Prosthodontics is one of the branches of dentistry that deals with the replacement of missing teeth and the associated soft and hard tissues by prostheses (crowns, bridges, dentures) which may be fixed or removable, or may be supported and retained by implants.
The term “prostho” means replacement and “dontist” means dealing with teeth. Essentially, prosthodontists are the recognized experts when anything needs to be replaced in your mouth. This can range from a single tooth, multiple teeth, or all teeth and gums in the mouth. While many other dentists can do some of these treatments, prosthodontists are the specialists dedicated to this type of care. At Doctor Sadiq Sharaf Dental Center, we have highly experienced Prosthodontists who can help you with your complex & complicated problems.
Crowns and Bridges
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Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.
How do Crowns Work?
A crown is used to entirely cover or “cap” a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.Your dentist may recommend a crown to:
- Replace a large filling when there isn’t enough tooth remaining
- Protect a weak tooth from fracturing
- Restore a fractured tooth
- Attach a bridge
- Cover a dental implant
- Cover a discolored or poorly shaped tooth
- Cover a tooth that has had root canal treatment
How do Bridges Work?
A bridge may be recommended if you’re missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and other disorders.
Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.
How are Crowns and Bridges Made?
Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.
Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.
How Long do Crowns and Bridges Last?
While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.
Partial Dentures & Complete Dentures
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A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available — complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.
Complete dentures can be either “conventional” or “immediate.” Made after the teeth have been removed and the gum tissue has begun to heal, a conventional denture is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed.
Unlike conventional dentures, immediate dentures are made in advance and can be positioned as soon as the teeth are removed. As a result, the wearer does not have to be without teeth during the healing period. However, bones and gums shrink over time, especially during the healing period following tooth removal. Therefore a disadvantage of immediate dentures compared with conventional dentures is that they require more adjustments to fit properly during the healing process and generally should only be considered a temporary solution until conventional dentures can be made.
A removable partial denture or bridge usually consists of replacement teeth attached to a pink or gum-colored plastic base, which is sometimes connected by metal framework that holds the denture in place in the mouth. Partial dentures are used when one or more natural teeth remain in the upper or lower jaw. A fixed bridge replaces one or more teeth by placing crowns on the teeth on either side of the space and attaching artificial teeth to them. This “bridge” is then cemented into place. Not only does a partial denture fill in the spaces created by missing teeth, it prevents other teeth from changing position. A precision partial denture is removable and has internal attachments rather than clasps that attach to the adjacent crowns. This is a more natural-looking appliance.
How Are Dentures Made?
The denture development process takes a few weeks and several appointments. Once your dentist or prosthodontist (a dentist who specializes in the restoration and replacement of teeth) determines what type of appliance is best for you, the general steps are to:
- Make a series of impressions of your jaw and take measurements of how your jaws relate to one another and how much space is between them.
- Create models, wax forms, and/or plastic patterns in the exact shape and position of the denture to be made. You will “try in” this model several times and the denture will be assessed for color, shape, and fit before the final denture is cast.
- Cast a final denture
- Adjustments will be made as necessary
Are There Alternatives to Dentures?
Yes, dental implants can be used to support cemented bridges, eliminating the need for a denture. The cost is usually greater, but the implants and bridges more closely resemble the feel of real teeth. Dental implants are becoming the alternative to dentures but not everyone is a candidate for implants. Dental implants may also be used to support dentures, offering more stability. For more details book a Consultation with our dentist & get advice about implants or dentures.