Fixed Dental Implant Bridge vs. Implant Denture – What is the REAL Difference?

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:

Upper denture

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.

IMG_8191

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:

IMG_4909

IMG_8193 

IMG_5456 

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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.

IMG_4749 

The inside of the denture looks like this.  It has clips that attach to the bar and make it snap in.

IMG_4705

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 Bone volume for samplesif this is not determined in the photographic assessment before anything is done.

 IMG_1731

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

This entry was posted in Dental Bridges, Dental Implants, Dentures - Overdentures, Example Dental Implant Cases and tagged , , , . Bookmark the permalink.

75 Responses to Fixed Dental Implant Bridge vs. Implant Denture – What is the REAL Difference?

  1. shilpa says:

    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!

  2. Typhoon Forget says:

    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

  3. 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.

  4. mike wilson says:

    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?

  5. 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

  6. Bob says:

    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.

  7. 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

  8. Bob says:

    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.

  9. 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

  10. Bob says:

    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.

  11. Hi Bob,
    I will send the info to your email. Please reply that you received it.
    Dr. Amin

  12. sara hunley says:

    What is the cost of a fixed bridge compared to teeth implants. I need only a small bridge about 3 missing teeth Approx. cost

  13. 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

  14. Margaret Johnson says:

    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

  15. Kimberly says:

    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

  16. ann says:

    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

  17. Bonnie Long says:

    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!!

  18. John Dunbar says:

    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

    • Ramsey Amin DDS says:

      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

  19. Catherine mccreadie says:

    High I’ve wore top denture from age 16 hate it so much lost my teeth thru bad asthma hw much would it cost me get fixed denture

  20. Michael says:

    Hello Doctor,
    I recently had oral surgery removing several bad teeth. 3 weeks later we were supposed to add Acrylic temps until I could decide whether to go with implants or bridges for the final solution. I paid $12,000.00 for the temporary work with temps not including the $5000.00 for the oral surgeon who removed the bad teeth and a metal l bracket from a 20 year old broken jaw injury which was causing an infection so 3200 was the actual price for the teeth removal. I have 8 teeth saved on top and 8 teeth saved on the bottom. When the Temps were put in they cracked twice in for days. When I went back for the second repair and started questioning the durability of the acrylic was when I was told by the dentist he never put in the acrylic and I had the resin based temps in and now he will be putting the acrylic teeth in this week. First of all he led me to believe that the acrylics were in already which now has taken the trust away I had in him. Was there a big difference in cost from the resin based temps and the Acrylic temps? For 12000 I assured I was getting great temps which would buy me 1 year to save for the permanent teeth. The permanent work he has estimated at $30,000. Which now Iam started to question also. Any advice would be greatly appreciated…

    • Ramsey Amin DDS says:

      Hi Michael,

      It sounds like there have been some
      miscommunications. Don’t let them get you down. You will be so happy that you had the implants when this is all done.

      In complex situations like you have, I prefer to control all the dentistry from start to finish. This means that one implant dentist is responsible for the surgery and making the teeth. This also helps reduce cost.

      Temporaries do break. Materials are one factor but your bite design and your compliance is usually more important than the material. You should only be chewing very soft foods like pasta until the real teeth are put on.

      Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  21. pkleghaei says:

    Thanks for explaining, Really nice info sharing…..

  22. katrice says:

    Hi Dr.Ramsey
    Im a 34 year old woman that needs major help……I have missing teeth, a few cavities and 5 days ago my gold crown fell out along with my tooth…im afraid of dentist due to the fact that was hurt very badly while getting a tooth pulled….I really want implants but I cant afford it…any suggestions?? is there any insurance that would cover implants??

    • Ramsey Amin DDS says:

      Hi Katrice,

      I understand your fear of dentistry and dental implants. You can sleep through most of it using IV sedation. This way you can get the dental work that you need done in a comfortable manner. It is really awesome. I use IV sedation 1-3 times daily.

      Here is a link;

      http://www.burbankdentalimplants.com/details-of-sedation/

      All procedures can be done safely while you are sedated.

      Respectfully,

      Dr. Amin.

  23. Paula Green says:

    Dr Amin, how nice of you to answer all these questions. I am in WV and have had dental problems as long as I can remember. While in grade school, one of my front teeth was partially broken off and became abcessed(sp?) The dentist said that because my front teeth weren’t straight he had to pull all four front permanent teeth to place a partial. The wires on the partial ruined the rest of my top teeth and I had a full upper denture in high school. Fourteen years ago at the age of 43 yrs., I had five dental implants with an over denture. One year ago, one of the implants broke between the bone and the gum(I think). The surgeon removed the implant and placed cadaver bone around the remaining four implants. A few days ago, I removed the denture and felt pain and noticed the abuttment was loose. I panicked and inserted the denture. When I tried to remove it, it felt like the implant was pulling out. I called my dentist, who is on vacation, and was told to not remove the denture and just clean it as well as possible since he can’t see me for ten more days. My dentist had advised against the permanent bridge, saying my teeth would look very long. I noticed you use pink gum and wonder if my dentist could possibly do this since I will probably, once again, need another surgery.

