Dental Implant

[walaa talaat]

what are implants?
Implants are devices that replace the roots of missing teeth. They are used to support crowns, bridges or dentures . Implants are placed in your jawbone by surgery. Most of the time, implants feel more natural and secure than other methods of replacing missing teeth, such as dentures.
There are many reasons it's important to replace missing teeth:



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Having all of your teeth can make you more self-confident. You don't worry that people notice that you have teeth missing.

When teeth are lost, the area of the jawbone that held those teeth starts to erode. Over time, you can lose so much bone that you will need a bone graft to build up your jawbone before your dentist can place implants or make a denture that fits properly.

Tooth loss affects how well you chew and what foods you are able to eat. Many people who have missing teeth have poor nutrition, which can affect overall health.

The loss of teeth can change your bite, the way your teeth come together. Changes in your bite can lead to problems with your jaw joint, called the temporomandibular joint.
Losing teeth can lead to changes in your speech, which also can affect your self-confidence.There are several types of implants, including:

,Root form ,Transosseous ,Ramus frame
Blade formRoot-form implants are the most common type used today. A root-form implant is made of titanium. It looks like a small cylinder or screw. After an implant is placed in the jawbone, a metal collar called an abutment eventually is attached to it. The abutment serves as a base for a crown, denture or bridge.
The key to the success of all implants is a process called osseointegration. This is the process in which the bone in the jaw bonds with the implant. Titanium is a special material that the jawbone accepts as part of the body.
The ability of titanium to fuse with bone was discovered accidentally. In 1952, a scientist named Per-Ingvar Brånemark was using titanium chambers screwed into bones as part of his research to discover how bone healed after an injury. When he tried to remove the titanium chambers, he found they had become bonded to the bone
Dr. Brånemark then did further research into how titanium implants might work. In 1965, the first root-form implants were placed in people. Other types of implants also have been used for the last 30 to 40 years. Many implant systems are available from various dental manufacturers.Successhttp://www.simplestepsdental.com/i/b/blue_bar.gif
Studies indicate that surgical placement of root-form implants is successful more than 90% of the time. When these implants fail, the problems usually occur within the first year after surgery. After that, only about 1% of all implants fail each year. Implants have become increasingly popular since the American Dental Association (ADA) endorsed them in 1986. Between 1986 and 1999, the number of implant procedures tripled. An ADA survey found that the average number of implants placed by a dentist who does the procedure was 56 per year in 1999, compared with 18 in 1986.
It is now estimated that between 300,000 and 400,000 implants are placed every year in the United States.
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Depending on your particular problem, implants can be more expensive than the alternatives (denture or bridge). A basic implant plus a crown can cost between $1,500 and $4,000. The fees will depend on many factors and vary considerably. Insurance companies generally do not cover this cost, although you should always check with your insurer. While the upfront cost for implants can be more than for other types of restorations, the investment can pay off in the long run. You may not need an implant for every missing tooth. Your dentist can discuss how many implants you will need.
Other benefits of implants include:

Feel — Because implants are imbedded in your bone, they feel more like your natural teeth than bridges or dentures.

Convenience — You will not need to worry about denture adhesives or having your dentures slip, click or fall out when you speak.

Nutrition — You will be able to chew better with implants. Chewing can be difficult with regular dentures, especially ones that don't fit perfectly. A regular upper denture also covers your palate, which can reduce your sense of taste.
Self-esteem — Because implants are so much like your natural teeth, you will think about them less. Your self-esteem and confidence will be improved because you will not have to worry about denture problems or people noticing that you have missing teeth. Regular dentures also can affect your speech, which can make you less self-confident when talking with others.http://www.simplestepsdental.com/i/5/5x5transSpacer.gifhttp://www.simplestepsdental.com/i/5/5x5transSpacer.gif

[dr.tamtamology]

موضوعك جميل

جزاكي ربي خيرا

[walaa talaat]

Who Is an Implant Candidate? :faces223:

If you're interested in replacing a missing tooth or teeth, dental implants may be an option for you. Not everybody, however, is a good candidate for implants. A good candidate should have the following:

Good health <Healthy gums <Enough bone to anchor the implants in the jaw — Some people who have lost bone in their jaw still can get implants, but first the bone must be rebuilt using special procedures.
A commitment to taking very good care of the implanted teeth and surrounding gums — Daily brushing and flossing are essential. Regular visits to the dentist for follow-up are also important.Some people may not be good candidates for implants. They include:

<Young people whose jawbones have not developed completely Pregnant women <Heavy smokers — Smoking hinders healing in the mouth. It can reduce the likelihood of a successful implant. <Alcohol or substance abusers I People who have received high-dose radiation treatment of the head or neck People with chronic diseases or systemic problems, including:
<High blood pressure <Diabetes <Connective-tissue diseases <Hemophilia
Significant immune deficienciesYou still may be a good candidate for implants even if you have one of these conditions. It depends on the extent and severity of the condition. People who take certain medicines, such as steroids or drugs that suppress the immune system
People who severely grind or clench their teeth — These habits can place too much pressure on the implants and increase the risk of failure.Your dentist can evaluate you to see if you would be a good candidate for implants.
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Implant therapy involves a team. The surgeon (usually an oral surgeon or a periodontist) places the implant or implants. Then the restorative dentist takes over. This is usually a general dentist or prosthodontist. The restorative dentist will make the crowns, bridges or dentures that the implant or implants will support.
Your first step is to make an appointment with one of these professionals for an evaluation. He or she will coordinate your treatment with the other members of the implant team.
Your initial evaluation will include an examination of your mouth and teeth and a thorough review of your medical and dental histories. Your mouth will be X-rayed. You might also have a computed tomography (CT) scan. This will provide information on the amount of bone in your jaw and its shape.

[د/حسام رفعت]

حلوة جدا سلسلة المقالات دى يا دكتورة ولاء يا ريت تستمرى فيها in english بلاش العربى ويا ريت الناس اللى تدخل تناقش أوتقول معلومه حتى ولومعلومه بسيطه أو يضع استفسار علشان كلنا نستفيد من بعض

[ايهاEب]

بجد مقالات متميزة
بس هو السؤال بقى كما في الفقرة الاولى..في الموضوع التاني
ايه هي خطوات علاج العظم المصاب عشان ينفع يبقى implantable

[د/حسام رفعت]

بجد مقالات متميزة
بس هو السؤال بقى كما في الفقرة الاولى..في الموضوع التاني
ايه هي خطوات علاج العظم المصاب عشان ينفع يبقى implantable
بيتعمل bone graftيا دكتور ايهاب وغالبا بياخدو من rips boneودى بتبقى عمليه كبيره under general anaesthesia بس فى سؤال أنا نفسى حد يجاوبنى عليه هل artificial boneينفع استخدمه بدل ما أعمل graft

[walaa talaat]

