“Third teeth“ do not have a good reputation. Frequently, the denture wobbles and/or fits poorly, resulting in pressure marks which often occur due to underlying bone loss. In these cases, the denture needs to be adapted by means of special padding. The chewing force while eating ends up being significantly reduced – in most cases, merely 20 per cent of the usual chewing force transmission remain. Generally speaking, due to a lack of suction, the denture in the lower jaw tends not to adhere as well as its counterpart in the upper jaw. This frequently results in a loss of taste and foreign body sensation, posing a problem particularly for patients with gag reflexes. Speaking, laughing, and eating are thus accompanied by a constant feeling of insecurity.

By means of an implant-supported bridge, we are able to compensate for these disadvantages of a mucosa-supported bridge.

Typically, four implants are placed in the lower jaw; next, a bar is mounted. The “bar denture“, which is designed to be removable, is characterized by a particularly high level of stability and guarantees excellent support. A completely fixed supply via three implant-supported bridges can certainly also be pursued. The advantages and disadvantages need to be discussed with the patient.

We have more generous possibilities in the upper jaw as neither the tongue nor the mouth base are in the way here. Thus, it is possible to mount a completely fixed supply, which however obliges the patient to accept limitations in terms of cleaning. Even in a toothless jaw, the periodontal bacteria can continue to exist and give rise to peri-implantitis in situations involving newly inserted implants.

For this reason, a very elegant solution for a toothless upper jaw is a “removable bridge“ founded on at least half a dozen implants. In turn, the bridge is mounted on a bar or telescope construction, resulting in a “not quite fixed“ supply. Nonetheless, the supply is arrestable by means of a latch, enabling the patient to perform a complete fixation. At the same time, the patient can remove the implant upon releasing the latches, thus facilitating the process of cleaning. This option is particularly relevant for elderly patients with reduced motory capacities. In addition, this type of supply – unlike the (purely mucosa-supported) complete denture – is devoid of a palatal bar, meaning we can maintain the sense of taste without having to deal with any foreign body sensations. Patients are typically very content with this type of supply as it provides them with a close-to-perfect combination of the highest aesthetic demands and outstanding periodontal hygiene capabilities.