    • Ramsey Amin DDS says:

      Hi Paula,

      I’m sorry to hear about your dental situation. Some overdentures cause more stress on implants than fixed bridges.

      Most of my patients that I treat elect to have fixed upper porcelain dental implant bridges instead of snap on dentures. You are likely to be missing bone, so pink porcelain will be needed and is recommended. You will likely need at least 6 implants. Your four sound a bit too weak for this.

      Look at this page for some examples;

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      • Paula Green says:

        Thank you for your prompt reply, Dr Amin. I will try to find a surgeon in WV that can do this for me. Hopefully, I will finally have no dental worries.

        Paula

  24. Silver T says:

    Hi Dr. Amin,
    I’m 66, female, have 5 implants to bottom jaw. I am going to get a removable snap-on denture, but would like to have fixed denture that only can be removed by a dentist. Is 5 implants enough for the fixed denture and how much more to get fixed over snap-on denture?

    • Ramsey Amin DDS says:

      Hi Silver,

      Yes, five implants are enough…if they are in the right spot.

      I use five lower implants routinely to support full fixed porcelain bridges for the last fourteen years.

      I would suggest porcelain instead such as the prettau fixed dental implant bridge. It is super strong and looks great and has low to no maintenance. Fixed hybrid dentures break all the time and start looking bad after only 1-2 years because they are plastic dentures.

      I have many samples in this link;

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  25. RJ Anderson says:

    Q1: Sir…you state that a fixed bridge is the best option. Do you mean it’s the best option between the two methods discussed here (overdenture vs fixed bridge) or best option compared to any restoration? I’m thinking of having my awful and too far gone upper teeth removed and a implant and crown placed for each individual tooth. Is that the best option short of having own natural teeth? Or would you still recommend fixed bridge?

    Q2: re: fixed bridges….what is your opinion on a fixed bridge that is in two or four segments? I know one dentist that likes to use a PFM bridge in two pieces, one left and one right side of upper on 8 implants. Another dentist suggested 8 implants supporting 4 segments of a bridge. I guess the advantage of this is not having to remove/repair/replace the whole full arch if something goes wrong but is there also maybe an advantage as far as bite force being spread out over the bridge differently?

    Q3: Is PFM being dropped by a lot of dentist in favor of other options in order to metal free? Like using zirconia instead or e.max? Or is PFM still a great choice?

    Q4: I have been researching hours upon hours, days upon days trying to find out what the best option is for my case. In your opinion can you list what the absolute best 3 or 4 options (in order of bestness*) are for someone who needs to have all uppers extracted?

    *I like to make up my own words ;)

    • Ramsey Amin DDS says:

      Hi Rod,

      thank you for your organized questions!

      q1: The ‘best option’ is different for each person. Just like a minivan maybe a better option than a Ferrari. Your unique situation, desires and anatomy will determine this if money is no object. There are many times when I do replace every single tooth with an implant. Often times, every back tooth is a single tooth implant while the front benefits from some spacing between implants and skipping sites for cosmetic reasons.

      q2: Segmented bridges are great when using traditional technique materials such as PFM. CAD/CAM technology reduces some of the fit problems that leads implant dentists to break up into segments.

      q3: Yes to zirconia –
      Emax is great for esthetics too. PFM’s are good but they do chip!

      q4: Very difficult to answer without seeing you. Fixed, cemented or screw retained CAD/CAM bridges or single unit implants are the best **IF** your bone, bite and facial esthetics will allow. An overdenture or traditional non-implant upper denture would be the less optimal choice.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  26. lisa says:

    An overdenture helps fill in the bone loss on the upper teeth. The pink acrylic can be used to add bulk. If I choose a fixed full upper implant supported bridge is there any way they can still add to the gumline for bulk and to restore lip fullness? I have to make a decision thanks

    • Ramsey Amin DDS says:

      Hi Lisa,

      A fixed implant solution can still support your lips. Your bone loss and skeletal relationship has to be pretty severe under my care to have an overdenture due this reason. Most of the time that choice is made to save money.

      It is very routine in my Burbank office to create full lip support using non-removable dental implant teeth.

      There are VERY special contours that need to be built into the teeth to support your lips the right way.

