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Screwed In Bridge Instead Of Overdenture

This patient had a lower left overdenture instead of a fixed screwed in bridge for many years which she did not like. The overdenture is not a real bridge. It has a removable denture that snaps in and out of the implants.

Before treatment upper and lower over dentures. The bad implant is under the gums on the right side of the photo.
Old overdenture with bad contours catching food and causing bad smell

Implant bridge Using Old Implants

What’s unique about this case is that the overdenture was only on one side!  The old implants could be used just as they are to make a fixed bridge.

To me, it does not make sense to have something removable on the bottom jaw when something fixed is attainable. I suspect it was done as a removable overdenture on implants because of operator inexperience.

Over the years, the overdenture placed a lot of pressure on the gums causing one of the implants to fail. Locator overdentures rock the implants back and forth and put a lot of pressure on the gums, which chokes off their blood and nutrient supplies.

Process of Converting Overdenture To Fixed Bridge

For this patient I extracted and removed the one failing implant and made a small zirconia fixed bridge on the remaining implants. A digital impression was taken with a trios scanner. I then fabricated a temporary bridge to test the fit, function and aesthetics before going to the final. This allowed the patient to try everything out to make sure she can clean it and that we both like everything about it.

Digital dental implant impression taken with trios. You can see where the bad implant is because the tissue is red. That one will be removed.
Failed bloody implant removed. You can see bone on it!
Temporary screw retained bridge to test everything out before going to final.
Temporary screw retained bridge to test everything out before going to final.
Gums healing nicely around dental implants after overdenture was removed.
Underside of the implant bridge showing titanium abutments and zirconia bridge.
Final dental implant Bridge underside. The hump is there to fill in the missing bone from the failed implant from the past.
Final bridge top view
Final zirconia bridge side view -please note the upper is still an old denture and has not been replaced
Final zirconia bridge-front view — only the lower is new. The upper is a regular denture

After wearing the temporary bridge for a few months I then converted her over to the final, which takes a very precise fit since zirconia undergoes shrinkage during the lab fabrication process.

The new bridge has much better contours and does not have that “smell” that she did not like.  Overdentures are made out of plastic acrylic that absorbs odors.

The patient’s goal is to replace her upper as well with zygomatic implants, but she has some sinus issues that need to be resolved first.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California
818-846-3203

2 thoughts on “Screwed In Bridge Instead Of Overdenture

  1. My overdenture that fit over 4 Mini implants was lost by Memorial Sloan-Kettering Hospital while a cancer patient. I owe them my life but unfortunately the Denture is gone and very costly to replace and they will not provide any relief for the Financial loss.. But the further complication is that the oral surgeon who made the overdenture 9 years ago is now hospitalized and failing. I tried finding out from him and his office what lab was used for the titanium mini implants but they have no idea. And no records. And the gentleman is very elderly. So I’ve seen a new potential implant denture specialist dentist who said that we could potentially restore the overdenture at worst, but he’s seriously recommends that at least two full size implant be used and create a fixed denture to work with that system. My question is this, if that new dentist inserts 2 implant .. does he remove the minis that are in the center of my lower jaw first and if yes, is there is any risk? Will the removal of those mini implants fracture the bone? Another words do I end up with a nightmare simply to try to insert to new strategically-placed full sized implants adjacent to where the minis currently are. In other words he’s not going to try to put new ones into the position where the minis are they will straddle the opposite ends of where those Minis. Are now.

    1. That is some tough lock but at least are alive! They are not that many manufacturers of many dental implants. I think if you see a true dental implant specialists will be able to recognize what these are and be able to order parts. Typically the mini implants are removed if you are going to have traditional ones placed as well. Two implants are not enough. Four would be much better. It is best to have all similar type of implant so that the ability for the implants to grab (like locators) the parts are easily accessible. You can always cut the smaller implants level to the bone if they break off in the removal process.

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About Ramsey A. Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.