:faces173:Bone Augmentation and Nerve Repositioning

For dental implants to be successful, the jawbone must have enough bone to support them. You may not have enough bone because of tooth loss from periodontal gum disease, injury or trauma, or a developmental defect. If your jaw is too short (up and down), too narrow (side to side), or both, you will need a procedure to add bone to your jaw before implants can be placed.
Bone augmentation is a term that describes a variety of procedures used to "build" bone so that dental implants can be placed. These procedures typically involve grafting (adding) bone or bonelike materials to the jaw, and waiting several months for the grafted material to fuse with the existing bone.
Several different procedures can be used for bone augmentation. Your dentist will select a procedure depending on the type, location and number of implants to be used. If you need a bone graft, it is important that you and your dentist discuss all of the options available to you.
After a bone augmentation procedure, dentists usually wait 6 to 12 months before placing implants, although some dentists may place them sooner.
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Most bone augmentation procedures involve the use of bone grafts. The best material for a bone graft is your own bone. This most likely will come from your chin or ramus (the back part of your lower jaw). If your dentist cannot get enough bone from these areas, he or she may need to get bone from your hip or shin bone (tibia) instead. The hip is considered to be a better source because the hip bone has a lot of marrow (soft tissue within the bone). The marrow contains bone-forming cells. If you don't like the idea of having bone removed from your body to be placed in your jaw, other options are available. Your dentist can use materials made from the bone of human cadavers or cows. Synthetic materials also can be used for bone grafting. Most dentists prefer using a person's own bone, possibly in combination with other materials. But the choice is yours. You should discuss your options and their risks and benefits with your dentist before any procedures are done.
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In a typical situation, a patient has lost a single tooth and wants to have it replaced with a crown supported by a dental implant. However, the tooth has been missing for several years and there is not enough bone to support the implant. In this case, bone taken from the patient's chin can be used to "rebuild" the lost bone so that it can support an implant. This type of procedure is done in a dentist's office. Local anesthesia will be used to numb the area where the bone augmentation is needed (recipient site) as well as the area from where bone will be removed (donor site). The dentist first will make an incision (cut) in the gum where the implant will be placed to determine how much and what type of bone is needed.
He or she then will make an incision in the gum below the lower front teeth to expose the chin bone. A block of bone will be removed from the chin along with any bone marrow. Many dentists fill the spot where the bone was removed with another type of bone-graft material. Then they cover this with a membrane (thin film of tissue) to keep soft tissue from filling the space as it heals. The incision then is stitched closed.
To place the removed bone in the recipient site, the dentist first will drill little holes in the existing bone to cause bleeding. This is done because blood provides cells that help the bone heal. The block of bone that was removed from the chin will be anchored in place with titanium screws. A mixture of the patient's bone marrow and some other bone-graft material then will be placed around the edges of bone block. Finally, the dentist will place a membrane over the area and stitch the incision closed.
After a bone augmentation procedure, you will be given antibiotics, pain medicine and an antibacterial mouthwash. You will be asked to avoid certain foods. You also will be told how to avoid putting pressure on the area while it heals. If you wear a denture, you may not be able to wear it for a month or longer while the area heals. If you have natural teeth near the bone graft, your dentist may make a temporary removable bridge or denture to help protect the area.
The bone graft will take about 6 to 12 months to heal before dental implants can be placed. At that time, the titanium screws used to anchor the bone block in place will be removed before the implant is placed.
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Many people are missing several teeth and need several implants. If bone needs to be built up to support several implants, a lot more bone graft material will be needed than if a single implant is being placed. If you are having several implants placed and choose to use your own bone for a bone graft procedure, the bone probably will have to be taken from your hip, shin or another site. This type of procedure is done in the hospital under general anesthesia. It requires an overnight stay.

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The success rate for bone grafts in the jaws for the purpose of placing dental implants is very high. However, there is always a chance that the bone graft will fail, even if your own bone was used. Bone grafts are not rejected like organ transplants. When they fail, it is usually because of an infection or because the grafted bone wasn't stabilized and has come loose from your jaw. Dentists don't know why some bone grafts fail. They do know that certain people — such as those who smoke and those with certain medical conditions — have a higher risk of graft failure than others. A failed graft will be removed. Once the area has healed, your dentist can place a second graft.
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In addition to bone grafting, many other types of procedures can be used to build bone for placement of implants. One procedure is called a sinus lift (or elevation). It increases the height of your upper jaw by filling part of your maxillary sinus with bone. The maxillary sinus is the area above your jaw on either side of your nose. This is done when the back part of the upper jaw does not have enough bone to allow implants to be placed.
A ridge expansion is a type of bone graft that can be done when the jaw is not wide enough to support implants. Your dentist uses a special saw to split the jaw along the top (ridge) and packs graft material into the newly created space. Some dentists will place implants directly after this procedure. Others will wait several months for the ridge to heal. This procedure can be done in the dental office under local anesthesia.
One of the newest procedures for augmenting areas of bone is called distraction osteogenesis. This procedure originally was used for lengthening the bones of patients with abnormally short legs. It now has been adapted for use in the mouth. A surgeon makes cuts in your jawbone to separate a piece of bone from the rest of the jaw. A titanium device inserted with pins or screws holds the piece of bone apart from the rest of the jawbone. Over time, the space between the piece of bone and the jawbone is widened slightly by unscrewing the device, and the area between the pieces gradually fills in with bone.
"Distraction" refers to the process of separating the two pieces of bone. "Osteogenesis" refers to the forming of new bone. Distraction osteogenesis is used more often to make the jawbone taller, but it can be used to increase the bone in any direction. The procedure is becoming more common.
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A nerve called the inferior alveolar nerve runs through the lower jaw. This nerve gives feeling to the lower lip and chin. In patients who have lost significant amounts of lower jawbone, it may not be possible to place implants without damaging this nerve. To address this problem, an oral surgeon can drill a small window in the bone and move the nerve to one side. The implants then can be placed through the bony canal previously filled by the nerve. This technique is not used very often because it is possible to damage the nerve just by moving it.