      I suggest you seek out an ABOI credentialed dentist in your area.

      Good luck!

      Dr. Amin.

  27. Maria Kandetzki says:

    Hi,
    I have a dental implant that I have done a 5 months ago. It was done in my country.
    My dentist there advise me that because the time I spend there was too short. It could become loose, and I should go to a dentist here to tight it up. Could you please do this?

    Thanks,
    Maria

    • Ramsey Amin DDS says:

      Hi Maria,

      I don’t really understand your question. Your implant is unlikely to become loose!
      I can help if you need!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  28. radhika says:

    Hello sir,
    i am 18 year old
    i chipped my front right tooth when i was 16 and at first it was operated upon and fixed with dental cement as the chip was really minor, later my dentist suggested capping and i went for it, but it is opaque ( i think because of metal acrylic) and does not look natural, over time has even moved upwards making gap between my teeth, i want to replace it as it looks really bad.
    please suggest what material will be the best and most natural looking but not very very expensive!?

    • Ramsey Amin DDS says:

      Hi Radhika,

      Your teeth are priceless! A month after having a great result, you will be happy that you spent the money to do it right!

      Each situation is different but you can use E.Max Press, Lava or felspathic

      good luck!

      Dr. Amin

  29. Annie says:

    I have had implants and am ready for my fixed denture. However, one of the screws came out of my implant, is this normal and should I be concerned. My biggest fear is that my temperature denture, which cost over $1600 has fitted so poorly and will not stay in and it makes me look 10 years older. Should I be concerned that my permanent denture/implant will not look any better. How can I make sure my permanent implant fits and looks more natural. I have all my savings riding on this and can not afford to have it redone.

    I live on the east coast. Thanks for your time in answering my questions.

  30. Louis says:

    Great post! We will be linking to this particularly great article on our website.
    Keep up the great writing.

  31. Philip Royall says:

    Dr Amin, your site is great!

    1. Could snap ins be better than permanent screw in types in regards to a solid zirconia bridge? It seems it might be easier to clean around the posts daily. Do certain foods cause snaps-ins to snap out?

    3. What is the difference between an overdenture and a solid zirconia bridge? Despite reading and seeing the pictures here it appears my “acrylic permanents” look more like an over denture and they are extremely hard to clean! They are screwed in.

    4. What is the cost difference between an over denture and a solid zirconia bridge? Do any insurances cover any part of this?

    So far I have broken an upper and lower tooth on my titanium bridge. I have flattened a few teeth in the 4 years I have had them. I do wear a night guard. Also, it is so offset from the actual gum that chewing seems to cause stress/irritation around the posts (at least, that is my thoughts). No screws are in a tooth structure. The over hangs make it very difficult to clean underneath despite my using a Water-Pik device.

    Thanks for any help you can offer. You have a stellar website. Very sadly though, I am a “by-product” of the VA bureaucracy (Given all that, the rotating student left healing posts off for 30 minutes). Eh, he is my doc. No smiles there.
    Regretfully, I am in Bama… (ouch)

    • Ramsey Amin DDS says:

      Hi Philip,
      I’m going to try to answer each one of your questions! My answers are marked by*****

      1. Could snap ins be better than permanent screw in types in regards to a solid zirconia bridge? It seems it might be easier to clean around the posts daily. Do certain foods cause snaps-ins to snap out?

      *********** it is extremely rare that removable snap in dentures would be better than a solid zirconia dental implant Prettau bridge. Removable teeth are made out of acrylic and are essentially dentures that snap onto titanium dental implants. They will require much more maintenance and complete replacement in a few years. It is solid zirconia Prettau dental implant bridge is nonremovable and does not chip, break or need to be replaced as frequently as a snap in denture****

      2. What is the difference between an overdenture and a solid zirconia bridge? Despite reading and seeing the pictures here it appears my “acrylic permanents” look more like an over denture and they are extremely hard to clean! They are screwed in.

      ****** even though they are screwed in, I design certain features in order to be able to clean them. It is really important to me that my patients understand how to keep their dental implants clean and plaque free to avoid the potential for bone loss around the actual dental implants. An interdental brush, rubber tip, WaterPik, floss and electric toothbrush are all necessary adjuncts to keep fixed dental implant Bridges clean. All patients should see a dental hygienist at least 2-3 times a year and have routine x-rays every 1-3 years to evaluate crestal bone loss***

      3. What is the cost difference between an over denture and a solid zirconia bridge? Do any insurances cover any part of this?

