Implant Supported Dentures – What are your options?
Implant supported dentures can be very confusing because of the wide variety of options available. If you are looking for implant supported dentures cleaning and maintenance tips, then click here
For a mouth missing all or nearly all of your teeth there exists four major implant supported denture, implant supported bridge, or implant retained denture options. If you are only interested in something that stays in the mouth at all times then check options 1 and 2. They are the implant supported dentures and the implant supported bridges. The second two options are removable. All costs listed are for our office and assume Dr. Bauer is completing both the implant surgery and denture or bridge fabrication phases.
The first two options are completely fixed, therefore you do not have to take them in and out.
1. Fixed full-arch implant supported prosthesis
This consists of 4-8 implants and a fixed dental bridge, bridges, or individual crowns. This is the main way we treat patients now because it is the most esthetic and when we use individual teeth the easiest to repair. The first photo below is of someone with very natural looking all on 6 with zirconia and nanaohybrid individual teeth. You can see more about this all on 6 mouth recreation with the link. The second photo a little farther down is of much whiter full arch implant supported bridges, that is one piece on top and one piece on bottom with six implants each. This upper and lower jaw implant supported bridge smile can be found on the link. These are like an all on 4 supercharged. One big difference between these implant supported bridge options and the traditional all on 4 is that this option has a future if you ever lose an implant. That is because the bridge can survive without all the implants being successful. Furthermore, it is made of porcelain so it looks nicer and holds up better. Additionally, one can also treat a single jaw with an implant supported zirconia bridge.
Cost of implant supported bridges
This type of implant supported bridge costs about $28,000 per jaw. There may be variance in both the surgical side, like number of dental implants and need for bone grafting, and what frame and teeth you choose. You can find more information about the all on 4 or more framework options and the all on 4 ore more teeth selection on our links.
Cost on this type of appliance can get very high if you don’t have bone in the right places and want really top of the line esthetics. This option does give you the best result you could ever possibly have. Implant supported bridges provide you with enough implants to replace all or most of your teeth. Especially relevant is the fact it is made out of porcelain teeth that look very natural. Implant supported bridges are somewhat similar to having a new set of teeth that can not rot.
Dr. Bauer extracted all of this patients remaining teeth, placed 12 implants, and delivered his teeth in one morning. It takes a month and a half to prepare for that day, but these are teeth in a day done by Dr. Bauer.
Long term issues with implant supported bridges
- Porcelain chips/breaks on implant supported bridge – Could happen over your lifetime – can sometimes be repaired – if not the cost would be about that of a new dental crown if not too large. If large fracture very costly.
- Implant fail – unlikely to happen – if only one or two then likely that would not be a problem because should have enough implants left – cost very little to fix.
Positives of the implant supported full arch bridge
- Good esthetics
- Great strength, wear, and durability
Negatives of implant supported full arch bridge
- Some breaks can not be repaired
- Some types of frameworks do not have a lot of history so we don’t know what can go wrong
2. Implant supported dentures (all on 4)
Implant supported dentures consist of a denture that usually attaches to four dental implants. The implant supported dentures option is heavily advertised as an “All-on-4”, yet there can be more implants. In addition to all on 4, another common name for implant supported dentures is hybrid denture.
An implant supported denture is a very good option. Implant supported dentures are fixed, meaning they stay in at all times. There are several significant disadvantages compared to an implant supported bridge. First of all, this option usually has less implants and therefore provides 1 or 2 less teeth on each side in the back. Additionally, if an implant ever failed and you only have 4 the whole prosthesis may not function properly anymore. Furthermore, implant supported dentures use high end denture teeth and acrylic instead of porcelain. Denture teeth and acrylic are less esthetic and much less durable. Acrylic is porous and thus impossible to really clean. This can result in unpleasant odors. On the plus side acrylic is much cheaper to repair than the above option.
Cost of implant supported dentures
Implant supported dentures typically cost $26,000 per jaw in our office. There is some variance on the surgical side (number implants and bone grafting).
Risks and maintenance of implant supported dentures
- Acrylic versions will almost certainly have problems of some sort. – Research
- Damage, break, and wear of acrylic teeth is very likely – cheap if just one, but several hundred to redo multiple worn teeth. Must give up appliance for few days.
- Implant failure of all on 4 – highly unlikely – if one lost will be less stable, and possibly start a domino effect of losing more implants. If only have 4 implants to start with, then the loss of even one implant can be catastrophic.
Positives of the implant supported denture
- Lower cost to fabricate and easier and cheaper to repair than first option
- Has a long history of use so we know most of the potential issues, even the long term ones.
Negatives of implant supported denture
- The teeth wear down, especially for grinders
- Teeth break and the acrylic breaks, and this can be a regular recurring problem for some.
How to clean your implant supported denture can be found on our All on 4 maintenance page.
Those first two implant supported options can have a lot of overlap. The following options are removable. Therefore, you can take them out at night to clean them. They vary greatly in their stability and biting force depending on the number of implants you have and the design.