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[walaa talaat]

types of implants:faces173:
Today, most dental implants are made of titanium, a metal that has special qualities that make it useful for this purpose.
Titanium develops a thin film on its surface that protects it from corrosion. It is resistant to acids, salt solutions and oxygen, among other things. Titanium also is almost completely nonmagnetic. It is extremely strong for its weight.
Perhaps most important, the body does not reject titanium implants as foreign objects. When implants are placed in bone, the bone grows around the implant. The process is called osseointegration.
Titanium implants come with many types of surfaces, including:

Acid etched, Plasma sprayed, Acid etched and grit blasted
Hydroxyapatite coatedHydroxyapatite is a part of what bone is made from. It bonds with bone in a process called biointegration.
There are several types of implants. Root-form implants are by far the most popular. Transosseous implants also are performed occasionally. The other types are used rarely.
Your dentist decides which type of implant to use based on the quality of the bone in your jaw and the type of crown, bridge or denture that will be placed on the implant.
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Root-form implants are called endosseous or endosteal implants, meaning they are placed in the bone. They look like screws, thick nails or cones, and come in various widths and lengths. For root-form implants to be successful, the bone needs to be deep enough and wide enough to provide a secure foundation.
Root-form implants can be inserted in two stages or one stage. The two-stage process is the traditional way. In this procedure, the implant is "buried" under the gum tissue for three to four months. Then it is exposed during a second surgical procedure. In a single-stage procedure, the implant is placed in the bone and remains exposed in the mouth.
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Transosseous implants originally were designed to be used in people who had no bottom teeth and very little bone in the lower jaw. However, they are rarely used today because placing them requires extensive surgery, general anesthesia and a hospital stay. Also, their use is limited to the lower jaw.
Placing transosseous implants involves inserting two metal rods from below the chin, through the chin bone and into the mouth. The ends of the rods can be seen inside the mouth. These are used to attach a denture.
Most dentists today prefer to use bone grafts or another endosseous implant method instead of the transosseous method. They are equally effective and do not require the level of surgery needed for transosseous implants.
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This type of implant can be used if the lower jawbone is too thin for a root-form implant. A Ramus-frame implant is embedded in the jawbone from the back corners of the mouth (near the wisdom teeth) to near the chin. Once it is inserted and the tissue heals, a thin metal bar is visible around the top of the gum. Dentures are made that can fit onto this bar. Ramus-frame implants also can stabilize weak jaws and help to prevent them from fracturing.

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This type of implant also is known as a plate-form implant. It is a type of endosseous implant (placed in the bone), but it is used less frequently than a root-form implant. Blade-form implants are flat rectangles of metal with one or two metal prongs on one long side. A blade implant is placed in the jaw so that the prong(s) stick out into the mouth. The prongs can support crowns or bridges.