      ******* a solid zirconia bridge probably costs one third more than an overdenture… In the long-term an overdenture will be replaced several times while a fixed solid zirconia bridge is very unlikely to be replaced if it is designed correctly and executed by an expert dental implant provider…. You do get what you pay for. When he comes to your body parts, go for the best. insurance hardly covers anything at all unfortunately***

      So far I have broken an upper and lower tooth on my titanium bridge. I have flattened a few teeth in the 4 years I have had them. I do wear a night guard. Also, it is so offset from the actual gum that chewing seems to cause stress/irritation around the posts (at least, that is my thoughts). No screws are in a tooth structure. The over hangs make it very difficult to clean underneath despite my using a Water-Pik device.

      ****Sounds like you have a acrylic fused to metal bridge on dental implants. You have a flange designed that does not lend itself to proper cleaning. The design of the bridge and the position of the implants in the bone are critical to being able to have a bridge it does not break and is easy to clean. My recommendation would be to replace your acrylic dental implant bridge with a Prettau solid zirconia bridge if you have enough from the edges of your teeth to the tops of your implants**

      Thanks for any help you can offer. You have a stellar website. Very sadly though, I am a “by-product” of the VA bureaucracy (Given all that, the rotating student left healing posts off for 30 minutes). Eh, he is my doc. No smiles there.
      Regretfully, I am in Bama… (ouch)

      *****Thank you for your very kind words. Thank you for serving our country***
      Respectfully,
      Ramsey Amin DDS

  32. Stephanie says:

    I just returned from the periodontist , who did a cat sac , and a panoramic can on my teeth. He said I have internal resorption ,and an implant would not work. He said it would take years and many bone grafts. I am 56 yrs old. He suggested a fixed bridge using 5 upper teeth. The tooth is #19 that had a root canal 32 years ago. I had had trauma to the tooth as a child.

    He also said he could do gum tissue support on my canine tooth which needed it. He would make small incisions in my pallet, and then make a splint to cover the pallet so my tongue would mess with it. He said it would take 2/3 months to heal.

    My question. What will support my fixed bridge, will I have to have 4 implants? He never mentioned implants on the other teeth. Just gum tissue surgery.

    • Ramsey Amin DDS says:

      Hello Stephanie,

      Having an abscess over a previously bone grafted area for a dental implant is not that common. The bone may or may not work its way out on its own. The antibiotics will likely help tone things down for a while and buy you some time until your regular dental implant dentist can see you.
      Without seeing you and your x-rays, it is difficult for me to tell you otherwise. Most bone grafts are articulated materials that have the size of small granola. If one of these tiny pieces comes out it means that it was never integrated in the first place. This does not mean that the entire bone graft is going to fail because of one particle that did not integrate.
      Have faith that things will go okay. Thank you for your very kind words. I wish you the best.
      Ramsey Amin DDS
      Burbank, California

  33. Andrew says:

    i was really curious about how much it would cost to get a none corosive and none conductive metal to have either placed over my canines or implanted as my canines. yes they will be sharp. i tend to be looking at these all the time but, the metals i have found are so expensive like platinum or rhodium. the “noble” metals. what i was looking for is something that is durable as well as the current factors ive listed before. is there any other metals that have these properties that aren’t as expensive per ounce? also how much would dental work cost me for both teeth?

    • Ramsey Amin DDS says:

      Hello Andrew,

      Dental implants made of titanium have been around since the mid-1960s. There is a ton of research and data to support the use and safety of titanium alloys. Metal has to be biocompatible to be able to be placed into your body. The cost per ounce of titanium is negligible. Manufacturing of a medical device that is safe to be implanted into patients is priceless.

      I wouldn’t try to reinvent any type of alternative material without long-term studies prior to its release.

      The cost of most dental implant procedures are generally related to the training, judgment, and experience of your dental implant surgeon. Anybody can put a screw in, but placing it precisely into the human body to replace a body part is of critical importance. Oftentimes the bone needs to be rebuilt in order to even have a dental implant.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  34. Helen K says:

    Hi,
    I have a 4 tooth bridge on the right side of my mouth and a 10 tooth bridge on the left side. Tooth #15 (anchor tooth) had a root canal done on it in 2011. It now has a small amount of decay. My dentist suggested getting an eval for a re-do on the root canal. My quote was over $2,000 over the phone . If I decide to get the tooth pulled instead, would I need an implant to replace the extracted tooth and a new 10 tooth bridge? If a root canal can be done to save the tooth, what is the success rate of a root canal being done again on the same tooth.

    Thanks for your time!
    Helen

    • Ramsey Amin DDS says:

      Hello Helen,

      Every time you root canal tooth, it gets weaker. It sounds like this one tooth is very important for your 10 tooth bridge. You should really consider the possibility of a fixed implant replacement such as a monolithic zirconia Prettau dental implant bridge. This would involve extraction of most or possibly all of the teeth on that arch and replacement of those teeth with a dental implant fixed bridge.

