There is a common mistake that I hear from patients on a regular basis.
Often times, I see patients for second opinions for dental implants to replace all of their teeth. They tell me they are having all their teeth removed and having a "bridge"
When I dig deeper or reference their paperwork, they are actually getting an overdenture!
Whoa! Yikes! Wait a second!
There is a HUGE difference between a "fixed bridge" and "overdenture" which some falsely call a "removable bridge"
Look at these pictures:
Note the size of the two.
An overdenture is just that…a denture that goes over implants and it is removable. It must be taken out at night and cleaned underneath.
Don't get me wrong, overdentures are fantastic for the right situation. Nine times out of ten, the right situation is a person that has had dentures for years and needs extra hold and security with their dentures. They can be made to look great.
Fixed bridges are cemented or screwed to the implants and cannot be removed by you. Unlike dentures that have pink acrylic and plastic teeth, fixed bridges are porcelain fused to metal.
You will not have anything touching the roof of your mouth going over your gums with a fixed bridge. The teeth "emerge" from the gums and are not plastic like dentures.
Overdentures can be made with porcelain teeth, but that only makes the dentures look better. It does not make them smaller or feel more natural.
Fixed bridges have a gold substructure underneath them. Hence the name "porcelain fused to metal." Because they have gold they are very strong compared to their overdenture counterpart.
If you are missing a little bit of gum, I usually make pink ceramic porcelain near your natural gum line. This will make it so the teeth don't look too long and square. Having that little triangle of gum between the teeth makes all the difference when you smile.
These are fixed porcelain bridges that I made for the whole upper jaw. These patients lost all of their upper teeth:
The cost of dental implants and a fixed bridge is more than an overdenture. A significant amount of gold is needed to make your implant bridge. Gold is about $1900 an ounce (in 2011) and it takes a several ounces to make a full upper or full lower bridge with 12 teeth. Of course, the fewer the teeth, the less the cost will be.
This is a picture of a patient of mine without his overdenture in place. The implants are connected to a bar that the removable teeth snap onto.
The inside of the denture looks like this. It has clips that attach to the bar and make it snap in.
A fixed bridge requires much more precision to make than an overdenture and typically more appointments. The implants also need to be much more precisely placed, whereas an overdenture has some leeway.
What is right for you? It really depends on what you want, your budget, and how much bone you have.
The position of your lips and how much space you have between your top ad bottom teeth is CRITICAL. This is often overlooked by your average dentist. Your face and lips can end up looking too bulky or caved in if this is not determined in the photographic assessment before anything is done.
You typically need more bone and more implants to make a solid fixed bridge than an overdenture. Depending on your situation, bone grafting may be necessary. These are things I can only determine by evaluating you in person.
If you are missing all of your teeth, a CT scan is almost always necessary to have a safe surgery.
The fixed bridge is the best long term solution and requires very little maintenance. An overdenture may be upgraded in the future to a fixed bridge.
Bottom line… A fixed bridge is the best and an overdenture is meant for people that already have dentures.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California
http://www.burbankdentalimplants.com
Thanks for clarifying this. I wish I had you do my surgery. The doctor I saw is not considered to be an expert like you are. I may travel to come see you!
I would like to know what is the different in cost (approximate) between the overdenture and the fix bridge. Are the number of implants the same for both procedures
You will need more implants for a fixed bridge than an overdenture. Typically 6 -10 implants are ideal for a fixed bridge.
The main cost difference is not the surgery, but rather the teeth. There is extensive lab expense involved.
A fixed bridge can cost double the cost of an overdenture. A fixed bridge is the best of the best.
with a set of fixed bridge dentures, what should the cost difference be between acrylic and porcelain – I was told that fixed acrylic would run about 16000 vs 25000 for porcelain.
Is this price spread accurate?
Hi Mike Wilson,
Yes…that price range sounds fairly normal.
Does this include standard or custom abutments? Does this include or exclude the implants, bone grafting, and extractions?
Consider the long-term costs of definite repairs if you go with the acrylic style. Tooth fracture is very common if it fixed with plastic denture teeth.
Does this help you?
Dr. Ramsey Amin
Please provide a ball park estimate for making and installing an upper and a lower fixed bridge. 16 implants are already in place and ready to go. Thank you for your assistance.
Hi Bob,
A few question so I can answer you more accurately.
1. Were the implants placed in such a way to accept a “screw-retained” bridge or a cemented bridge?
2. Do you have enough lip support with your current temporary?
3. Are the final abutments in place or do you just have healing abutments?
4. Do you want acrylic teeth or porcelain?
5. Would you be available to come in for me to look at you if you are local?
Respectfully,
Dr. Amin
In answer to your questions:
1. Were the implants placed in such a way to accept a “screw-retained” bridge or a cemented bridge?
They should have been done I believe for a “screw-retained” bridge but I am not sure.
2. Do you have enough lip support with your current temporary?
Do not have a current temporary.
3. Are the final abutments in place or do you just have healing abutments?
Healing abutments.
4. Do you want acrylic teeth or porcelain?
Porcelain
5. Would you be available to come in for me to look at you if you are local?
We are in San Gabriel. I am asking about
my wife and will need to see if she approves.
Thanks.