3. Implant supported overdenture and telescopic prosthesis
This consists of 4 or more dental implants and a removable prosthesis that attaches in some manner to the dental implants. There may be a metal bar to support the denture. The cost of a dental implant supported overdenture is $23-30,000 per arch. The use of custom metal support bar vs. telescope, the number of implants, the amount of bone available, what the teeth are made of, and how esthetic you want it all influence the cost. We feel there are very few times where this is the best option. This option often makes things overly complex and expensive while leaving the patient with removable teeth.
Support Bar
Four Implants and Support Bar
Disadvantage from previous options is that this is a removable appliance and you take it out at night to clean. However, you should not notice any difference during the day. In a way the fact that you can remove this is an advantage because it allows you to clean underneath it.
Why implant supported overdenture instead of the fixed options?
This option is often used for people with high upper smile lines so that the prosthesis can hide the edge where denture meets gum tissue but will still be cleanable. It is also beneficial for individuals with extreme bone loss that need lip support (we would have to tell you this). They are also less expensive to repair if something goes wrong. Bar supported overdentures are stable since have at least four supporting implants. Advantage over final option is more implants = more stability = you can eat more things and function more normally.
Implant supported overdenture risks
- Damage or break teeth – possible – cheap fix if acrylic teeth but must give up appliance for few days more expensive if porcelain
- Implant fail – highly unlikely – may be a little less stable but likely will need no change or repair other than removal failing implant – can possibly add new implant and use same appliance if you feel need to at that point
- Depending on type may need to reline or repair part of denture – could happen or may never happen – cost is fairly cheap but requires give up for few days
- Attachment parts wear out – will happen every 2-4 years – usually cheap and quick fix
4. Implant retained overdenture
This consists of 2 or more implants and a removable appliance. Looks similar to the above option. The cost is $9,000 for 2 implants in the lower jaw. Upper jaw needs at least 4 though so about $5,000 more. We don’t like this option for the upper jaw so you will not hear us discuss it. However, it does exist and some dentists like to use it as an option.
This is one step up from a denture, but is more like a traditional denture than the other options. Implant retained overdentures provide more support but you will get some sore spots. Occasional relining of the denture is common because it relies on your existing tissue and bone for support and that tissue and bone changes over time. It’s better than a denture but moves around, not as stable as any of other options.
Four implants with Locator attachments
The underside of a lower dental implant retained denture with two locators. The two green things you see snap onto two dental implants that are anchored into the mouth.
Implant retained overdenture risks
- Damage or break teeth – possible – cheaper fix but must give up appliance for one few days
- Implant fail – highly unlikely – will be less stable – can add new implant and use same appliance if you feel need to at that point
- Reline denture – will need about every 3-5 years – moderate cost must give up for few days
- Attachment parts wear out – will happen every 2-4 years – usually cheap and quick fix
Lower jaw Implant Supported Dentures options
For the lower jaw you can do any of the previous four options. Whatever option you choose you could later upgrade to a higher level. The overall cost of doing it that way would be more since we would be making some things twice. Going from either option #3 or 4 to #1 or 2 (implant supported dentures) would be the most costly and have similar costs to starting from scratch, minus a couple implants.
Upper jaw Implant Supported Dentures options
For the upper jaw all four options are available. Additionally, an unsupported regular denture is also a viable option. The upper denture functions fairly well by itself with Fixodent and most people that have one get by just fine. The cost of that is around $2500.
This page is meant to give you an idea about costs and options of implant supported dentures. You will need to meet with us to determine what option is right for you. Some of these options may not work for you due to lack of bone. We can determine this for you with our CBCT machine, which takes 3D x-rays.
I hope you find this all on 4 and implant supported denture information helpful and it is not too overwhelming. I try to provide you with a lot of information without getting too technical. This page does not contain everything you would need to know to make an informed decision for yourself.
“How long does the implant supported dentures process take?”
The all on 4 or implant supported denture process and the rest take about the same amount of time. As a general rule dental implants require 3-6 months to heal in the lower jaw and 4-6 months in the upper jaw. After the dental implants have healed, and depending on which option you have chosen; 4-14 weeks for me to complete your teeth. There also can be quite a bit of pre dental implant work that I may need to do depending on your option; up to 8 weeks worth. You typically will always have some sort of teeth to wear through out the entire process, usually fixed in place if options 1-2 and sometimes 3.
We recommend reading this several times and making a list of questions that you may have. Bring these questions to your consultation so that we may review them together. Please feel free to contact our office to set up a consult appointment so that we can discuss your long term goals of having a functioning, attractive set of teeth.
What happens if you do not get dental implants and instead get something completely removable?
Bone loss will continue at an accelerated pace. The images in the bone loss post show this loss. The process continues over the years without dental implants. The longer the area has no teeth the harder it will be to get dental implants into the jaw since the less bone exists.