Chris Salierno, DDS
Chief Editor
In my practice, I make more implant overdentures than conventional dentures. I’ve also realized that overdentures might be a better solution than fixed-implant restorations for certain cases, such as severe bruxers and those with poor hygiene. Are implant overdentures on the rise nationwide? I asked three experts for their observations.
Steve Pigliacelli, CDT, MDT
Vice president of Marotta Dental Studio
In this age of full-arch fixed-implant bridges, I have seen a steady increase in overdentures in my lab. Whether due to cost or lack of bone, many patients are opting for bar or direct-to-implant attachment overdentures. Ball, ERA, Locators, Rhein Equator, GPS, and mini-implants are common direct-to-implant attachments. Lower dentures retained by two implant attachments are very popular. Meanwhile, upper dentures will have four implants and a bar. I have found that for patients who have severe bruxing issues, a fixed case is not always a great option. Instead, a bar with two separate overdentures is a good alternative. In this scenario, the dentures can be easily repaired for years without removing the bar.
CAD/CAM-milled dentures are getting better every day. Eventually these will allow quicker, easier, and more durable monolithic dentures that can be remilled and replaced instantly. With these new materials and digital workflows, full dentures, partial dentures and implant overdentures will continue to grow with more enduring success.
David Avery, CDT
Dental technology section editor, Journal of Esthetic and Restorative Dentistry
The percentage of adults facing edentulism is decreasing, but as the baby boomer demographic ages, we are starting to see a significant increase in complete edentulism numbers. This broad market has a significant percentage of patients who are not candidates for the costlier fixed implant option. The increased popularity of mini-implants is creating a subset of cost options that will make it possible for improved retention and function with attachments to positively affect another economic sector. Also, as the marketplace continues to diversify with an emphasis on lower cost alternatives in the root-form group, reduced cost to the patient should improve implant-retained case acceptance as well.
Chris Bormes
CEO of Preat Dental
I see a trend in patients moving from fixed to removable due to the hygiene and esthetic challenges of fixed restorations. Our dexterity does not improve as we age, and it is extremely difficult for a patient to exercise good hygiene on a ridge-lapped or modified ridge-lap prosthesis. This combination of a food-trap design and poor hygiene leads to halitosis, excessive bacteria, periodontal issues, and potential implant failure. A removable bridge allows the patient the best of both worlds—a prosthesis that feels fixed, can have a flange to restore esthetics, mask high or gummy smile lines, and be easily removed for improved hygiene. It may be a bar-retained prosthesis or four well-placed stud attachments, such as locators. Locators are low profile, easy to work with, and self-align, and the eight different retention levels allow customization to patient needs.