[ايهاEب]

لو كان فيه صور يا دكتورة للانواع كان يبقى افضل

[dr.tamtamology]

مشكوره يا دكتوره علي موضوعك القيم

بجد تعبناك

ربنا يجزيك كل خير

[walaa talaat]

questions and answers
:faces173:
Are implants always successful?
Modern implant techniques have been in use since the 1950's. Improvements in procedures and materials have given implants a ten year average success rate of 93 percent or better. This enviable success rate is improving every year!
Can failed implants be replaced?
In the unlikely event an implant fails it can usually be replaced by another. In fact, most patients wouldn't have it any other way!
Is everyone a candidate for implant treatment?
In general, anyone healthy enough to undergo routine tooth extraction or oral surgery is probably able to receive an implant. There are some health conditions that warrant special consideration. Certain chronic diseases, heavy smoking or alcohol abuse may contraindicate implant treatment. After careful evaluation of your health history, your dentist will alert you to any conditions that may effect your treatment. Remember, age is not a factor.
Will others know I have dental implants?
Today's implant treatment enables you to have your new teeth look, feel and function like your own. Even though others will be unaware you have dental implants, many patients are so pleased they tell everyone they know. Dental implants offer some of the finest restorative results possible in modern dentistry.
How long does complete treatment take?
Depending of the type of implant and replacement teeth selected, the total time can be as little as a few weeks to six or more months. If bone grafting is necessary, further time may be needed. Your dentist will discuss your options with you and advise you of the time requirements.
Will I need to be hospitalized?
Most implant procedures are performed in the dental office under local anesthesia. Although, some patients may desire pre-medication or IV sedation to control apprehension. Hospitalization may be necessary for complex surgical procedures or general health reasons.
Is there pain or discomfort?
Many patients report implant surgery less troublesome than having teeth removed. With modern anesthesia and close attention to post operative care you can expect minimal discomfort.
Will I be without replacement teeth at any time?
Immediately following surgery you may be instructed not to wear replacement teeth in the surgical area. If required, this period is usually short, and temporary teeth are soon provided so you can quickly "get on" with your life.
How much does implant treatment cost?
The cost of implant treatment depends upon the number and type of implants placed and the type of replacement teeth needed. For example, replacement of a single tooth with implant treatment costs about as much as a dental bridge. The bridge necessitates "cutting down" adjacent teeth for crowns. Implant treatment does not. More complex treatment, such as bone grafting, will add to the cost. The cost can vary in different countries, so it's is best to consult your dentist. The improvement in your self confidence, comfort, eating habits and appearence will make dental implant treatment one of the best investments you've ever made!
Are implant supported teeth as strong as my natural teeth?
Yes. Research shows that in many cases implants are actually stronger then natural teeth. Compared to removable teeth, studies show implant supported teeth have 100 percent or better chewing efficiency. Dental implants can make it possible for you to enjoy your favorite foods, improve your nutrition and your appearance!

[walaa talaat]

لو كان فيه صور يا دكتورة للانواع كان يبقى افضل

some pictures of types of implants
http://www.enexus.com/dental-implant/images/blade300.GIFplate form implant


http://www.uniteddentaldc.com/implants_jpg-483acb8b190a7.jpgroot form implant




http://willesdendental.co.uk/_images/ramus_frame.jpg
ramus frame implant



http://www.duttondental.com/images/services-subperiosteal.png
subperiosteal implant


http://www.dentistry.kku.ac.th/comdent/student/DENTAL%20IMPLANT/image/bladeimplant.gif



http://www.dentistry.kku.ac.th/comdent/student/DENTAL%20IMPLANT/image/transOsseous.gif

[walaa talaat]

An implant-supported denture is a type of overdenture that is supported by and attached to implants. A regular denture rests on the gums, is not supported by implants, and tends to fit less firmly in the mouth
An implant-supported denture is used when a person doesn't have any teeth in the jaw, but has enough bone in the jaw to support implants. An implant-supported denture has special attachments that snap onto attachments on the implants.
Implant-supported dentures usually are made for the lower jaw because regular dentures tend to be less stable there. Usually, a regular denture made to fit an upper jaw is quite stable on its own and doesn't need the extra support offered by implants. However, you can receive an implant-supported denture in either the upper or lower jaw.
You can remove an implant-supported denture easily. Some people prefer to have fixed (permanent) crown and bridgework in their mouths that can't be removed. Your dentist will consider your particular needs and preferences when suggesting fixed or removable options.
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There are two types of implant-supported dentures: bar-retained and ball-retained. In both cases, the denture will be made of an acrylic base that will look like gums. Porcelain or acrylic teeth that look like natural teeth are attached to the base. Bar-retained dentures require at least three implants. Ball-retained dentures need at least two.



