Screwed In Bridge Instead Of Overdenture

Screwed In Bridge Instead Of Overdenture

Screwed In Bridge Instead Of Overdenture

This patient had a lower left overdenture instead of a fixed screwed in bridge for many years which she did not like. The overdenture is not a real bridge. It has a removable denture that snaps in and out of the implants.

Before treatment upper and lower over dentures. The bad implant is under the gums on the right side of the photo.
Old overdenture with bad contours catching food and causing bad smell

Implant bridge Using Old Implants

What’s unique about this case is that the overdenture was only on one side!  The old implants could be used just as they are to make a fixed bridge.

To me, it does not make sense to have something removable on the bottom jaw when something fixed is attainable. I suspect it was done as a removable overdenture on implants because of operator inexperience.

Over the years, the overdenture placed a lot of pressure on the gums causing one of the implants to fail. Locator overdentures rock the implants back and forth and put a lot of pressure on the gums, which chokes off their blood and nutrient supplies.

Process of Converting Overdenture To Fixed Bridge

For this patient I extracted and removed the one failing implant and made a small zirconia fixed bridge on the remaining implants. A digital impression was taken with a trios scanner. I then fabricated a temporary bridge to test the fit, function and aesthetics before going to the final. This allowed the patient to try everything out to make sure she can clean it and that we both like everything about it.

Digital dental implant impression taken with trios. You can see where the bad implant is because the tissue is red. That one will be removed.
Failed bloody implant removed. You can see bone on it!
Temporary screw retained bridge to test everything out before going to final.
Temporary screw retained bridge to test everything out before going to final.
Gums healing nicely around dental implants after overdenture was removed.
Underside of the implant bridge showing titanium abutments and zirconia bridge.
Final dental implant Bridge underside. The hump is there to fill in the missing bone from the failed implant from the past.
Final bridge top view
Final zirconia bridge side view -please note the upper is still an old denture and has not been replaced
Final zirconia bridge-front view — only the lower is new. The upper is a regular denture

After wearing the temporary bridge for a few months I then converted her over to the final, which takes a very precise fit since zirconia undergoes shrinkage during the lab fabrication process.

The new bridge has much better contours and does not have that “smell” that she did not like.  Overdentures are made out of plastic acrylic that absorbs odors.

The patient’s goal is to replace her upper as well with zygomatic implants, but she has some sinus issues that need to be resolved first.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California
818-846-3203

5 Comments

  1. My overdenture that fit over 4 Mini implants was lost by Memorial Sloan-Kettering Hospital while a cancer patient. I owe them my life but unfortunately the Denture is gone and very costly to replace and they will not provide any relief for the Financial loss.. But the further complication is that the oral surgeon who made the overdenture 9 years ago is now hospitalized and failing. I tried finding out from him and his office what lab was used for the titanium mini implants but they have no idea. And no records. And the gentleman is very elderly. So I’ve seen a new potential implant denture specialist dentist who said that we could potentially restore the overdenture at worst, but he’s seriously recommends that at least two full size implant be used and create a fixed denture to work with that system. My question is this, if that new dentist inserts 2 implant .. does he remove the minis that are in the center of my lower jaw first and if yes, is there is any risk? Will the removal of those mini implants fracture the bone? Another words do I end up with a nightmare simply to try to insert to new strategically-placed full sized implants adjacent to where the minis currently are. In other words he’s not going to try to put new ones into the position where the minis are they will straddle the opposite ends of where those Minis. Are now.

    March 9, 2020 at 7:55 pm Reply
    1. Ramsey Amin

      That is some tough lock but at least are alive! They are not that many manufacturers of many dental implants. I think if you see a true dental implant specialists will be able to recognize what these are and be able to order parts. Typically the mini implants are removed if you are going to have traditional ones placed as well. Two implants are not enough. Four would be much better. It is best to have all similar type of implant so that the ability for the implants to grab (like locators) the parts are easily accessible. You can always cut the smaller implants level to the bone if they break off in the removal process.

      March 12, 2020 at 12:50 am Reply
      1. Margaret A Argento

        Thank you doctor for your clarification and recommendations. I have an appointment to see the dentist who’s been doing implants and Dentures for 30 something years. He will take the appropriate scan of my mouth and then we’ll look at what our options are. But at least you’ve clarified some of my concerns. Sure I realize ideally there should be four implants I know they’ll be two. I’m thinking perhaps three but I don’t think my mouth will accommodate 4 without having to remove 1 of The minis or 2. Andre dentist who treated my mouth is said it’s small. Also I think the oral surgeon originally was concerned about the location of the nerve.

        But thank you very much for discussing the fact that someone should easily identify the mini implants. I just think that this new dentists feels they’ve been beat up for a while now since I have no Cancer and a meeting by tearing. And although there is no movement of the minis, I don’t think the life expectancy would be more than a few years left, do you agree? So I think he wants to we lie on the new implants.

        March 12, 2020 at 1:31 am Reply
        1. Ramsey Amin

          I had a hard time understanding your question. I think you meant to say “rely.”

          Yes, I would rely on the new not the minis!

          October 14, 2020 at 8:33 pm Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!