The advent in recent years of titanium implant technology has greatly improved the lives of those who wear dentures, but its high price puts it beyond the reach of many who need it most.
Now a $400,000, four-year Faculty of Dentistry study is looking at the cost and design of dental prostheses used with implants, to see if they can be better made, and at a lower cost.
"We are investigating which designs work best, as well as the cost of making and maintaining prostheses," said project director Dr. Joanne Walton, an associate professor in the Dept. of Clinical Dental Sciences.
"Practitioners have their own sense of what works, but it is not backed up by research. By looking at commonly used designs, we may find that one of the least expensive dentures is just as good as the most expensive. If so, it makes sense to offer that alternative to patients," she said.
"We want to know what will bring the greatest good to the greatest number of people."
About 70 per cent of the population over 65 has at least one denture. And between 30 and 40 per cent of Canadians over 65 have no teeth at all in either jaw.
Conventional dentures--difficult to fit, sometimes painful--are often poor substitutes. That's what made titanium implants the biggest advance in dental care in 50 years.
The expensive procedure sees two or more titanium cylinders implanted into the bone of the lower jaw. Titanium is a biologically compatible metal that bone cells can adhere to, firmly attaching it to the jaw. Short studs are left protruding above the gum and dentures equipped with special fasteners simply snap onto them.
"Many people who get implants say they have not had such a good, firm fit since they had their own teeth," Walton said. "We see a lot of people who are severely handicapped by tooth loss, and sometimes they cry and hug us because they are so happy at the difference it makes. As a dental clinician, it is a very exciting field to be in."
But as implants have become more common, Walton and other clinicians have found that problems can develop with the prostheses they retain. The research literature has little to say about this.
The UBC study will attempt to remedy this by looking at issues such as prostheses breakage, patient satisfaction and keeping dentures properly adjusted, said Michael MacEntee, professor of Clinical Dental Sciences.
Another major focus is cost. With as many as five implants required to fit a prosthesis, the cost can range as high as $12,000, prohibitive for a senior on a fixed income.
"It is not a trivial amount of money. That's why we feel it's important to look at the economics and cost-effectiveness of implant prostheses," MacEntee said. "Nobody has really analysed the cost and its implications before."
The study is asking for volunteers who will receive implants and dentures for just $1,800, including follow-up repairs and adjustments for two years at no cost.
All dental work will be done by qualified professionals, not students, and will use only proven techniques and materials. All that is asked of participants after the implants are in place is to attend regularly scheduled dental appointments.
The study is funded by the National Health Research Development Program of Health Canada and Nobel Biocare, the Swedish company which produces the titanium implants.
For more information or to participate in the study call the Oral Implant Clinic at 822-5583.