<LI class=content>Bar-retained dentures — A thin metal bar that follows the curve of your jaw is attached to two to five implants that have been placed in your jawbone. Clips or other types of attachments are fitted to the bar, the denture or both. The denture fits over the bar and is securely clipped into place by the attachments.
Ball-retained dentures (stud-attachment dentures) — Each implant in the jawbone holds a metal attachment that fits into another attachment on the denture. In most cases, the attachments on the implants are ball-shaped ("male" attachments), and they fit into sockets ("female" attachments) on the denture. In some cases, these attachments are reversed, with the denture holding the male attachments and the implants holding the female ones.http://www.simplestepsdental.com/i/t/top_hdr_bar.gifhttp://www.simplestepsdental.com/i/A/AnchorSpace.gifhttp://www.simplestepsdental.com/i/5/5x5transSpacer.gifThe Implant Process http://www.simplestepsdental.com/i/b/blue_bar.gif
The implants usually are placed in the jawbone at the front of your mouth because there tends to be more bone in the front of the jaw than in the back. This usually is true even if teeth have been missing for some time. Once you lose teeth, you begin to lose bone in the area. Also, the front jaw doesn't have many nerves or other structures that could interfere with the placement of implants.
The time frame to complete the implant depends on many factors. The shortest time frame is about five months in the lower jaw and seven months in the upper jaw. This includes surgeries and the placement of the denture. However, the process can last up to a year or more, especially if you need bone grafting or other preliminary procedures.
Two surgeries usually are needed — one to place the implants in the jawbone under your gums, and a second surgery to expose the tops of the implant. The second procedure comes three to six months after the first.
A one-stage procedure is now used sometimes. In this procedure, your dentist can place the implants and the supporting bar in one step. The success rate of this procedure is high. However, it is moderately less successful than the more conventional two-stage procedure.
Initial consultation
Before any work is done, you will visit either a dental specialist called a prosthodontist or a general dentist who has advanced training in the placement and restoration of implants.
During the exam, the dentist will review your medical and dental histories, take X-rays and create impressions of your teeth and gums so that models can be made. In some cases, the dentist may order a computed tomography (CT) scan of your mouth. This allows the dentist to see the exact position of your sinuses (located above your upper teeth) or nerves, and to make sure they will not be affected by the implant placement. A CT scan also may be done to see how much bone is available and to determine the best locations for the implants.
If you are not already wearing a complete denture to replace your missing teeth, your dentist will make you one. You will use this temporary denture until the implant-supported denture is placed. It will take about four visits, spanning several weeks, to complete this denture. By making this temporary denture, your dentist is able to determine the best position for the teeth in the final denture. The temporary denture also can be used as a backup if something happens to the final implant-supported denture.
Once the temporary denture is finished, the surgeon will use a copy of it as a guide to help place the implants in the proper positions. Holes will be drilled in the copy of the denture so that the surgeon can see where the implants should be placed.
First surgery
Month 1 (if no denture needs to be made)
Month 2 (if denture needs to be made)
The first surgery involvesplacing the implant in the jawbone. During the first surgery, an incision is made in the gum where the implant will be placed. A hole is drilled in the bone, the implant is placed into the hole, and the incision is stitched closed. After this surgery, you should avoid putting pressure on the implants. You will not be able to wear your temporary denture for about four weeks, and you should avoid eating hard foods during this time. After four weeks, you will be able to wear your temporary denture again. The temporary denture will, however, need to be modified, to make sure it fits properly. It will also be given a soft reline (new lining next to your gums) to help to reduce the pressure on your gums.
After the first surgery, the dentist will wait three or four months if implants were placed in the lower jaw, and five or six months if they were placed in the upper jaw, before scheduling the second surgery. During this time, the bone and the implants integrate (attach and fuse).
Second surgery
Month 4 or 5 (no denture needed to be made)
Month 5 or 6 (denture needed to be made)

