Multiple Implants & Full Arch Denture Options

Full arch dental implants and multiple dentures

When multiple teeth are missing or require extraction, dental implants can be strategically placed to restore both function and aesthetics. Treatment options are carefully assessed, planned, and tailored to each individual.

For patients missing all teeth in the upper jaw (maxilla), lower jaw (mandible), or both, this is known as a “full-arch” situation. Several restorative solutions are available, which can generally be categorised as either fixed or removable options. These include snap-in removable over dentures (with or without supporting bars) and fixed, permanent implant-supported dentures, as briefly outlined below.

Talk to us about your your specific needs and determine the most suitable treatment plan.

Reasons many of our patients consider implant-supported dentures include:

Difficulty having proper chewing function
Lack of denture stability
Too bulky dentures
Phonetic/speaking difficulty with dentures
Aesthetic issues
Intolerance to having a bulky plate in their mouth (gag reflex)
Having to use gooey denture adhesives

Reasons some people avoid implant-supported dentures:

Cost
Too scared of surgical procedures
They have never been given the information tailored to their needs

However, there are indications and sometimes contra indications for implant-supported dentures.

1. Snap-in over-dentures on implants (removable)

This option is the most hygienic option, especially for those who have had a history of gum disease.

It includes placement of between 2 to 6 implants (depending on the case) in the jawbone with the denture that snaps in firmly.

The denture can be taken out when necessary.

Advantages of snap-in over-denture option:

The cheapest option
While stays firm in the mouth, it can easily be removed by patient
The most hygienic
Easier to prevent future complications
Easier to modify the design in future, if necessary
Works best in the lower jaw with 2 to 4 implants
Works best in upper jaw with 4 to 6 implants
Can provide lip support with acrylic extension below the lip
Less number of implants required compared to all other options

Disadvantage of snap-in over-dentures:

It is not permanently fixed (this can be an issue for some people)
The connecting part (ball and socket) may need maintenance over time due to wear and tear
Still requires acrylic part around artificial teeth, sitting on the tissue
It can still feel bulky for some patients (especially in upper jaw)

2. Over-denture on metal frame and bars connected to implants (removable)

A bar is fabricated over the implants and the denture sits on the bar.
It is more comfortable for patients since it gets most of the stability from the metal bar frame.

The bar is screwed onto the implants and the denture can still be removable.

Advantages of implant-supported over-denture with addition of metal bar:

More stability of the denture
More comfortable for patient
Little gum to denture contact and friction required
Is hygienic
Less number of implants required compared to the fixed option (Option #3)

Disadvantages:

More expensive than the first option
The metal bar and frame may need further maintenance over long term
Presence of a metal bar in the mouth when no denture is in may not feel pleasant

3. Fixed implant supported denture

This option includes placement of multiple implants (4 to 6 implants, depending on the length of the dental arch) and the teeth are screwed onto the implants.

There actually is no denture, the teeth are screwed onto the implants.

It remains fixed in the mouth and can only be removed by the clinician in-office.

Advantages of completely fixed option:

No removal of denture required
The amount of pink acrylic used is minimal (pink porcelain may be used)
Minimal gum coverage and contact, therefore no gum friction occurs
Stability is the best

Disadvantages of completely fixed option:

More number of implants need to be placed
Since more number of implants need to be placed, there is more chance of the need for bone and gum graft
The most costly option
The fact that it remains fixed, can be counter-productive for hygiene, therefore:
This option should only be indicated for very motivated individuals with perfect oral hygiene
It needs stricter maintenance and monitoring with the surgeon over long term

FAQs

Dental Implants

Are the implant-supported dentures (fixed or removable) risk-free?

Almost all options can be complication-free short term. The key point is to plan the right choice and option for you, so that long-term, there are no complications.
The correct option is always the one that is individually tailored and decided between you and your specialist. This is the first step in minimising long-term complications.
Nevertheless, complications with any of the above options can arise. The only way to reduce the risk of complications is to have a very regular follow up and monitoring scheme in place. This usually includes a short visit to your specialist, 3 to 4 times a year.
At each of these short appointments, your specialist surgeon will check every single component of your implant-supported denture. Also, your brushing and cleaning technique is reviewed. Your general medical and dental state is reviewed for any additional risk factors.

Is there any warranty for the provided implant-supported denture?

If at any of the future appointments, any modification or adjustment is required, your surgeon and the restorative dentist will be responsible to advise you of that.
At Shire Periodontics and Implant Institute, as long as you have followed up with your regular monitoring appointments, any extra work required can usually be considered as part of the warranty of the provided work.