Full arch rehabilitation, also known as full arch restoration, is a periodontal prosthetic procedure that restores multiple missing teeth in the upper or lower arch (jaw). It relies on a combination of dental implants and prosthetic teeth to restore your smile and provide what can be a life-long tooth replacement solution. Once a prosthetic teeth plan is developed by a prosthetic dentist, the surgical implant plan can be developed by your periodontist.
Full arch rehabilitation may be a suitable option if you are missing several teeth in the upper or lower arch and are looking for a long-term solution that could restore your smile.
You may benefit from full arch rehabilitation if you
- Suffer or will suffer from significant tooth loss due to periodontal disease, dental caries (cavities), fractured/broken teeth, or failed root canal procedures
- Lost a group of teeth due to facial trauma
- Currently have full or partial dentures but are looking for a more permanent option
- Are experiencing significant bone degradation that limits the success of other prosthetic devices or solutions
- Have tried other periodontal prosthetics with limited or no success
- Experiencing difficulty chewing and digesting food
Patients that fit into one of the general scenarios above are usually considered good candidates if they are in relatively good health. If you are suffering from a systemic disease that is not yet controlled, you may want to consult your doctor before undergoing full arch rehabilitation.
The rehabilitation process starts with a consultation with both a prosthetic dentist and a board certified periodontist. During these sessions, your doctors will review your medical history, dental history, examine your mouth, and take a cone beam CT scan (CBCT) to determine if your jaw can support the implantation.
If you and your doctors determine that full arch rehabilitation is the best solution for your needs, you can schedule the procedure. Depending on the condition of your mouth and jaw bone, you may need to undergo preparatory surgeries before the final implant placement. For instance, remaining teeth may need to be extracted, infection removed, or irregularities in jaw structure repaired, augmented or reduced.
On the day of your procedure, in general your doctor will make incisions along the upper or lower gum line and place the implants.
Immediately after the implants are placed and if part or your prosthetic plan, your doctor will insert temporary crowns which helps your gum to heal while your jaw fuses with the implants. Healing time varies by patient but typically takes between 3 and 5 months. During this time, your doctor will likely recommend a soft-food diet to support and maximize and expedite the healing process
Once your gums and implants have healed a test will be completed to determine that implant fusion with the jaw is complete. Then your prosthetic doctor with begin to create permanent prosthetic teeth. Once this is completed you will begin to care for your new teeth with basic dental maintenance, including regular brushing, flossing, inter-tooth brushes, and regular dental check up/maintenance visits every 3-4 months.
Dentures, like full arch replacements, are designed to return oral stability and function while improving the appearance of your smile. However, there are a few key differences between the two, some of which may make one option more suitable than the other.
Dentures are prosthetics that are designed to fit over your existing gums and are generally a less invasive option when compared to full arch implants. That is not to suggest that dentures are a completely surgery-free option. In some cases, your doctor may need to extract teeth or perform minor grafting or sculpting to ensure a proper fit.
Depending on your needs, dentures may also be a faster and more affordable option when compared to full arch replacements.
Despite these benefits of dentures, there are significant tradeoffs. Because dentures aren’t secured to your gum line or jaw bone, they can shift during normal use, particularly when biting, chewing or speaking. This makes them uncomfortable and difficult to chew with for most patients.
Another important consideration is gum health and the integrity of your jaw bone. Advanced periodontal disease and missing teeth can lead to jawbone degradation and a change in your appearance. Implants used in full arch replacement help maintain jaw bone integrity and can prevent additional issues or aesthetic changes. Since dentures don’t require implants, the jaw bone is not stabilized, and some patients may experience continued negative jaw bone and facial changes.
One final consideration is maintenance. Full arch replacement may require more invasive upfront work on the part of your doctor, but once implants and prosthetic devices are in place, patients can typically rely on a standard oral care regimen.
Dentures require thorough, daily cleaning and brushing with a non-abrasive toothbrush and paste. Though this may not deter some wearers, if you’re looking for a more traditional oral care routine, full arch replacement may be the better option.
In the short term, full arch rehabilitation leads to improvements in your appearance and overall oral health. For many, this signifies a return to normal, where they can chew, speak, and smile with confidence. This is an important short-term effect for those who may experience social anxiety or depression due to obvious or severe periodontal disease or trauma to the teeth or jawbone.
However, the benefits of a full arch rehabilitation aren’t purely aesthetic. The nature of this periodontal prosthetic solution makes it ideal for maintaining the integrity of an individual’s jaw structure and long-term appearance.
When multiple teeth are missing or a patient is suffering from advanced periodontal disease, the jaw bone can degrade, shift, and diminish. Over time, this can lead to additional tooth loss or permanent changes in an individual’s appearance.
Full arch rehabilitation provides stability and encourages gum stability. This, when paired with routine oral care, can stop disease progression and lead to long-term oral health and more successful outcomes.
If left untreated, even slight cases of periodontal disease can lead to significant and painful damage that can affect not only your appearance but your overall health as well.
Your dentist is skilled and trained in oral health and can perform common procedures like tooth extractions, root canals, and fillings, as well as other more advanced procedures. They can also identify and help you treat early-stage gum disease.
However, periodontal specialists receive an additional three years of postdoctoral training that focuses specifically on identifying, treating, and preventing gum disease and other serious periodontal conditions. They are also specially trained to understand your medical history and to interact with your physician(s), as well as to identify the correct treatment path and provide long-term care that can enhance and maintain your oral health.
If you’re experiencing any signs of periodontal disease, have missing teeth, have decreased chewing ability, or have been advised by your dentist that you should speak to a periodontist, you should schedule an appointment as soon as possible.
Dr. Bonacci and his team of experienced staff can offer you the guidance, treatment, and support you need to improve and maintain your oral health and restore your smile. Contact us today for your consultation.