      Of course I have not seen you, or your situation, but one tooth supporting 10 teeth is a recipe for long-term failure. A new 10 tooth bridge is not likely to last few more than 3-5 years if it involves back teeth on the molars. Some front Bridges on teeth that do not have root canals can last many years without problems.

      Each situation is unique. Keep in mind that Bridges flex in the Center if they are made of porcelain fused to metal. Recurrent decay around the edges of your crowns and Bridges are very common. Be sure you exercise perfect oral hygiene.

      I have included a link for the Prettau dental implant bridge so that you can know your options should this come to fruition.

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      Good luck and keep me posted.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  35. Diane B says:

    In Feb 2014 I went in to get permanent fixed dentures. I had 8 implants placed on my upper arch and 6 placed on my lower and am in the process of getting fixed permanent bridges. My bridges were made and placed in June of this year. The day they were placed I went to eat pasta and the bottoms broke loose. I went back to my dentist and he said the cement didn’t hold and he tried 3 different cements without success. I was given back my old bottom denture plate until a different bridge is made.He is now going to place a metal bar to attach the bridge to and says they will be non removable. Well tonight after work my upper bridge came loose on one side. Will I loose the upper bridge over the weekend . I can’t get ahold of my dentist, I can’t go with out any upper teeth until Monday. I don’t have my old upper plate it was left with my dentist. What can I do if all of my teeth fall out. I was told the abutments are screwed to the implants and the bridge is cemented to the abutments. The cement is not holding! I’m concerned now because the new bridges he is having made are acrylic and not porcelain like the ones he first made, which is what is loose today, and we are having trouble keeping them in my mouth. They are suppose to be fixed?? And these were just put in 1 month ago. He says I will be happier with the acrylic because I complained about the clicking noise when I talk, you can see the abutment posts along my gum line and he said the gum line can’t be built up on the porcelain bridge, and I wanted longer teeth in the front because now the teeth are straight across and my smile doesn’t follow the smile line of my lower lip. All of this is just to try and give you a little info on my case. My big concern right now is that I’m going to loose my teeth over the weekend and don’t know what to do. Thanks in advance if you can give me any guidance.
    Why am I having so much trouble with these porcelain bridges?

    • Ramsey Amin DDS says:

      Hello Diane B!

      Wow, this is quite a story. I apologize in replying nine days after your original post. I was out of town and my entire office was on vacation.

      Something sounds very wrong here. Cement does not hold bridges in place. It merely just fills gaps. There is no reason for the bridge to rely on the cement for to hold in. It sounds like something is strange with the design of this bridge. A dental implant bridge that is cemented can often hold with just Vaseline and not even need cements because it has built in retention by the shape and length of the abutments. This means they have a very tiny gap in the cement simply provides friction in the seal.

      Yes your teeth are supposed to be fixed and not come out. Clicking noises can also be a sign that the teeth are too tall in your mouth. We call this vertical dimension of occlusion. In my own dental implant practice in Burbank California, I take patients through temporaries in order to test their speech, phonetics, facial support, bite and of course aesthetics. Typically all this is worked out in temporary stage.

      I use acrylic only for temporaries or another material called pmma. Regardless, it sounds like your dentist is going to make this right. I’m sure he has no ill intentions.
      If for some reason your teeth fall out at an inopportune time, recement them with a store-bought dental temporary cement.

      Sorry for the trouble you are having. This is very unusual. On a side note, most of the bridges that I make on dental implants are either retained with screws or have CADCAM milled custom abutments. These are two things that will help prevent the teeth from falling out. This is all by design by a very skilled dental laboratory guided by the dentist.

      links that will help you

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      ;)
      Very respectfully,
      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, CA

  36. Debbie b says:

    I now have the final thing in my month which should have been a titanium bar fitted on 7 implants. Not sure why at the very last minute this dentist decided not to give me a titanium bar. This was not the plan at all and only to find out as the teeth was going into my month. I don’t think I have any bar at all. Does this make any sense? will I end up with issues down the road. I think I have this fixed bridges porcelain but not fused to metal bar only implants.
    This dentist didn’t place my implants and picked up from someone else mess.
    I am seeing my dentist this week and don’t know what questions to ask him. Please help me. I need to be reassured he did not cheap out on the last minute. I think the bar was sent back and some screw up happened at the last minute this is why i now have no bar. He said it was difficult to make the bar with titanium so he use chrome brushed. I am so confused. I can’t afford to do this again for the third time. I am now over $50,000 and still questioning the quality. My trust is so not there and I wish it was. Please help

    • Debbie b says:

      Sorry I forgot to mention it is the all upper teeth. fixed bridge is what I have in now. I can not clean it because have no space. Also my bottom teeth is like a roller coaster (meaning a slight dip. Thank you again. Please reply within a couple days. I am meeting with the dentist this Thursday.

