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Medical Forum / General / Dentistry / March 2007Dentures
I am in the decision process of getting upper and lower dentures. My dentist suggested doing a root canal in two of my lower teeth to put two posts that will hold my lower dentures in place. I am curious about how this has worked for anyone else that may have had this procedure. Has it been worth the extra $1,000, what it will cost me to secure your lower dentures? Have you had any problems? Also, another factor for me is the fact that I have diabetes that may also effect my success with this whole procedure. Please shed some light on this subject for me. Thank you! Doing canine supported lower overdentures was standard of care 25 years ago. We would do a root canal on these canines and then cut them down to the gumline. Some people got cast gold copings to cover the exposed dentin and some people got amalgam at the orifice of the exposed canal. Studies showed that retaining these teeth help retain the alveolar bone in this area, hence better retention for a lower denture. However, I found that after a few years patients developed either tooth decay on the roots that rendered them non restorable, or they developed periodontal disease which resulted in mobility and loss of these teeth, but at least we preserved the bone for a period of time. Today, I would say, the standard of care is to remove the teeth and place implants where the canines were. After they indicate a lower full overdenture can be made very easily, especially with Locator brand attachments. The implants, of course don't get decay and peri-implant disease unlike periodontal disease is uncommon. However the fee is quite high when compared to the older technique. But when you consider the eventual loss of the abutment teeth, it is probably more cost effective for the long run to have 2 implants. This type of case is precisely the kind of case that Dr. Branemark, the father of endosseous implants, invented the technology. I hope other people post with their experiences. > I am in the decision process of getting upper and lower dentures. My dentist > suggested doing a root canal in two of my lower teeth to put two posts that [quoted text clipped - 4 lines] > may also effect my success with this whole procedure. Please shed some light > on this subject for me. Thank you! Works well. Doesn't last forever, but I have gotten them to last up to 10 years. $1K is cheap. Steve >> I am in the decision process of getting upper and lower dentures. My dentist >> suggested doing a root canal in two of my lower teeth to put two posts that [quoted text clipped - 9 lines] > >Steve Agreed. Longevity can be extended with a drop of fluoride in the wells before placing the denture daily. Also a casting could be placed over the abutments. Have done some with attachments too. Can say that the retained roots definitely help preserve the residual ridge. BTW, Terry this is called an over-denture. > I am in the decision process of getting upper and lower dentures. My dentist > suggested doing a root canal in two of my lower teeth to put two posts that [quoted text clipped - 4 lines] > may also effect my success with this whole procedure. Please shed some light > on this subject for me. Thank you! A 1000 bucks sounds excessive for a couple of root canals and some amalgam. But, well taken care of teeth with posts (attachments) will give you great service and be appreciated by you. The admonishment "WELL TAKEN CARE OF "is a must, especially if you're a diabetic! Implants can be placed at a later date if the natural teeth are lost. They too need scrupulous care! As a diabetic you'll need to give things some special care. Keeping your blood sugars below 100 and keeping the retained roots clean are essential!!! I'd shop around for the best deal on the root canals and would decline any copings UNLESS the teeth need restoration due to decay. Good luck! Dr. G. prosthodontist & FACP  SignaturePlease reply via newsgroup. I'm not trying to be argumentative, but the patient mentions "two post" in addition to the two root canals (I usually use ERA attachments.). I don't think $1,000 is unreasonable for this service at all. That barely covers the two endos. My main problem is finding two cuspids with good enough bone support and little decay to use for this procedure. The cuspids don't need to be good enough to crown and make a partial ('cause then you would crown them and make a partial <G>), but they can't be flopping in the breeze either. Out in Hooterville, it is quite difficult to 'sell' 2-4 implants to support a lower denture. That would add $3-5K to the fee. Even though it is worth it, patient acceptance is virtually non-existant, *UNLESS* they have been using an overdenture for the last 5-10 years and can't imagine a floating plate again (I let patients 'experience' a regular lower for a week or two before putting in the ERAs). I don't think I've done one of these for a couple of years, but they are quite nice in certain situations. Best wishes, D My dentist >>suggested doing a root canal in two of my lower teeth to put two posts that >>will hold my lower dentures in place. > A 1000 bucks sounds excessive for a couple of root canals and some > amalgam. > Good luck! > > Dr. G. > prosthodontist & FACP > I'm not trying to be argumentative, but the patient mentions "two post" > in addition to the two root canals (I usually use ERA