Restorative / Prosthodontics
Prosthodontics is the art and science of the repair or replacement of missing or damaged teeth, resulting in the restoration of proper form, function, and esthetics while maintaining the integrity of the teeth in harmonious relationship with the adjacent hard and soft tissues.
Fixed prosthodontics can be used to restore single or multiple teeth, spanning areas where teeth have been lost. In general, the main advantages of fixed prosthodontics when compared to direct restorations is the superior strength when used in large restorations, and the ability to create an aesthetic looking tooth. As with any dental restoration, principles used to determine the appropriate restoration involves consideration of the materials to be used, extent of tooth destruction, orientation and location of tooth, and condition of neighboring teeth.
Crowns & Onlays
A crown is used to cover a tooth and may be commonly referred to as a “cap.” Traditionally, the teeth to be crowned are prepared by a dentist, and records are given to a dental technician to construct the prosthesis. The records include models, which are replicas of a patient’s teeth, and the impressions used to make these models. There are many different methods of crown fabrication, each using a different material. Some methods are quite similar, and utilize either very similar or identical materials. Crowns may be made of gold or other similar metals, porcelain, or a combination of the two.
All gold crowns are used on posterior teeth of patients that are heavy grinders and who show evidence of extensive wear on their teeth.Porcelain applied to gold crowns is for areas with low to moderate functional demands and in areas where there is a high aesthetic demand.
Crowns, when done correctly and well, provide many years of service, are virtually undetectable and represent the ultimate in dental restorations and prosthodontics.
An onlay is a method of tooth restoration, which covers, protects or reinforces one or more cusps. Onlays are methods for restoring teeth in an indirect way. Onlays are often used when teeth present extensive destruction due to caries or to trauma.
An inlay is a restoration which lies within the confines of the cusps. These restorations are considered to be more conservative than onlays or crowns because less tooth structure is removed in preparation for the restoration. They are usually used when tooth destruction is less than half the distance between cusp tips.
A partial is a removable partial denture or ‘RPD’. It is a prosthesis that is placed in the mouth to replace the function and appearance of a few missing teeth. It is usually made out of metal and plastic.
The two main types of dental partials are fixed and removable. The health of the remaining teeth has a lot to do with determining which type is a better choice for you. A fixed dental partial attaches artificial teeth to the jaw with a dental crown. It can also be attached under the gum with dental implants. Removable dental partials consist of a metal framework with plastic teeth and gum areas. Metal clasps hold the RPDs in place, but they can be removed easily for cleaning.
If you have lost a few teeth, partial dentures make it easier for you to speak and chew. They help maintain the shape of your face and help prevent remaining teeth from shifting. Dental partials prevent problems that are caused by changes in teeth spacing, such as TMJ, headaches and earaches.
Traditional methods to replace a missing tooth or teeth include the fabrication of a bridge. A bridge is a fixed partial denture or FPD. A bridge is used to span, or bridge, an edentulous area (space where teeth are missing), usually by connecting to fixed restorations on adjacent teeth. To replace a missing tooth with a bridge, at least one tooth on either side of the space created by the missing tooth must be prepared for a crown. Then a false tooth is joined to the crowns, and the entire structure is cemented to the prepared teeth.
The teeth used to support the bridge are called abutments. A bridge may also refer to a single-piece multiple unit fixed partial denture (numerous single-unit crowns either cast or fused together). The part of the bridge which replaces a missing tooth and attaches to the abutments is known as a “pontic.” For multiple missing teeth, some cases may have several pontics. The patient cannot remove the bridge, and special aids are available to keep it clean.
Complete dentures are used when an individual loses all of their teeth. When a patient no longer has any natural teeth, complete dentures are the traditional method to restore function and appearance. Many patients experience difficulty wearing conventional dentures because of poor stability and decreased chewing function. The use of dental implants to improve the stability and retention of dentures is the recommended.
An Overdenture is a denture that uses precision dental attachments to hold the denture down. The overdenture attachment can be placed in tooth roots that have been saved, or placed into dental implants which have been placed to receive them. If Fixed osseointegrated prosthesis may not be possible in certain cases. In such cases, an overdenture can be made and connected to osseo-integrated implants.
Maxillofacial prosthetics is a branch of dentistry that deals with congenital and acquired defects of the head and neck. Maxillofacial prosthetics integrates parts of multiple disciplines including head and neck oncology, congenital malformation, plastic surgery, speech, and other related disciplines. Restoration of acquired defects may be intraoral or extraoral. Intraoral defects may involve the mandible, tongue, soft palate, or hard palate, while extraoral defects may involve any other area of the head or neck.
Maxillofacial prosthetic device is a product designed to repair injuries and congenital (birth) defects of the face, jaw and hard and soft palates.
The obturator prosthesis is designed to replace missing structural components of the maxillary arch including the palate and associated dentoalveolar structures. Placed at the time of surgery, an interim obturator prosthesis replaces the surgical obturator following completion of the initial phase of healing in the immediate postoperative period. In this phase of treatment, multiple adjustments to the prosthesis are required as healing progresses. Teeth are frequently added to increase the level of function and improve the patient’s nutritional intake.
The definitive obturator prosthesis is the final phase of the prosthetic rehabilitation of the maxillectomy patient. In addition to replacing the hard and soft tissues of the palatal structures and creating an effective seal for both speech and swallowing, functional teeth are replaced to maximize the capacity for oral function and restore facial symmetry.