in today for routine maintenance (he had an implant placed by me, fifteen years ago).

While he was heading towards his prepared operatory, I was coincidentally passing through the hallway to visit another patient when he exclaimed with a slight concern,  “Hey doc, my front tooth implant is loose.” Before I had a chance to say good morning, I instantly snapped on a right-handed glove and reached across to wiggle his front tooth with my index finger and thumb  “Any pain,” I asked?  My young new hygienist, stared in both confusion and curiosity.  The patient replied, “No”.

I asked my hygienist to take a radiograph to confirm my suspicions and low and behold…. they were correct! I assured him not to worry and that all was well with his implant and that it was simply a LOOSE ABUTMENT SCREW. I was able to accommodate his issue and concerns,  right after his cleaning appointment.”

The abutment screw is a tiny screw that engages the implant abutment. The implant abutment is the structure that is above the gum line and is seated on top of the dental implant platform. An implant crown, is usually cemented onto the screwed down abutment.

On occasion, the little tiny abutment screw “backs out”, thereby releasing the abutment/crown complex from the implant fixture. Patients will interpret that as a wobbly implant crown that clicks ( the clicking is the sound made when the base of the titanium abutment tips on and off the titanium implant screw platform).

Pain is usually an indicator of bad things. Pain upon manipulation of the tooth complex would have indicated a failing implant fixture requiring it’s immediate removal.

In this situation, not to worry. No shot needed to fix the problem. Usually a simple fix. A small access hole needs to be created with the dental drill thru the existing crown to yield a direct straight-line access to the top of the abutment screw head.  Then a quick retightening of  the screw with a special miniature implant screwdriver. Seal the access hole with a composite resin and done….A ten minute fix!

The abutment screw can loosen due to unbalanced forces on the implant abutment crown or a patient para-functional habit such as bruxism ( tooth grinding).

It’s best that the dentist replaces the abutment screw with a new one. Then, a final bite adjustment is important to minimize extraneous forces on the implant crown (which  minimize chances of that recurrence).  An abutment screw replacement is suggested because one must assume that the original abutment screw was previously torqued down to the manurfacturers specifics ( 35 Newton/Cms ). When any screw is torqued, it is essentially stretched to a maximum twist before stress tolerances are destroyed yielding a snapping screw. The inherent nature of the screw’s metal contracts back creating tension onto the opposing implant’s internal threads giving a compression force in addition to a mechanical locking of threads of both implant and abutment screw.

A bite guard may be recommended after the new screw is replaced to minimize occlusal lateral forces that could potentially be responsible for stressing the abutment screw and weaken it’s integrity..

 

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com