Hi Bob,
Since you live so close, why don’t you come in for free evaluation?
I am here until Wednesday, then wont be back until 2011.
Please bring a current panoramic x-ray or fmx AFTER all the implants have healed more than 4 months.
If you do not have that x-ray, it can be taken for a nominal fee.
It will also be helpful, to have the name and sizes of implants that you have.
Please speak to Angie or Sophia when you call.
Looking forward to meeting you!
Dr. Ramsey Amin
Since we are not really local, I was hoping for a ball park figure to see if it is worth while coming in to see you.
Hi Bob,
I will send the info to your email. Please reply that you received it.
Dr. Amin
What is the cost of a fixed bridge compared to teeth implants. I need only a small bridge about 3 missing teeth Approx. cost
Hi Sara,
In order to quote you accurately, I would need to see you.
It will depend on your bone structure, and the area of the missing teeth. If I am able to use a one-piece implant, that can save you some money.
Keep in mind that if you decide to do a regular bridge, you will be replacing it in 5-7 years. An implant bridge is usually done only once!
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California
http://www.burbankdentalimplants.com
I am a 59 yr. old female. In the last year, all of my teeth were pulled. I had a set of dentures made that cost more than a thousand dollars. My gums would not support them. Then I had surgery to have four implants in the top of my mouth and two in the bottom. Because a couple of the top ones did not graft due to my not having enough bone, they were redone using cadaver bone. Then I was referred to a dentist to have dentures made. He initially told me that my bottom dentures could be adjusted to fit over the implants, but that I would need “hybrid” dentures made for the top. A couple weeks later he sends me a copy of his “plan” for me. Now he says I need six abutments at the cost of $470.00 each, and new dentures upper and lower. He says that the estimated cost will be around $5,700.00. (I have already had to pay for than $11,000.00 for the extractions, dentures, and implants.) Why do I need implants and abutments? I am throughly confused and broke.
Hi Margaret,
The most important thing about your treatment is the plan that is developed before you ever start. A diagnosis is made, then the treatment is executed to follow the diagnosis. Sometimes, immediate dentures need to be replaced and can not be used for the final teeth. In my office, I control all these factors by doing the surgery and making the teeth myself in most cases. This controls cost and leads to great results. Have a discussion with your dentist about what your options are at this point.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
818-846-3203
Hello Dr. Ramsey, I am a 28 year old female, and my mouth needs a lot of work. I have been to several dentist for consultation, but was not satisfied, on what they told me. My front two teeth are discolored, and one has an infection, and is longer than the other. I also have some missing teeth on each side of my jaw. I have a build up of calcus as well. I was told that it would take 2 years to fix my teeth. Why so long? I am interested in a impant bridge. Do you think I will be paying a lot for an implant bridge for the top of my jaw. I do not want to spend a fortune, but I want something that will last and look natural.
Hi Kimberly,
It sounds like you need a fairly substantial reconstruction of your mouth. Depending on the extent of bone grafting and making teeth, sometimes it can take 1-2 years to complete. Bone by nature heals slower than other parts of our body.
As far as cost goes, dental reconstructions can vary depending on your needs. I have done rehabilitations from as little as $1500 to as much as $90,000. You really need to have a diagnosis and treatment plan that is well thought out and phased properly.
I hope this helps.
Respectfully,
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
hi dr. amin,
i like your info but am based in east bay area, do you have a referral close to hayward?
email annoneh@yahoo.com
Hi Ann,
Your best implant dentists in the country would be found here:
http://www.aboi.org/index.html
Repectfully,
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Hello Dr. Amin!
In the past 6-7 months, my remaining lower teeth have broken and 3 of the 7 teeth that I have are at varying heights of “nub.” I have gumline cavities to all 7 that remain. These are front teeth as I have lost back/jaw teeth at various times d/t extractions. I realize that you would need to see me for an accurate price on the removal of these and the cost of either a “fixed” or an “overdenture.” However, I am hoping you can give me a rough estimate on the cost of either procedure/appliance. I would definitely prefer the fixed but my finances are, of the course, the issue. I do not have insurance, so all costs are out of pocket. I am a nurse and my smile is very important to me as well as my patients. I feel as if I look like a “crackhead” or “meth user.” I would hate to have someone that looked like a drug user caring for me or my loved one! Therefore, I am not smiling like I used to! I know my teeth are visible when I speak, so I look down or away when conversing. I was very impressed when I saw that you answered people’s questions, so I am hoping you can answer mine & n afford someone with your expertise to make me smile again!!
I am a 75 year old 10 years out from a heart transplant. I have a full upper denture and a bridge with only 6 teeth on the lower. i have had quite a bit of bone loss on the upper jaw but am considering implants. My dentist had CAT and MRIs done and determined I could support an upper full im plant devise with 4 posts if the outer two were installed radially. My question is should i consider a removable or fixed device? the difference in cost is $22000 vs $15000. Are the fixed devices really worth the difference in price? I do not like the full pallet dentures i now have.
Thank you
Hi John,
Fixed implants are MUCH better than removable. Just make sure the bridge is porcelain not acrylic plastic.
Four implants is too few for a fixed bridge. If one fails, there is no back up and you will lose everything.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry