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An implant overdenture is a removable denture that snaps onto two or four implants in the jaw, so it stays in place while you chew and talk. It solves the main problem of a conventional denture, which rests on gums that change shape and loosen over time. It still comes out at night, which is part of why it costs less and needs less surgery than fixed implant teeth. At Vizcaya Dental Arts Dr. Flavio Kottar places the implants and makes the overdenture.
What an implant overdenture is
An overdenture has several parts working together:
- The implants themselves sit in the bone.
- Small attachments, called abutments, screw onto the implants and stand just above the gum.
- Inside the denture are metal housings with replaceable inserts that grip those attachments.
- The denture usually has a metal framework inside the acrylic for stiffness, so it does not flex or crack under the extra force it can now take.
It is still a denture. It covers the gum, it comes out for cleaning, and it is made in the same careful way: impressions, bite records, a try-in of the tooth arrangement and adjustments. What changes is that it is anchored.
What changes
Overdentures give far better stability and chewing function than any conventional denture. Patients tell us about eating foods they had given up on, speaking without worrying, and not needing adhesive. In our experience the function comes close to that of a fixed implant bridge, at a lower cost and with less surgery and less bone needed.
It is still a denture. It rests partly on the gum, it comes out at night, and the inserts wear and need replacing.
Who is a good candidate
Two groups of patients ask us about overdentures. The first already wear dentures and have had enough of the lower one moving: the lower jaw gives a conventional denture almost nothing to hold onto, and two implants change that completely. The second are about to lose their remaining teeth and would rather plan for stability from the start than live with a loose denture first.
In both cases the requirements are the same as for any implant:
- Enough bone, or a realistic surgical route to it.
- General health that allows minor surgery, with smoking and poorly controlled diabetes discussed because both raise the risk of losing an implant.
- The dexterity and willingness to take the denture out every night and clean around the attachments.
Patients who find that routine difficult may be better served by a different design, and that conversation happens before treatment.
How many implants
For conventional root-form implants, our usual plan is four implants in the upper jaw and two in the lower. The upper jaw has softer bone and the upper denture covers the palate, so it needs more support; the lower denture has far less to hold onto, so even two implants transform it. The number and position depend on your anatomy and on the design of the denture, which is why we plan the implants and the denture together.
Planning around your bone
The key question is whether there is enough bone to place the implants. We assess that with a CT scan, which shows the height and width of the bone in three dimensions and tells us whether conventional implants are straightforward. When they are, Dr. Kottar places them here in the office.
When they are not, usually because the teeth were lost many years ago and the ridge has shrunk, there are surgical alternatives, particularly for the upper jaw, that use longer implants anchored in denser bone further away. Those are placed by an oral surgeon, and we coordinate the restorative side. The scan shows which route is realistic, and we go through it with you.
From the first visit to the final denture
- Step 1 of 5 Assessment and CT scan
We examine your mouth and any existing denture, take a CT scan and medical history, and plan the number and position of implants around the denture design. You receive a written estimate.
- Step 2 of 5 Placing the implants
Done with local anesthesia, with sedation available. If teeth still have to be removed, we consider placing the implants at the same time as the extractions when the bone and gum allow.
- Step 3 of 5 Healing, with teeth to wear
The implants fuse with the bone over roughly three to six months. During that time you wear a temporary denture, often with adhesive. An existing complete denture can sometimes be relined to serve as the temporary. Occasionally small temporary implants are used to steady the temporary denture; they are not a substitute for the permanent ones.
- Step 4 of 5 Exposing the implants
If the implants were left under the gum to heal, a short visit uncovers them and fits the abutments.
- Step 5 of 5 Making the overdenture
Impressions, bite records and a try-in of the teeth in wax, so you can see the appearance before it is finished. Then the final denture with its framework and housings is delivered and adjusted.
Daily care
An overdenture must come out at night. Sleeping in it keeps the gum covered around the clock, and that leads to inflammation and infection under the denture.
- Take it out, and brush the implants and the abutments the way you would brush teeth.
- Brush the denture with a denture brush.
- Keep it wet overnight in water or a denture cleaning solution suited to the material.
- Put it back in the morning by lining it up and pressing it into place with your fingers; biting it into place wears the inserts quickly.
Maintenance
Even with no natural teeth left, you still need to see us at least once a year, and more often if your gums or general health call for it. At that visit:
- We check and clean the implants.
- We check the fit of the denture.
- We do an oral cancer screening.
- The retention inserts inside the housings wear with use and need professional replacement; for some patients that is every six months, for others once a year. It takes a few minutes, and it is an ongoing cost to plan for.
Where overdentures sit among the options
A conventional denture, an implant overdenture and a fixed implant bridge solve the same problem at three different levels of function, surgery and cost.
| Conventional denture | Implant overdenture | Fixed implant bridge | |
|---|---|---|---|
| Held by | The gums and the ridge | Two or four implants, with snap attachments | Four to six implants, screwed in place |
| Comes out | Yes, nightly | Yes, nightly, for cleaning | Only by the dentist |
| Chewing | Limited by what the ridge can hold | Much better; the denture stays put | Closest to natural teeth |
| Surgery | None | Implant placement | More implants, often grafting |
| Cost | Lowest | In between | Highest |
| Daily care | Remove, brush, soak | Remove, brush, clean around the implants | Brush and floss under the bridge |
| Ongoing upkeep | Relines as the ridge changes | Retention inserts replaced every six to twelve months | Professional checks; removed for maintenance |
Frequently asked questions
Does an implant-supported denture come out?
Yes. An implant overdenture is removable. It snaps onto attachments on the implants during the day and comes out at night for cleaning. A fixed implant bridge, sometimes called a hybrid or All-on-4, is a different treatment that stays in and is removed only by the dentist.
How is it different from All-on-4?
Both use implants. An overdenture is removable, usually sits on two lower or four upper implants, needs less bone and costs less. A fixed hybrid is screwed onto the implants, usually more of them, and is not removed by the patient. In our experience the overdenture gives almost as much chewing function as a fixed design, at a lower cost and with less surgery.
How long until I can eat with it?
You will have a denture to wear throughout. The implants heal for roughly three to six months before the overdenture is attached to them; during that time you wear a temporary or adjusted denture, often with adhesive. Once the overdenture is in, most patients notice the difference in chewing right away.
Can my current denture be used?
Sometimes, as the temporary. An existing complete denture can often be relined to fit over the healing implants. The final overdenture is normally a new denture with a metal framework and the housings built in.
What if I do not have enough bone for implants?
Conventional implants need a certain amount of bone, which we measure on a CT scan. When there is not enough, particularly in the upper jaw of someone who lost their teeth long ago, there are surgical alternatives that an oral surgeon can provide. We will tell you what the scan shows and what the realistic options are.
How often do the inserts need replacing?
The small retention inserts inside the denture wear and need professional replacement, in some cases every six months, in others once a year. It is a quick procedure that we usually do at your checkup, and it is an ongoing cost to budget for.
Sources
Professional guidelines and peer-reviewed reviews this page draws on.
- Feine JS, Carlsson GE, Awad MA, et al. The McGill consensus statement on overdentures: mandibular two-implant overdentures as first choice standard of care for edentulous patients. International Journal of Oral and Maxillofacial Implants. 2002;17(4):601-602. PubMed
- Thomason JM, Feine J, Exley C, et al. Mandibular two implant-supported overdentures as the first choice standard of care for edentulous patients: the York consensus statement. British Dental Journal. 2009;207(4):185-186. DOI
