Today, research offers dentistry multiple cosmetic solutions to cater to patients’ needs through the use of a wide range of products made with different materials which replace natural tooth material. In particular, dental restorations are made by dental laboratory specialists to replace lost or compromised natural teeth for functional or cosmetic purposes. Dental prostodonthics is a branch of odontology which refers to designing and realising restorations according to the following requirements:
Functionality: it entails restoring correct mastication and the joint functions (opening, closing, right-left mobility, protrusion, retrusion and correct pronunciation).
Durablity: dentures must endure the masticatory load and corrosion caused by buccal liquids.
Safety: dentures must be non-toxic and totally biocompatible in order not to harm patients’ health. They also have to be modelled so as not to damage mouth tissues.
Cosmetics: false teeth must look as natural as possible; therefore, considerable care must be paid to preserve patients’ facial features.
Fixed restorations are bonded to a support or an abutment and cannot be removed but by a dentist. Three types of fixed restorations are available, depending on their functions:
Reconstruction: include crowns, inlays, and dentures are used to reconstruct the remaining parts of a tooth after an extraction and to avoid its complete destruction.
Replacement: fully replaces natural teeth through specific elements (e.g. bridgework)
Stabilization: which has to block and distribute mastication correctly (eg. splints).
When directly anchored to a tooth or stump, these elements are called crowns, when clasped to the adjacent filed teeth to replace missing teeth they are called bridges; they are called dentures-on- implants when placed on bone-fitted implants. Fixed restorations also include veneers, that is thin layers of ceramics or zirconium-ceramics which are placed over the frontal teeth for functional or cosmetic purposes. In recent years, CAD/CAM implant dentistry has replaced traditional implant methods, and restorations are now fabricated with the use of computer-aided milling and design. Digital technology allows clinicians to provide patients with extremely precise fitting and natural looking restorations.
Crowns or caps are restorations applied to a single tooth whose root is still intact. They are anchored either to the tooth stump accurately prepared, or to an abutment screwed into the root capping the tooth, or on to the abutment or stump fixed to the implant.
To fabricate crowns, Dr Bahri Adis uses premium-quality materials only, which have been tested for biocompatibility. Materials include ceramics and zirconium-ceramics. The former consists of a metal support to fix the external ceramics cap. The latter offers the most aesthetically and functionally innovative solution since, as a substitute for diamond, it is extremely hard, deformation-free and more lightweight than other materials.The use of zirconium-ceramics caps guarantees incomparable cosmetic results as these caps offer natural teeth-like translucence.
Crowns, and other bridgework, are usually made of metal, metal-ceramics, or ceramics only.
Bridges are restorations which replace extracted teeth and include the adjacent teeth previously prepared (abutted) to receive the bridge. Therefore, bridges consist of both the lost teeth and the abutments. They can replace a full arch of teeth (complete circular denture) or partial replacing two or more teeth.
Bridges are fabricated with the same materials as crowns, ceramics or zirconium-ceramics.
Semi-fixed restorations are semi-mobile prostheses anchored to two to four implants using male-female snap-ins. Semi-fixed restorations are used when patients do not qualify for fixed restorations implants because of bone tissue resorption. These types of prostheses offers greater strength, durability and stability when compared to removables that are implant-retained by means of locators.
Removable restorations include all those dentures used to replace a full arch of teeth or grouped teeth. They can be easily removed by patients during the day. Removable restorations include complete dentures, partial dentures, combo-framework dentures.
Partial dentures are anchored to the remaining teeth through clasps or attachments. When partial dentures present a metal framework they are called framework partials, whereas combo-partials are partial dentures made of mixed materials fixed onto the implant through precision clasps. Metal-clasps-free framework dentures can be made with thermoplastics or acetal-dental. In addition, metal-free, nylon partials can be realised, guaranteeing greater biocompatibility and flexibility.
Complete dentures are non-physiological devices which are used to fully restore mastication. Indeed, when edentulism or complete lack of tooth or root occurs, masticatory functions are performed by the oral mucosae and the underlying bones.
Complete dentures must be created respecting a patient’s facial profile. They are also known as complete removables as patients themselves can remove and reinsert them during the day.These prostheses are meant to replace full edentulous arches by means of a supporting acrylic resin framework. They consist of false teeth made of either ceramics (uncommon) or dental resin, with remarkable cosmetic results. Dr Bahri Adis plans such prosthetic devices which are then fabricated by specialist dental technicians so that dentures (especially those replacing frontal teeth) look perfectly natural and fit the patient’s facial profile and expressions.
Implant surgery can be performed in cases of small edentulous areas, or to guarantee greater denture stability with sufficient remaining jawbone. In these cases, implant-supported overdentures would be applied (in the lower arch two implants with screws are fitted in the canines area).
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