      • Ramsey Amin DDS says:

        The bottom teeth should be leveled out. This ideally is done before the upper is made! I see now that you are having an upper fixed dental implant bridge made! see my other comments please

        Dr. Amin

    • Debbie b says:

      Type of implants: screwed in implants and supposed to have a bar. fixed meaning only dentist can take it out.

    • Ramsey Amin DDS says:

      Hello Debbie,

      I am not completely clear where your seven implants are but I’m guessing they are in your upper jaw. It sounds like you are having a CAD milled titanium bar to support a hybrid fixed bridge. This means that the titanium bar is fabricated by computer-aided design and computer-aided milling…. These are really good and quite accurate. They allow the implants to be joined strongly but passively.

      It sounds like you are on the way to a fixed dental implant bridge, but it sounds like a hybrid. Most dentists make hybrid bridges. This means the teeth are plastic denture teeth on top of a metal substructure. Regardless of the material that’s used, a slight space needs to be developed for you to be able to get underneath with special floss threaders and tiny brushes. The space needs to be very small if it is on your upper jaw so that your speech is not affected.

      So the bar is likely just a substructure for the fixed bridge. He has to try this piece in to make sure it fits. You should be very clear on whether you’re getting in over denture or a fixed dental implant bridge.

      My preference is a Prettau dental implant fixed bridge which is made of monolithic zirconia.
      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/
      The implants had to have been placed purposely for this particular restoration prior to surgery. Not all implant positions will be able to have this superior bridge.

      Good luck with everything… I’m sure it will turn out well! ;)

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      • Debbie b says:

        We were clear we were doing a bar, fixed dental implant bridge.
        He took a ct scan to clarified this was capable of doing.
        I now have this finial in my month.
        This is what I have.
        -No space for getting underneath with special floss threaders and tiny brushes.
        -seven implants screwed in type should have been a bar. But Dentist decided not to without tell me at the very last minute.
        – I can not clean underneath nor can I take this plate off.
        -He said I should never have to take it out every. I said I would cleaning this was the plan.
        -It is the screw in type just no bar
        -one screw not plugged at all because no space for plug
        Do see me having issues down the road?
        -Just screws on porcelain but not fused to metal bar only implants.
        Quality? How long will this last? I am scared I am going to be back to start over in five years or sooner. I can’t afford it

        • Debbie b says:

          Sorry, I meant the other dentist and I were very clear on the bar. He did the scan and he plugged off one of the eight implants. Everything was a go with the bar. Something changed at the last minute. This just not right .

        • Ramsey Amin DDS says:

          Debbie,

          I would have to see you in person to answer these questions. I know you and I have had quite the long discussions.

          A fixed bridge is always better than a bar overdenture if that is what you have. Usually a bar means it is removable

          Ramsey Amin DDS

  37. Ana says:

    Oh wow. You are an incredible dentist. Thank you for responding to everyone’s inquiries.
    I’m 33 years old and had an implant supported denture placed on my upper jaw a year ago.
    My dentist assured me I would be very happy with it.
    Wow, I was most disappointed. He didn’t have an exact model of upper dentures, he only showed me lowers, which I don’t need. They seemed ideal because they would not cover my palette like the temporary denture I had for a year prior to that.
    When I got it I was shocked how bulky it was. I make sure not to open my mouth too wide because though it doesn’t cover my palette, it’s extremely noticeable. The metal on the back that sits on my frontal palette makes it really obvious.
    I had to transfer right after I got them overseas the following week.
    They always have rocked and so I still have to use adhesive. One of the main things I had looked forward to was not having to use that stuff.
    Since they are acrylic, after a year they worn out to the point they have begun to crack and a piece of acrylic fell right under one of the abutments.
    I’m coming up on my yearly dental visit. I’m in the military, it’s all been done via the military. I am very grateful overall. I am no longer in pain and my smile is pretty.
    However, I am considering asking to get a permanent implant supported bridge. I want to be as informed as possible. I read numerous posts here and all the complications and room for error from dentist that are either not competent or misinformed.
    Also, all the possibilities for complications very particular to each individual.
    I’m definitely bookmarking this page. Most likely I won’t get this new dental work done till I return to the states over a year from now. If the military won’t do it, I will definitely pay for it myself.
    There is one thing that turns me off from bridges. The look of it at the gumline seems unnatural from images I have seen. Also, I have a partial bridge in my bottom jaw and there is a slight gap between my gums and the bridge. It’s no big deal in the bottom. I just have to brush really well down there to remove all food particles that get stuck.
    I do hear that there is that gap between the bridge and the gums that requires individuals to use a water pik to really get in there and clean. The idea of having food stuck in between my gums and bridge and not being able to remove it adequately does worry me. I have been pain free with healthy gums for 2 years now, I don’t want to risk gum disease again.
    So can implant supported bridges look as pretty and natural as a well made denture?
    Is my worry for gum disease really a concern? Or is it something easily preventable simply by brushing well with an electric toothbrush and the use of a water pik?
    Also I believe I have 8 implants supporting my denture, if not 8 then 6. Will these most likely be used if I go for an implant supported bridge? I’m guessing so. They seem well placed in my gums.
    Thank you!

    • Ramsey Amin DDS says:

      Hello Ana,

      Thank you for your very kind words. Yes it takes a lot of extra time to respond to 100s of inquiries and run my private practice in Burbank, and balance family at the same time. It is definitely a juggling act…LOL
      It sounds like you have had quite the disappointment in having a dental implant over denture. I do not suggest this type of treatment for a 33-year-old that has not had dentures before for many years. Over dentures are far better for people who have had dentures for many years and are just looking for better support.

      There are definitely really bulky but typically did not rock at all. And yes you are correct, because they’re acrylic they wear out and break all the time especially if the space between your implant in your teeth is minimal. We call this interarch space.

      We all have to remember that what is created by nature and what is created by man are always going to be different. Just like a prosthetic leg looks and feels different than a natural leg, a dental implant tooth has similar disadvantages because it is man-made. The most important thing about making the gumline look natural is to make sure that this transition between pink porcelain occurs under the lip. We do not want to see the transition zone between pink porcelain or pink acrylic when you smile. It is very difficult to mask this because natural tissue has blood within it.

      When done properly, a full mouth dental implant bridge such as the Prettau full contour zirconia bridge can be done in a very pretty smile. Please see the link below and see some real patients that have had this treatment. This needs to be handled by someone who is very skilled and very experienced with full mouth restoration with dental implants. Gum disease and peri-implantitis is always a concern. Make sure your nonsmoker and have excellent oral hygiene with routine hygiene visits at least every 6 months.

      Generally 6-8 implants will support a fixed bridge such as a Prettau bridge or porcelain fused to metal bridge with pink-colored ceramic. Keep in mind that some dentists are far better with re-creating pink ceramics than others. Some labs are just far more experience with this.

      http://www.burbankdentalimplants.com/prettau-dental-implant-full-mouth-bridge/

      http://www.burbankdentalimplants.com/what-is-peri-implantitis-and-what-do-i-do-about-it-bone-loss-around-dental-implants-burbank-dentist-ramsey-amin-reviews/

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  38. Kay Harris says:

    Dear Dr Amin,
    Thank you for your website and the photos of both fixed upper jaw implants and the photos of the removable over dentures. Almost 3 years ago I had the few remaining upper teeth I had removed. I did this rather then trying to save these 6 teeth. I had several dentist recommend implants rather then trying to restore the 6 teeth which all were crowned and 2 with root canals.
    I had 5 implants placed in the day I had the 6 teeth removed. 4 months later I went in and 3 implants were removed due to not adhering to the bone. I did have 2 CAT scans which indicated I had enough bone. The dentist did extensive bone grafts several times and placed several more implants. I have lost tract of how many implants were placed. Eventually I had to have a sinus lift and then another bone graft. As a result I finally have 4 good implants. I took calcium suppliments during this whole process. I was in my 70’s when this process began and now I am 80 years old.
    This past week after about 4 months of planning by the dentist creating my snap in over denture I finally got some permanent teeth. I would have prefered the fixed implants but am grateful for the snap ins. I was not sure I liked all this metal in my mouth with the bars but I guess I will get used to it all. I can snap the over denture okay and snap it in in the morning. My dentist charged me up front and never asked for another penny for all the extra work he did. I had one dentist doing the implants and another doing the denture, they both worked closely together. All in all I am grateful to have a new set of teeth at age 80 years. I just worry if I get old and feeble will someone else be able to get the denture out and in.
    Thanks for the photos, they look just like what I have. Kay

    • Ramsey Amin DDS says:

      Hi Kay,

      Thank you for sharing your story. It is definitely an unusual one. If these types of complications happened on a regular basis, nobody would be having dental implants or bone grafting done.

      Fortunately dental implants and dental implant bone grafting is a highly predictable procedure for the vast majority. I’m so sorry you had such issues along the way.