attachments.). You're right! I missed that. It must have been late when I read and replied. I have used both magnets and the Zest attachment. The magnet is a bit bulky in my opinion, but both work. I would like to point out that it is possible to make an overdenture without attachments. Better to have them,of course, but depending on the oral dexterity of the patient and the contours and fit of the denture it can work. Dr. G., FACP prosthodontist > I don't think $1,000 is unreasonable for this service at all. That > barely covers the two endos. [...] > Best wishes, > D SignaturePlease reply via newsgroup. Doing a case right now with #22, 23, & 24 ground down to the gumline. No periapical pathology, no pockets, no *evident* pulp exposure. Just goin' over the top with nothing added. Cautioned that extraction or endo may be needed at a later date. Steve > I would like to point out that it is possible to make an overdenture > without attachments. > Dr. G., FACP > prosthodontist BTW, *I* didn't grind them down to the gumline. The PATIENT did. ;-) Steve > Doing a case right now with #22, 23, & 24 ground down to the gumline. > [quoted text clipped - 8 lines] >> without attachments. Dr. G., FACP >> prosthodontist >> I am in the decision process of getting upper and lower dentures. My dentist >> suggested doing a root canal in two of my lower teeth to put two posts that [quoted text clipped - 21 lines] > Dr. G. > prosthodontist & FACP What kind of attachments are you using in these cases? Zest? ERA? Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Back in the early 80's, I used Zest since it was about the only one out there. I even tried one with magnets. Both systems were decent, but there were maintenance issues with the attachments (mainly the denture portion). ERAs work much better and need fewer repairs. D > What kind of attachments are you using in these cases? Zest? ERA? > > Steve > Back in the early 80's, I used Zest since it was about the only one > out there. I even tried one with magnets. Both systems were decent, [quoted text clipped - 8 lines] >> >> Steve Thanks. I haven't used Zest in years, but don't do too many overdentures either. I've used ERA and these "O" ring kinda retainers. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >Back in the early 80's, I used Zest since it was about the only one >out there. I even tried one with magnets. Both systems were decent, [quoted text clipped - 8 lines] >> >> Steve Am using ERA also, for about 17+ yrs. Did an Mtech couple of years ago on some mini implants. just replaced the females and relined the lower. Worked out well. Cool! Haven't tried the mini's yet, but I am very interested. Steve > Am using ERA also, for about 17+ yrs. > > Did an Mtech couple of years ago on some mini > implants. just replaced the females and relined the > lower. Worked out well. Got a VHS sitting on my desk here (unopened, and a bit dusty) Imtec MDI sendax Mini Dental Implant System Bet they would send you one if you asked. Got this one when ordering the parts for that reline. It worked well but the surgeons don't seem to like them much. Don't know why. >Cool! > [quoted text clipped - 7 lines] >> implants. just replaced the females and relined the >> lower. Worked out well. > Got a VHS sitting on my desk here (unopened, and a bit dusty) > [quoted text clipped - 9 lines] > It worked well but the surgeons don't seem to like > them much. Don't know why. Surgeons won't like them because just about any general dentist can easily place them <G>. (No offense Dr. King) Just got back from the Midwest Dental Convention and listened to Gordo. He's using the Minis a lot and says it's a good place for GPs to get started with implants. I'm going to try a few cases, and a friend of mine in St. Joe is too. Obviously they aren't going to repace larger, traditional implants, but they offer a simple, less expensive option for stabilizing lower dentures. D >> Got a VHS sitting on my desk here (unopened, and a bit dusty) >> [quoted text clipped - 25 lines] > > D My study group recently hosted a lecturer speaking about minis. I told him I could imagine holding onto the lower anterior alveolar ridge between my left thumb and forefinger and thumb, while drilling through the gingivae with the pilot drill with my right hand. Suddenly I feel the drill saying hello and then piercing the skin of my left thumb. I dunno--I guess you just pull the drill out and try another hole? Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 The technique does not involve drilling a pilot hole the depth of the implant. You use the drill similar to a Stabident perforator. Tap, tap, tap on the ridge until you punch through the cortical plate. Start the implant by hand and it threads itself into the bone. It would be difficult to get it to exit through the cortical plate in this manner. Immediate loading is a nice advantage as well. D > My study group recently hosted a lecturer speaking about minis. I > told him I could imagine holding onto the lower anterior alveolar ridge [quoted text clipped - 4 lines] > > Steve On Mar 13, 11:20 pm, "Dr. G." <99ca_kno...@essbeeceeglobal.NOT.net> wrote: > A 1000 bucks sounds excessive for a couple of root canals and some > amalgam. Depends on the location. Single root canal in a molar cost me ca. $800 with another $700 paid by the insurance. That was at an endodontist in metro west coast. |
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