Replacing the top teeth with dental implants
“Mary didn’t mind the look of her denture – it was the fact that it was removable, she really wanted fixed teeth back, teeth that she could rely on for eating, and teeth that wouldn’t drop unexpectedly”
What Mary was looking for
Over the years, Mary had used a good quality removable denture, and this had served her well.
On the top, she had three remaining teeth, and they all had crowns on them. The previous dentist had built in “special attachments” which is a very good way to hold the removable denture in place.
Mary was actually referred to me by another dentist, who had recommended to just replace the missing teeth with teeth on dental implants – becuase the remaining teeth were still healthy, and could be made to look nicer if they had modern porcelain crowns placed.
But there was a problem. If you look at the x-ray (below), you will see that in one place where we needed to place the implant, there was only about 3mm of bone!
For most implants, I look for a minimum of 10mm of bone, so there was clearly a lack of bone here. So what were our options now?
These pictures show Mary with and without her denture
Option 1 – sinus lift
The reason there is not enough bone is that over time the air sinus in the cheek bone has enlarged, and thinned out the bone, where the teeth used to be.
It is possible to carry out a treatment called a sinus lift, and this effectively reverses the bone thinning effect, its very sucessful, but it does have some drawbacks:
- It will take about 9 months for the bone to become hard, so it will be nearly a year until we can fit the teeth.
- For the week after a sinus lift, most people will get a lot of bruising and swelling (but surprising very little pain)
Option 2 – All on 4
The second option is to remove the remaining (healthy) teeth and place 4 implants, with the back two being angled slightly to avoid the sinus.
The downside here is that we need to remove healthy teeth – something that seems counterintuitive!
The big advantage is that with this treatment, it is possible that Mary gets a full set of fixed teeth in one day, and the implant healing happens with the fixed teeth in place.
The other advantage is that we have full control of the look of the end result. There is no visible junction between implant teeth/ gums and the natural gums. This gives a better looking end result.
Mary opted for the all-on-4 type of option, and the above photos show what her smile looked before the treatment day, and how it looked after.
The teeth provided on the day are designed to look good, but it is important to know they are not as strong as they should be to be a long term solution.
So after the implants are fully healed, we then go through the stages to replace the missing teeth with a thinner and stronger set of teeth. At this stage, we can fully customise the appearance of the smile, and really make it fit the individual.
After 6 months, we went through all of the stages to make the final metal bridge.
This is a long lasting, better looking and thinner bridge, which is much less likely to break. If it does break, then it can easily be repaired in most cases.
This treatment cost £15,000 in total. £10,000 was the initial treatment to place the implants and build the initial trial smile.
The final £5,000 is for the final bridge, which is placed 6 months later.
Finance options are available on this type of treatment