      You should be tested for osteoporosis/osteopenia and know your T score by taking a DEXA scan with your physician. I am guessing you may have had some sort of underlying disease such as diabetes mellitus, osteoporosis or have possibly been on long-term Fosamax or Boniva which could’ve resulted in failure.

      Regardless I’m happy that you’re doing well now. Again thank you for sharing your story. There are several thousand people that read this blog on a regular basis.

      Good luck,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  39. teresa devol says:

    Hello. I had all my teeth pulled I was supposed to get full bridge implants the dentist took our full 401k pulled all my teeth and then lost his license cause he killed a patient using meds to sedate and wasn’t licensed to. I lost a lot of bone I’m sure I will need bone grafts. What kind of cost am I looking at at worst case scenerio? If I come there to do it how long will I need to be there?

    • Ramsey Amin DDS says:

      Yikes Teresa!

      What a horrible story. I feel so badly for all parties involved here.
      IV sedation in a dental office is extremely safe when the provider is well-trained, experienced and does this on a daily basis. Do not assume that all dentists are trained alike.

      I am assuming this is one of these dental implant super centers which advertises on the radio extremely low rates and a factory, clinic-like atmosphere? I routinely see patients from these Walmart style centers which come to me with poorly placed dental implants , lots of complications and broken teeth.

      There was a place in Orange County Southern California that this occurred. Were you treated in this location?

      Without seeing you in person, there is no way for me to know how long he would need to be here. Where do live?

      Very respectfully,
      Ramsey Amin DDS

  40. Kay Harris says:

    Dear Doctor Amin,
    Just wanted to let you know I did have a DEXA scan and all was fine. I have a slight case of ostepenia. I do not have diabetes and I never have been on Fosomax. I think my problem was that I had lost several teeth as a young girl and my bone disintegrated. The oral surgeon doing the implants felt my bone was okay until he began the surgery.
    All in all I am doing okay with the snap in denture.
    Thanks for your reply, Kay

  41. M says:

    Hi! I’m 48 and never had any problem with my teeth until last year in July. I felt some swelling in my front left upper tooth gum. When I touched it started to pus, very small amount of pus. After that I had to go to rinse my mouth in every 5 minutes cause there’s a bad taste in my mouth. I have no dental insurance, but a friend dentist saw me and told me that I have serious gum disease and only a periodontist can fix my problem. Because of severe financial problem I couldn’t go to a periodontist, now my tooth is loose and pus still comes. Front left upper tooth is getting longer and those two teeth are getting so much space in between them. I don’t know what to do or where to go, can you suggest anything please. Thank you!

    • M says:

      Hi! I’m 48 and never had any problem with my teeth until last year in July. I felt some swelling in my front left upper tooth gum. When I touched it started to pus, very small amount of pus. After that I had to go to rinse my mouth in every 5 minutes cause there’s a bad taste in my mouth. I have no dental insurance, but a friend dentist saw me and told me that I have serious gum disease and only a periodontist can fix my problem. Because of severe financial problem I couldn’t go to a periodontist, now my tooth is loose and pus still comes. Front left upper tooth is getting longer and those two teeth are getting so much space in between them. I don’t know what to do or where to go, can you suggest anything please. Thank you!

      • Ramsey Amin DDS says:

        Hello M,

        It sounds like you have long-standing, undiagnosed periodontal disease which has caused bone loss. If you are smoker, this is far more aggressive. If the teeth are loose, oftentimes this is going to lead to extractions.
        A periodontist may be a good start but is not necessarily a requirement. You need to have a great dentist as your main quarterback, and the periodontist as backup. Your case will likely require tooth replacement and restoration with either dental implants, partial dentures or even full dentures. Some dentists are trained in all types of specialty procedures and are true “total solution providers.” You may be best seeking an opinion of a total solution provider who can then steer you to a proper specialist if needed. Many of the best dentist in the world are general dentists who are trained in all types of specialty procedures such as endodontics, periodontics, implant dentistry, oral surgery, prosthodontics and others. I find that these providers have the best solutions both long and short-term.

        Regardless of who you see, you need to see somebody very soon.


        Ramsey Amin DDS

        • M says:

          Thank you Dr. Ramsey Amin for the fast reply! I want to ask you a question… I never smoked in my life, I drink soda once in months, don’t have sweets more often, I floss every day since last 25 years, I can’t even sleep if I don’t floss, I clean my toung regularly and there are people I know who are much older than me and they don’t even floss then what are the reasons I got gum disease? I am just wondering if people have gum disease because of some deficiencies. Thanks!

          • Ramsey Amin DDS says:

            hi M,

            I would have to see you to help you with this. There are some types of gum disease that present themselves without any pain or problem to the patient at all. The key is to see a dentist twice a year and to catch these things very early…sorry

            RA

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