Upper Denture vs Upper All-on-4: What Changes

Key takeaways

• The McGill consensus said complete-denture wearers are usually able to wear an upper denture without problems.
• The struggle they described was the lower denture, because it is too mobile.
• A fixed upper All-on-4 bridge is not the two-implant lower overdenture that statement recommended.
• This clinic's upper-jaw page allows for four implants, six or more, or a removable snap-on, depending on the jaw.

What did the consensus say about upper dentures?

Feine, Carlsson, and the McGill panel wrote this in 2002: "Complete denture wearers are usually able to wear an upper denture without problems, but many struggle to eat with the complete lower denture because it is too mobile." Conventional dentures, upper and lower, rely on the residual ridge and the mucosa. The adaptation problem they emphasize is the mandibular prosthesis.^[1]

The studies they cite found higher quality-of-life ratings when people received a two-implant lower overdenture opposing a conventional maxillary denture, compared with new conventional dentures. The upper denture stayed in the picture as the opposing plate. The intervention was on the lower jaw.^[1]

Dentures compared with dental implants keeps the wider comparison. The lower-jaw evidence is in a lower denture versus lower implants.

What is a fixed upper arch, then?

All-on-4, as a technique, is four implants and a fixed bridge. It can be planned on an upper jaw. It does not come out, and it does not sit as a plate on the ridge the way a complete denture does. The McGill statement never compared that fixed upper bridge with an upper denture. Treating the consensus as an upper-jaw verdict would reverse the jaw they actually studied.^[1]

What All-on-4 meant in the original lower-jaw series is the definition. Snap-on dentures versus All-on-4 separates a clip-in denture from a fixed bridge. Someone whose upper plate is tolerable, and whose lower plate moves, is closer to the consensus than someone who wants both jaws fixed.

Why does Renew plan the upper jaw on its own?

The upper jaw implants page says some patients are candidates for All-on-4 and others may benefit from six or more implants, depending on bone density and anatomy. It also lists a snap-on overdenture for people who want a removable option.^[2] The upper jaw is less dense than the lower and sits under the sinus, which is why that page treats it as its own plan rather than a copy of the lower-denture evidence.

The implant surgeon places the implants. Tom Szarski, DD, is the denturist who designs and fits the teeth with the on-site lab. A free consultation includes a 3D scan. The scan decides whether an upper denture is the prosthesis the consensus expected people to manage, or whether a fixed or snap-on upper plan is the one being discussed.

Sources

1. The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients — Gerodontology
2. Upper jaw implants — Renew Implant Centre