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. They are especially beneficial for the lower jaw.
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 or monolithic zirconia such as the Prettau dental implant bridge.
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.
Some 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. More recent advances allow fixed Bridges to be made out of solid zirconia such as a Prettau style dental implant bridge.
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. If you are missing a lot of gum and bone than more pink ceramic will need to be added to give you proper facial lip support.
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. The process of restoring multiple dental implants into a fixed bridge is a highly complicated procedure with a very high laboratory cost. It takes many more appointments to make a fixed bridge that it does an overdenture. There is little to no room for error in a fixed bridge. An experienced implant dentist will spend an extraordinary amount of time to make everything right so that you do not experience failure of the bridge. Replacing a full upper jaw with fixed dental implants is considered the single most difficult thing to do in dentistry.
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.
. The implants also need to be much more precisely placed, whereas an overdenture has some leeway.
Over dentures are far better for the lower jaw that they are for the upper jaw. I do not commonly recommended over dentures for the upper unless there is extreme circumstances usually related to facial skin support.
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 or bone leveling 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