Prosthetic treatment means that entire tooth or tooth part is replaced by the construction made by the dental laboratory. Thus dental prosthesis means different kinds of removable dentures, fixed dentures but also “fillings” from gold or porcelain made in dental lab.
Different prosthetic options
Making crown means covering tooth witn permanent material (fixed in the mouth) that restores strength and beauty of the tooth. When there is little of tooth structure remaining or most of the tooth consists of filling material, then making crown is indicated. Large fillings, especially on the posterior teeth, are not suitable to withstand the huge chewing forces and as a result they wear out quickly. That in turn causes reduction of the vertical height (reduction of bite height). This reduction may cause functional and esthetic problems in the future.
Root canal treatment is also an indication for making crown. Tooth where root canal treatment was performed is weaker than vital one and can fracture easily. Crown protects remaining tooth structure and integrity of tooth and also decreases probability of fractures. If only root remains, then in certain conditions it can be restored also by means of a crown. Then post & core have to be made first. Post & core is cemented into the root and retains the crown. High quality crowns can remain in the mouth even for decades. High quality crown supposes precise marginal preparation, excellent impression technique and usage of precious metal alloys or Zirkonia caps.
Other possibilities are: a) temporary restore tooth with filling material or b) just preserve tooth for further prosthetic management.
Bridge is a structure that replaces missing tooth and is fixed on the neighbouring teeth. Bridge is indicated when teeth surrounding the gap are destroyed and need crowns. When neighbouring teeth are intact or have small defects, then it is better to replace missing tooth (or teeth) with implant (or implants).
Other possibility is to replace missing tooth/teeth by means of removable denture. Sometimes missing tooth doesn’t need replacement.
Removable denture has metal frame, which gives strength and smaller dimensions and increases comfort. It is not necessary to remove this denture from the mouth at night. Removable denture replaces missing teeth and is fabricated when it is impossible to insert implants or to make bridges.
This means mixing different type of prosthesis. For example, some teeth may be restored with crowns or bridges, some are replaced by the removable part that is fixed by means of special attachments. Usage of such prosthesis is quite convenient. Combined works are done when it is impossible to replace all missing teeth with fixed prosthesis.
This is removable denture that is made from acrylic resin. This type of denture is fabricated when all teeth or most of them are lost. Denture may be used also as a temporary one.
When tooth colour is undesirable and bleeching doesn’t help, veneers may be a good choice. Veneers are made from porcelain and they are used mainly for the front teeth. Smile can be made perfect again by means of the veneers.
Instead of veneers, crowns are sometimes indicated. Veneers are made on the vital teeth (teeth that haven’t had root canal treatment), because crowns are indicated for devital teeth. Making crown on the tooth with treated root canal helps to preserve this tooth.
Inlays and onlays
Inlays and onlays (fillings made in dental lab) can be made from gold alloy or porcelain. They are more expencive than ordinary fillings, but more durable.
Implants and implant prosthesis
Missing tooth may be restored with implant, which is inserted into the bone. After healing crowns, bridges or other type of prosthesis can be fixed on the implant. Final result is very similar to the natural tooth. Implants can be used also to support removable dentures. Sometimes implants are the only choice to make prosthesis stable.