Getting fixed teeth in one day is the wish of many edentulous patients. Because fixed teeth mean an enormous gain in quality of life.
There are different fixed alternatives to the classic total denture.
In this article you will learn the procedure that we recommend and perform in our dental office.
Diagnostics with the DVT
In order to perform accurate planning and diagnostics, it is necessary to have a precise and dimensionally accurate reproduction of the jaw bone. For this purpose, radiographic imaging with DVT (Digital Volume Tomography) is very advantageous, as three-dimensional information of jaw bones is obtained.
The DVT reveals the following important information:
- Bone supply in vertical and horizontal direction
- Bone quality and bone density
- Space to the maxillary sinuses and the nerves in the lower jaw and palate
- Scattered foreign bodies in the bone and gums, e.g. amalgam splinters, root residues, overpressed paste from previous root canal treatments
The exact distances can be measured digitally and transferred to the patient’s anatomy. In this way it is possible to place the implants in exactly the right position and make ideal use of the jawbone.
Backward planning means first determining what the end result should be for the patient and building the entire plan according to that goal.
The goal is a fixed dental restoration that has the following requirements:
- The esthetics of the restoration should be natural and match the patient’s appearance.
- The denture should ideally support all anatomical structures such as lips and cheeks and make the patient look more youthful and healthy.
- The bite height and the chewing contacts should be anatomically correctly adapted. The bite height and bite position also change the patient’s appearance enormously, so that a youthful and natural appearance is to be aimed for.
- The jaw joints should be in an ideal position and in harmony with the entire body, so that the body statics are positively and not negatively influenced.
To ensure this ideal result, several steps are necessary:
- Impressions of the upper jaw and lower jaw and fabrication of models in the practice’s own dental laboratory
- Analysis of the position of the upper jaw and the temporomandibular joints by the Zebris System.
- Detection of the correct bite position through a correct coding of the jaws for the dental technician
- The dental technician uses this information to create a wax mock-up. This lays the foundation for the exact position of the implants and the subsequent temporary denture made of acrylic.
As you can easily see, an ideal result is only possible if the dentists and the dental technician have a lot of experience and the entire team is well coordinated.
Due to the dental laboratory in the practice, each individual step can be carried out in an ideally coordinated manner, which allows the best possible result to be achieved.
Ceramic implants – At least 8 per jaw
In our dental practice, the dentists use only ceramic implants, as they are preferable from the health and biological point of view.
To provide an edentulous jaw with a stable and long-lasting dental prosthesis, at least 8 dental implants are required. Unfortunately, the all-on-4 concept quickly reaches its limits and is not recommended.
If the anatomical conditions allow, more ceramic implants can also be placed so that, at best, each lost tooth is replaced by an implant, as is the case in a natural, healthy dentition.
You can learn about the advantages and disadvantages of ceramic implants and the differences to titanium implants here.
Operation day – Fixed teeth in one day
Patients get the fixed teeth they want in our office in one day. In completely edentulous patients, a total of at least 16 ceramic implants are required.
The operation is performed exclusively under local anesthesia, just as it is performed for fillings. However, general anesthesia may be used for patients with dental anxiety, severe gag reflex, or other appropriate reasons.
Based on the previously performed diagnostics with the DVT and through backward planning, the implants can be placed in the ideal position.
Of course, all steps for optimal implant healing are performed, e.g. the atraumatic surgical techniques, the use of A-PRF and ozone. Please read more under Biological Oral Surgery for these points.
After the dental implants are placed, the patient receives the correctly planned temporaries, which are cemented onto the implants and remain in the mouth for 3 months.
Definitive ceramic dentures
After approximately 3 months, the temporary resin restorations are removed and the patient receives the definitive ceramic restoration.
Through prior backward planning, the new prosthesis has all the desired and pre-planned goals. In this way, the temporomandibular joints are in an ideal position and the patient’s soft tissue profile is anatomically correct and harmoniously supported. The denture looks natural and does not differ from your own teeth. In addition, all tooth contacts are anatomically correctly adjusted to ensure even force distribution and pleasant chewing comfort.
If 8 implants have been placed per jaw, the definitive denture consists of four ceramic bridges.
If more implants are desired, ceramic crowns are used, as with natural teeth, which are cemented onto the ceramic implants.
Aftercare and longevity
Our goal is to ensure that the manufactured prosthesis lasts a lifetime and that peri-implantitis and implant loss do not occur.
The basis for high longevity is a healthy bacterial flora in the oral cavity. A good oral flora not only has health benefits, but also prevents ceramic implants from loosening prematurely during such dental rehabilitation.
In addition, it is important not to become deficient in vitamin D3. Low vitamin D3 levels can negatively affect bone metabolism, which promotes implant loss.
aMMP8 is an enzyme produced by immune cells that accelerates tissue breakdown. aMMP8 is produced when immune cells come into contact with oral bacteria and begin to defend themselves. Some people react with an excess production of aMMP8, whereupon there is an increased breakdown of bone and gums. As a result, the bone-implant connection suffers and implant loss may occur.
In our practice we can effectively improve the oral bacterial flora and ensure the basis for a long life of the fixed denture.
In addition, we can control vitamin D3 and the enzyme aMMP8.
What are the costs if I want to get fixed teeth in one day?
Per dental implant you have to calculate with approx. 5000 to 6000 CHF.
Can fixed teeth be performed with fewer implants?
Yes. With the All-on-4 method, a fixed denture can be anchored to the implants. Since this procedure has several disadvantages, we do not offer All-on-4 in our dental practice.
Does bone augmentation have to be performed?
We try to avoid bone augmentation as much as possible. However, if more severe bone loss has occurred, such a procedure, along with implant placement, is necessary. If necessary, only the patient’s own bone is used.
Does your practice have much experience in large implantological restorations?
Yes. Our dentists are very experienced and can solve any case with the best possible result. However, in complicated situations and with pronounced bone recession, it may be necessary to proceed in several steps.
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