http://www.simplestepsdental.com/i/I/ImpDent2.jpg Standard abutments connected to the tops of the implants
Once the implants have become fused with the bone, the second surgery can be scheduled. Your dentist will confirm whether the implant is ready for the second surgery by taking an X-ray. This surgery is simpler than the first. A small incision is made in your gums to expose the tops (heads) of the implants.
A healing abutment (collar) is placed on the head of each implant after it is exposed. This encourages the gums to heal correctly. The collar is a round piece of metal that holds the gums away from the head of the implant. The collar will be in place for 10 to 14 days. The dentists will adjust your temporary denture again and it may be given another soft reline. The reline material will secure the denture to the healing abutments.
About two weeks after the second surgery, the healing abutments will be replaced with regular abutments. Your gums should now be healed enough for your dentist to make an impression of your gums and implants. The impression is used to make a working model of your implants and jaw, which is used to make the denture framework and teeth.
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Month 5 or 6 (no denture needed to be made)
Month 6 or 7 (denture needed to be made)
At this point, the metal bar is placed on the implants. You will have the first try-in of your new denture framework to see if it fits properly.
http://www.simplestepsdental.com/i/I/ImpDent6.jpg http://www.simplestepsdental.com/i/I/ImpDent4.jpg Bar secured to implant with screws Fitting side (inside) of the denture showing the attachments
http://www.simplestepsdental.com/i/I/ImpDent5.jpg The denture is being seated on the implants and bar
Once the metal bar and the denture framework have been fitted together properly, the teeth are temporarily placed on the framework in wax. The whole denture is then tried in your mouth. If everything works well, the teeth are secured in the denture framework permanently. The bar or ball attachments also will be secured.
You will have to return to your dentist for another visit to have the completed denture inserted. When the denture is inserted, the denture is clipped onto the bar or snapped onto the ball attachments.
At this point, your temporary denture will be given a new reline. This will allow it to be used as a backup denture in case you lose or break your new overdenture.
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http://www.simplestepsdental.com/i/I/ImpDent7.jpg Patient wearing final upper and lower denturesYou will need to remove the denture at least twice a day for cleaning. You also should carefully clean around the implants and attachments.
For the first year, you should visit your dentist every three months for a cleaning and checkup. Your dentist will test all the parts of your new denture to see if they are secure. Even though your denture is stable, it still can move slightly when you chew. This slight movement can cause the denture to rub against your gums, which can cause sore spots. Your dentist will check your gums and also will check the way your top and bottom teeth come together (your bite).
The clip or other attachments on the bar-retained denture usually will need to be replaced every 6 to 12 months. They are made of a plastic material (nylon) and will wear after continued use.
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An X-ray will show the implants in the jaw and any attachments to them. Your dentist will take X-rays a few times during the procedure. They help the dentist to see that the implants, abutments and attachments are in the right places.

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In addition to the risks of surgery and of the implants failing, a bar-retained denture carries certain risks of its own.
A bar-retained denture needs space on the denture framework for the special attachments that are fitted to the bar. This means that there is less space available on the denture framework for the teeth to be fitted. Because of this the teeth sometimes can come loose from the base. This problem is easily fixed.
Also, when the bar is attached to the implants it is important that the bar is evenly balanced on each implant. Dentists call this a "passive fit." If the fit is not passive, the extra strain on the bar can cause the screws to loosen. If you grind or clench your teeth, it's more likely that parts of the denture will break or that your implants will come loose.
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Your implant-supported denture will be more stable than a regular denture. You will find it easier to speak and you won't have to worry about the denture becoming loose or falling out of your mouth. You generally will be able to eat foods you could not eat before. However, you will not be able to chew hard or sticky foods because they can damage the denture.
If you have an implant-supported denture in your upper jaw, it will feel more natural than a regular denture because the denture will no longer cover the roof of your mouth.