Root Retained Over-Dentures

Question:

Over the past 10-15 years I have lost more than half of my upper teeth and most of my lower molars. I am now having trouble chewing and my jaw joints are starting to ‘clunk’ when I open and close. I know I need to get this problem fixed but I’ve had partial dentures before and could never tolerate the feeling of something covering the roof of my mouth. I was recently told that the only way to avoid covering my palate was with an implant supported palate-less denture using four or more dental implants. Problem is that I really can’t afford that kind of treatment. I have great dental insurance so are there any other options besides dental implants?

Answer:

First of all your situation is not all that uncommon, and yes, dental implants can be very expensive and time consuming. First, there is the surgical fee for multiple dental implants and then there is the additional cost of the implant denture or crowns. Dental implants placed in the upper jaw can also take 6 or more months to fuse to bone before they can be restored. I strongly recommend a complete Neuromuscular workup to address your TMJ issues. If you cannot afford dental implants and the thought of a regular clasped partial denture is not appealing, then a root retained overdenture may be worth considering.

If you have adequate root length and bone support on three or more of your upper teeth and these teeth are spread out around the arch and your ‘bite’ is within normal limits then you may be a candidate for a root retained overdenture. Rather than utilizing a series of dental implants to support a denture we may be able to design an overdenture which attaches and detached to a series of individual post and root caps which are permanently anchored into the roots of your remaining (retained) natural teeth. This type of a prosthesis is removable by the patient and requires that root canal treatment be performed on all the chosen anchor teeth so that a cast post and root cap can then be bonded inside the tooth after it has been shaved down closer to the gumline. On the top of these root caps the male half of a two piece friction fitted attachment is typically attached and is made to line up with a matching female housing which is permanently buried in the acrylic on the underside of the denture. When three or more of these attachments are utilized, the overdenture can be snapped down on top of these root caps to create added stability and retention such that a large portion of the acrylic overdenture can now be removed to create extra room for the tongue. This has a profound impact on how the patient talks, breathes, laughs, eats and swallows. The added benefit to this type of prosthesis is that it allows the patient to retain several tooth roots and the surrounding jaw bone which helps to maintain the integrity of the patient’s arch shape and facial profile.

When this style of overdenture is fully seated to place nobody can see these attachments because they are all housed on the underside of the prosthesis. From a maintenance perspective, all the patient has to get into the habit of doing is snapping the overdenture in and out of their mouth daily to clean and care for the cast post and root cap screws which can be easily replaced every couple of years.

Esthetically a finished root retained overdenture looks fantastic and can be fabricated and delivered for considerably less than the cost of a 4x dental implant supported overdenture and usually with better insurance coverage. If you are interested in determining if this is a potential option for you or one of your family members, we invite you to give our office a call.