Bone Loss with Dentures By Dr. Damon on December 06, 2013

I see patients almost every day asking for a reline of their lower denture so that it would fit like it did 10 - 20 years ago. Generally, they need much more than a reline - Dental Implants and an Implant Denture. Yes, a reline may improve the fit for some patients, but there is a point almost every patient will reach when a stable fitting denture is not possible. This occurs when the ridge of the jaw bone reabsorbs overtime.

Many patients do not know that the jaw bone reabsorbs over time.

The absorption of the jaw bone is inevitable. With out teeth or implants to create stress on the bone, the remodeling process of bone can not occur. It is this remodeling process that builds bone. Most patients complain about the fit of the lower denture and it is the lower jaw bone that reabsorbs FOUR TIMES FASTER then the upper jaw. This is why I stress to all of my denture patients that they all need to be in implants, eventually. The best time to have implants placed is when the teeth are being extracted, therefore you only need one surgery. If it is not financially feasible, then implants should be placed within the next 3 years. The photo below shows what happens to the jaw when implants are not placed.

Jaw bone absorption




Here is a cross-section of different aged cadavers. After the teeth are removed the bone begins to atrophy and absorb. As you can see there is plenty of room for implants for all of these examples except for the last two. This is why getting implants close to the time of extraction is best.

Jaw bone absorption



Who needs Implants?

Who needs implants? In my opinion everyone. I think that lack of jaw bone to hold a denture is an oral health concern. Patients are able to have more oral function, longer more satisfying lives by being proactive and maintaining jaw bone for your entire life. Bone loss is inevitable.

If you are a patient who has lost your teeth at an early age (there are many of you out there) you need to begin getting implants as soon as you can. I see patients who are in their 20's and 30's with mouths full of rotten and too completely damaged teeth to save. If you are 20-30 you need to be working toward having a 4 implants in each jaw. Two up in the front and two in the back so you can maintain your bone throughout your life. Below is a proof that implants retain jaw bone around them, however this patient did not have any implants placed in the posterior of the mandible (back of jaw). This is where severe resorption still occurred. Implants preserving bone in lower jaw.







For patients who may be 60-70 years of age, typically two implants placed in the anterior mandible will be sufficient. Yes 4 is better but a minimum of 2 will retain bone in front of the jaw which will allow for long term support of the implant denture. If you don't think you have enough bone for implants, you most likely do. We can typically alter the jaw so that the height is lowered to where implants can fit, or we add bone by bone grafting.

If you would like to know more about implants and preservation of your jaw bone. Contact us today 817 336-2121. We look forward to meeting you!

Photos were taken from Carl Misch 3rd ed. Implantology Text Book.

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