Prosthetic Treatments
Prosthetic Treatments
Prosthetic Treatments

What is a Prosthesis?

In cases where teeth and/or surrounding tissues have suffered a loss of substance for a number of reasons (caries, periodontal diseases, accident, etc.) and in tooth loss cases or for aesthetic reasons without loss of substance, personalized restorations are called “prosthetics”.

 

What Are the Benefits of Prostheses?

In tooth loss cases, the chewing function, aesthetic appearance and psychology are negatively affected. Therefore, the completion of missing teeth by various methods increases the chewing efficiency, as well as eliminating the negative situations caused by aesthetic problems.

 

What is an Implant?

It is an artificial screw, which is biocompatible with the tissue that supports as the root of the missing tooth by placing it in the jawbone to replace the missing teeth. Fixed or movable prostheses are placed on these screws, which are inserted into the jawbone by surgical operation.

How Many Types of Prostheses Are There?

Prostheses are generally evaluated in two separate groups:

  • Fixed dentures: Restorations designed on the patient's natural teeth or on implants made in place of missing teeth that cannot be removed by the patient and produced with materials compatible with the texture and color of the teeth,
  • Dental crown: Covering the entire tooth with restorative material by making abrasions around a single tooth in accordance with certain rules,
  • Implant crowns: Restoration performed on a single implant,
  • Bridge: Complete covering of multiple teeth jointly with restorative material (in case of tooth loss),
  • Bridge over implant: Bridge restoration performed on more than one implant,
  • Inlay/onlay/overlay: In case of a lack of a part of the tooth, only the loss of substance is compensated by restorative material,
  • Laminate veneers: When there is no lack of teeth and the person is not satisfied with the shape and color of the teeth which are visible when smiling, the smile is made more aesthetic by making a minimal abrasion only on the front surface of the teeth (in some cases, no abrasion may be required according to the preliminary preparations). It is the most protective and aesthetic treatment method.

 

  • Movable prostheses: These are prostheses that are made in cases where there is an excessive tooth loss up to a point that is not suitable for the construction of fixed dentures in a person's mouth, or in cases where a person has lost all his/her teeth and these prostheses can be worn and removed by the patient at any time.
  • Total prosthesis: In cases where there are no natural teeth left in a person's mouth, prostheses, which are commonly called “palatal prosthesis”, are made by taking support from the tissue on the patient's jaw bones. It is used in cases where an implant cannot be made for a person.
  • Classical partial dentures: It is a type of prosthetic that can be removed and put on by the patient and they are made with the support from both the bone tissue of the jaw that is missing teeth and natural teeth remaining in the mouth (with the help of clasp) when there is an absence of teeth.
  • Precision attachment partial dentures: They are snap-on dentures that are supported by porcelain veneers made on natural teeth in the mouth and tissue on the jawbone in the event of a large number of missing teeth.
  • Dental prostheses: These prostheses are prepared by making a number of special preparations to increase the retention on a very small number of natural teeth or tooth roots that exist in the mouth and they can be put on and removed by the patient. Externally, they resemble total prosthesis.
  • Movable prosthesis on implants: In cases where a person does not have any natural teeth, these prostheses are supported by 2 or 4 implants placed in the lower and upper jaws and the patient's own jawbone to the extent that the jawbone and the patient's general health allow. Patients can put on and remove them.

 

 

What Are the Materials Used in the Construction of Prostheses?

In the construction of fixed prostheses following materials are used:

Metal-supported ceramics: It is a frequently used economical restoration which is obtained by baking ceramics on the substructure of an alloy that is the combination of different metals.

Non-metallic ceramics (full ceramics): This type of restoration is obtained by baking a different ceramic on the ceramic substructure or it can be made only from a single layer of ceramic and has a texture and color quite similar to the natural tooth because it does not contain metal. Thanks to today's technology, it is quite robust in restorations obtained from ceramics without substructure support.

 

In the construction of movable prosthesis, a polymer-based material called acrylic, which imitates both soft tissues (pink in color) and missing teeth, is mostly used. In addition to acrylic, ceramic and composite based materials can also be used in the construction of some implant-supported movable prostheses.

 

Question-Answer

Zirconium is a highly solid white material that is included in the group of full ceramics. When used as a substructure, ceramics of the desired color are processed on it. In some cases, a single-layer version called “monolithic/monoblock zirconium” is used. Its use has become quite widespread today since it does not contain metal substructure, it meets aesthetic expectations and is biocompatible with texture.

Computer-assisted design means computer-assisted manufacturing. After deciding on the type of prosthesis to be made and following the completion of the necessary preparations in the mouth, digital measurements are taken with the help of special optical intraoral cameras instead of the classical measurement process. The design of the prosthesis is completed on virtual models obtained from these digital measurements, and the production of the designed prosthesis is completed on scraping devices or with devices called 3D printers with zero touches from a human. The fact that it eliminates the classical measurement process, and all operations are completed digitally, minimizes the margin of error. In addition, one of the biggest advantages is that the treatments can be completed in one session. Many types of prostheses such as crowns, bridges, inlays, onlays, overlays, laminate veneers, implant prostheses, total prostheses can be produced using CAD/CAM technology.

It is a modern treatment method in which the color and shape problems, disproportions or tooth colorations that can be observed on a person's teeth and gums are planned in accordance with the patient's expectation and needs, and the approximate result can be shown to the patient in advance without any intervention on the teeth. Since planning and designing are performed entirely in a digital environment, this process is called “digital smile design”.

All the prostheses used for the rehabilitation of congenital or acquired deformities (for reasons such as trauma and cancer) in the maxillofacial region are called maxillofacial prostheses. Facial defects are facial deformations that occur in areas such as the eyes, nose, ears, and cheeks, and there may be one or more deformations. In addition to facial defects, there can also be deformities of the jaws.

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