I'm wrapping up my first year in clinic right now, and I have found this to be a very common topic of conversation. Before having the conversation of implants vs dentures with a patient, it is important to see if the patient is a good candidate for implants. Qibeto perfectly outlined exactly what to look for while deciding if a patient is a good candidate- systemic conditions, patients bone levels and available space. If everything checks out, implants are definitely an option. With the high cost of implants, it is definitely not a feasible option for many patients. If I have patients that are interested and cannot afford implants at the moment, we have gone ahead with fabricating full dentures with the idea of possibly doing an implant supported denture in the future. Finances has been the biggest roadblock for me in having patients choose dentures vs implant supported dentures.

Being now in the 4th year and fabricating a few complete dentures, I believe a great benefit to implants is retention, especially in the lower arch. Due to loss of ridge height and/or width, lower complete denture are not as retentive as the provider would like. The patient must train themselves to not push their denture out with their tongue as well as keep it down with their tongue. This lack of retention, often leads to lack of function. Patient's go on without using their denture because they cannot chew with it. Our recommendation if the patient can afford it or is willing to go on a payment plan would be an overdenture. Placing at least two implants on the lower arch can aid in retention because the denture directly snaps onto to implants. We are not longer using the ridge for support. It adds the stability to the prostheses which increases function. Implants have a high success rate and I believe improves the quality of life of a patient who wears a complete lower denture. In regards to an upper complete denture, they are significantly more retentive then the lower but an implant supported denture can be used for patient's who have maxillary tori, exostoses or can't tolerate the palatal portion of the upper denture. I believe implants are a great option for treatment.

Implants have been proven to be a very successful method of treatment, with a success rate in the high 90's. There are many indications and advantages of implants versus other methods of treatment. When comparing conventional dentures versus implant-retained dentures, the implants allow for better retention, stability, esthetics, and overall function. When patients demand increased retention and function, implant overdentures are a good choice because the cost is more reasonable compared to completely implant-supported prosthesis. Also, an implant replacing a single tooth compared to a fixed partial bridge has both advantages and disadvantages. Advantages of the implant include better esthetics, easier oral hygiene, maintains bone, and decreases the chance of decay occurring on the adjacent teeth. When the abutment teeth are crowned for a bridge, this increases the risk of developing decay. Disadvantages include cost, lengthy treatment, and higher discomfort due to placement of the implant. In my clinical experience so far, I have noticed that more and more patients are wanting implants versus a FPD, and I think this trend will only increase as time goes on and implants become even more successful. Therefore, knowing the indications and contraindications for an implant is especially important for new dentists.

This topic is definitely a hot topic since the popularity of implants has skyrocketed in recent years. What I typically see is that most people prefer the option of a fixed prosthesis as opposed to a removable one however several factors must be considered when determining whether or not a patient even qualifies for implants. First, systemic conditions. Is anything present that contraindicates treatment? Secondly, bone level is of the utmost importance and the relation of that remaining bone to anatomical structures (maxillary sinus, mandibular canal, etc.) If the patient qualifies, there is still the big factor of cost! Can the patient ultimately afford it? Also, implants are not always an immediate thing. There are phases of the treatment to assure that ossteointegration occurs and that the implant does not fail. Ultimately, conventional dentures and or implant retained dentures still have a place in dentistry for sure. It is a more affordable option for people who may not be able to afford implants or do not qualify at all while still maintaining aesthetic and functional satisfaction.