Missing All Upper or Lower Teeth

missing all lower teeth

Although many patients are able to wear an upper denture comfortably, some experience much discomfort wearing a lower denture and eating with a lower denture. Several implant-supported replacement options are available if one is missing all of the lower teeth.

Ball Attachment Denture

One option is to have two implants placed in the lower jaw and a denture fabricated that snaps onto these implants. This option allows the lower denture to be more stable while chewing as compared to chewing with a lower denture which is not implant supported. However, there will still be some movement of the lower denture, and sore spots will develop if any food particles, especially seeds, are trapped beneath the denture. As with all removable replacement teeth, periodic appointments for denture adjustments will still be required.

A mouth with the lower jaw missing all of its teeth

1. Before

A mouth with the lower jaw with two implants and no bottom teeth

2. Implants Placed

A mouth with a Ball Attachment Denture latched onto the lower jaw by two implants

3. Denture Attached

Bar Attachment Denture

Another option involves placing four to six implants within the lower jaw, the number of implants indicated depending on one’s jaw size and shape. Following sufficient healing from the implant surgery, the implants are connected with a custom-made support bar. The denture will then be fabricated with special internal retention clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called an “overdenture”. The advantage of this option is that it is much more stable than the first option and permits very little denture movement. The denture is still removable for easy cleaning and maintenance.

A mouth that has all teeth missing on its lower jaw

1. Before

A mouth without teeth and four implants connected by a metal bar on its lower jaw

2. Implants Placed

A mouth with a Bar Attachment Denture secured onto the lower jaw by four implants

3. Denture Attached

Screw Retained Denture

A third option involves placing five or more implants in the lower jaw and attaching a permanent denture. This type of denture is held in place by screws or clasps that secure it to the support posts or bar. This option does not touch the gum tissue, which enables one to clean under the denture without removing it. This denture replaces all of the missing lower teeth and will not be removed except at maintenance visits. Although cleaning under the denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent denture prefer this option due to its stability.

A mouth that has all lower jaw teeth missing

1. Before

A mouth that has six implants and no teeth on its lower jaw

2. Implants Placed

A mouth with a Screw Attachment Denture affixed onto the lower jaw by six implants

3. Denture Attached

Individual Implants

The final option is to have all teeth individually replaced so that they will appear to be embedded within the gum tissue, thereby most closely resembling the appearance of natural teeth. This option usually requires eight or more implants. Separate abutments or support posts for each one of these implants will be fabricated and crowns for each missing tooth will be placed. The teeth are often joined together for strength and support. Overall, this is the most costly option due to the number of implants involved as well as the corresponding replacement teeth that are fabricated for them. Replacement options for consideration may be limited by the size and shape of the jawbone.

A digital representation of the lower jaw missing all of its teeth

1. Before

A mouth showing the lower jaw with all the teeth as individual implants

2. Implants Placed

A mouth showing the healed lower jaw after individual implants were placed

3. Healing Completed

missing all upper teeth

A similar range of treatment options is also available when missing all teeth in the upper jaw. However, because the bone in the upper jaw is not as dense (not as hard) as that in the lower jaw, more implants are generally required to support the new replacement teeth.

Implant Retained Upper Denture

Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of the mouth with a complete denture. This option allows one to fully taste food as well as experience a better sense of its temperature, enabling the denture to feel more natural. This type of denture is also removable, thereby permitting easier cleaning of the support bar and the denture itself.

Individual Upper Implants

To achieve a restorative result that best simulates natural teeth (and is therefore not removable) placement of eight to ten individual implants is likely indicated. With sufficient healing of the surgical sites, abutments will be placed followed by the new replacement crowns.