Prosthodontics

Missing teeth can allow the surrounding teeth to become displaced.

By taking care of dental problems immediately, you minimize the risk of future problems.

• Crowns fix and protect teeth that are so damaged or diseased that they need more support than a simple filling.
• Bridges replace missing teeth and offer support for the surrounding teeth to help retain the integrity of the jaw and face structure.

Crowns, also known as caps, restore damaged teeth and mimic the shape, size, and color of the surrounding teeth. Crowns are indicated for cracked teeth and teeth with deep cavities; to protect teeth that have been filled by root-canal treatment; to provide extra support for bridges, and to cover poorly shaped or discolored teeth. Crowns may be made of metal, porcelain, or newer restorative materials like metal-free ceramics. They are custom-made and fitted for each patient in conformation with the size and length of the natural teeth. Crowns typically last five to eight years but can last much longer with proper oral hygiene.

The teeth to be crowned are prepared which involves reduction of the tooth size (usually under local anesthesia) followed by an impression or mould of the prepared tooth. This trimming of the tooth is required to create space for the crown to be fitted. The mould taken is then sent to a laboratory where skilled technicians will fabricate the crown.

A bridge stabilizes the bite of a patient who is missing one or more teeth. Bridges prevent the surrounding teeth from moving or shifting in the mouth. A missing tooth that is not replaced may cause surrounding teeth to become unstable and require removal, compromising oral health or change the shape of the face and diminish the beauty of a smile.

Unlike partial dentures, bridges are permanent; patients need not remove them. The missing tooth is replaced with an artificial tooth connected between two crowns (caps), which are permanently cemented or bonded on the adjacent teeth.

This is the most economic and most traditional method of tooth replacement. Dentures are removable objects that simulate the look and function of the tooth and its surrounding tissue. Most dentures are constructed with acrylic resins. However, patients can choose from a variety of options:

• Traditional plastic dentures
• Traditional plastic dentures with a metal framework to make the denture strong, light and biocompatible.
• Flexible dentures

There are two major types of dentures. The full denture replaces an entire jaw’s dentition, while a partial denture only replaces multiple or single teeth where there are still healthy teeth present. A partial denture also serves as a spacer to prevent the living teeth from shifting position.

Most patients with full dentures are in their later years and have lost most of their teeth. Patients with partial dentures are usually people who have lost a tooth to gum disease or injury. All patients receiving dentures find that their chewing improves, their oral hygiene becomes easier, and their speech clears up. On the outside, a denture can drastically improve your smile.

Dentures are specifically made for each patient’s unique anatomy. Initially, they will feel awkward, no matter how well they may fit you. The fact remains that it is not a living part of your mouth and it will feel foreign to you. However, after a short period of adjustment, most people don’t even notice that they’re wearing the dentures anymore.

Regular checkups with your dentist are encouraged in order to track changing conditions in your mouth. Should your teeth shift or your bones change shape with time, you’ll need a new set. Dentures have been around for a long time and are a proven way to replace lost teeth. If you require dentures please contact a dentist for a consultation.

This is the least expensive of all the removable partial dentures. These dentures are generally used for temporary or intermediary purposes until the final prosthesis is made. Still, yet we find many people keep this type of appliance for many, many years, just like permanent ones because as long as they are properly maintained, they look outwardly as good as the more expensive permanent appliances. The one pictured above replaces 4 missing teeth, leaving spaces for 7 natural teeth. Two of the natural teeth are clasped with wrought wire clasps which are cured into the structure of the denture base.

The pink material of the denture base is hard plastic and the same material used to make complete dentures. The main single advantage to this type of RPD is the cost. Also, the new teeth and new denture base can easily be added to an existing treatment RPD. These are frequently fabricated even if the remaining teeth have existing decay or periodontal disease and their prognosis is doubtful. If later in the course of treatment some of the existing natural teeth are extracted for any reason, new false teeth can be added quickly to the partial, maintaining the patient’s appearance.

Another common and more important use of these appliances is as an “immediate partial denture”. This means that the appliance can be made before the teeth are removed, and inserted immediately after the extraction of the planned teeth so that the patient is never without teeth. This is of special help when anterior teeth are to be extracted and the patient wants to return back to his/her normal routine immediately.

However, in spite of these advantages, they have a number of disadvantages too.

They are basically plastic and due to their irregular shape, these partials tend to break frequently, especially those made for the lower arch. These appliances are less stable compared to cast partials. Also, cases of allergy to this material have also been reported.

As the gums and supporting bone resorb, the false teeth tend to sink below their original level making it necessary to reline them frequently, and sometimes even to reset the teeth which adds to their expenses.

They are most frequently retained with wire clasps. These are frequently unsightly due to the limitations that pertain to their placement.

These Removable Partial Dentures are cast metal frameworks made of chrome cobalt. These frameworks are cast to fit the teeth . These are cast very thin and are much less likely to break than the all-plastic variety. For the same reason, they are much less noticeable to the tongue. 

The teeth have to be altered slightly beforehand in order that the partial denture can rest upon them without interfering with the way the patient bites the teeth together. Since they sit on the teeth, as well as being attached to them, they are extremely stable and retentive

The metal framework does not contact the gums. Thus, as the gums resorb, this type of partial does not sink with them and rarely requires relines.

Advantages

• Rarely breaks. Can also be used for complete denture cases where breakage is a frequent problem.
• It is made very thin, so less noticeable to the tongue
• More stable and retentive

However, a major drawback is the visibility of metal clasps which might be objectionable to some patients.

The most recent advance in dental materials has been the application of flexible materials for the fabrication of dental appliances. This material generally replaces the metal, and the pink acrylic denture material used to build the framework for standard removable partial dentures Flexible partial dentures are the comfortable, beautiful, and affordable choice

The flexibility, combined with strength and lightweight, provides total comfort and great looks! It is nearly unbreakable, is colored pink like the gums, can be built quite thin, and can form not only the denture base but the clasps as well.

The preparation is relatively simple because your natural teeth don’t need to be altered in any way. The denture is virtually invisible because there are no metal clasps and the material itself blends with the tissue in your mouth so that the only thing that shows is your beautiful smile.

These appliances are very durable and are designed to give a long-term performance under normal usage. Small accidents such as dropping the appliance in the sink or on the floor will not damage the denture.

Key Benefits Are:

• Retention – flexes into a retentive position, below the undercut.
• Comfort – thin, lightweight, and flexible.
• Esthetics-pink shades allow natural tissue tone to appear through the material.
• Strength – clinically unbreakable, more durable than acrylic, and won’t absorb stains or odors.
• Ease – no tooth or tissue preparation is required so patients can be offered a conservative and pain-free solution.

 Indications

• Allergies to conventional denture material
• History of partial frame breakage
• Alternative to implants or fixed products