Prosthetic Dental Treatment

What is Denture Treatment?

Denture treatment is a branch of dentistry that focuses on compensating for teeth lost due to various reasons or the loss of dental tissues through biocompatible artificial materials produced in a laboratory, with the aim of restoring the functions of chewing, speaking, and visual integrity of the person.

Tooth loss in human health not only creates a visual deficiency; it also directly affects the chewing function, which is the first step of the digestive system. Dental prosthesis treatment comes into play exactly at this point, focusing on the restoration of the unity of the mouth and jaw. Thanks to the medical materials developed from the past to the present, these artificial teeth, which replace the lost tissues, have reached levels that are quite close to human anatomy in terms of tissue compatibility and functionality. If missing teeth are not replaced, sequential functional losses such as jawbone resorption, tilting of adjacent teeth, and occlusal disorders can occur. Prosthetic applications are designed to overcome these biomechanical imbalances.

The dental prosthesis treatment approaches applied in the Avrupadent clinics serving in the Izmir region are carried out while considering the unique jaw closure dynamics and face ratios of each individual. The main goal of the applications is to restore the missing function of the person, while preserving the health of the temporomandibular joint and ensuring the natural course of phonetic (speech) ability continues. The acrylic, ceramic, or zirconium-based materials used are selected as part of a special planning to be clinically compatible with the gum and surrounding tissues.

Hangi Prosthetic Dental Treatment Hizmetine İhtiyacın Var?

In What Situations is Dental Prosthesis Treatment Applied?

The gaps occurring in the jaw structure affect not only that area but also the dynamics of the entire jaw system. Other teeth that shift into the vacant areas gradually lose their functional positions over time, narrowing the chewing space. Prosthetic treatments come into play in various clinical scenarios to prevent this imbalance. The main conditions that lead patients to consult a dentist and create a need for prosthetics are as follows:

Who Can Benefit from Prosthetic Dental Treatment?

The applicability of prosthetic restorations depends on the general health of the jaw tissues, not just on the age. Whether it is a young adult beginning treatment for a single tooth deficiency or an elderly individual who has lost all their teeth, deficiencies must be functionally replaced. However, in children and adolescents whose bone development is ongoing, different approaches (such as space maintainers or removable temporary devices) are generally preferred instead of fixed bridges or implant-supported prostheses.

Systemic diseases that the individual has (such as uncontrolled diabetes, etc.) can affect the process if an implant-supported prosthesis is being planned. In such cases, consultations with medical doctors are held, and the prosthesis construction stages are initiated after the medical condition is brought under control.

How is an Assessment Conducted Before Prosthetic Dental Treatment?

Measurements and designs taken without establishing a solid foundation for the prosthesis may result in dysfunction in the long term. Therefore, during the examination, the first check is whether the remaining teeth in the mouth are loose. If a tooth has a cyst or irreparable bone loss, it will be extracted prior to including it in the prosthetic plan. Teeth that can be saved are prepared as support bases for the prosthesis by being treated with root canal therapy or fillings.

Additionally, it is checked whether the opposing teeth have extended into the gap due to missing teeth. If this vertical space loss is detected, preliminary treatment procedures (leveling) are added to adjust the height of the planned prosthesis. After this clinical mapping is done, the appropriate material and type of prosthesis are determined.

What Types of Prostheses are Used in Dental Prosthetic Treatment?

The nature of tooth loss directly determines the type of prosthesis to be applied. Prosthetic applications, divided into three main groups as fixed, movable, and implant-supported, are further classified into different supporting materials and retention mechanisms:

• • Fixed Crown (Cap): It is the covering of a single tooth with a significant loss of substance using porcelain or zirconium, resembling a cap.
• • Fixed Bridge: It involves using healthy teeth on both sides of the gap caused by tooth loss as supports, filling the space in between with a porcelain body.
• • Movable Partial (Partial) Denture: These are structures that attach to existing teeth with clasps or precision attachments when too many teeth are missing to create a fixed bridge.
• • Movable Complete (Total) Denture: These are commonly referred to as palate dentures, which are supported by the tissue of the palate via suction forces when there are no teeth left in the mouth.

What is the Difference Between Fixed and Removable Prosthetics?

The choice of system has anatomical limitations. To create a fixed prosthetic, there must be natural teeth or implants that can bear the load on both sides of the gap. If the teeth in the very back of the jaw are lost and there are no supporting structures, then one would transition to removable prosthetics (hooked or clasped) that rely on the surrounding tissues for support. The structural differences between the two methods are classified below:

How Is the Process of Prosthetic Tooth Treatment Carried Out?

Treatment process; it progresses with the clinical preparation and shaping of the support teeth, taking measurements of the jaw closure, step-by-step realization of the infrastructure and porcelain trials in the dental laboratory, and the delivery of the prosthesis after approval of suitability.

Procedures require coordinated work between the physician and dental technicians. If a fixed bridge or crown is to be made, a reduction (preparation) is performed under local anesthesia on the enamel tissues of the supporting teeth to create space for the thickness of porcelain (approximately 1-2 mm). After the teeth are prepared, precise measurements are taken with classical silicone materials or digital optical scanners. While porcelain is produced in the laboratory environment, temporary teeth are placed on the patient in the same session to protect the teeth and prevent sensitivity.

In removable complete or partial dentures, the process begins with taking measurements. A detailed map of the palate tissue is created. Wax templates are prepared on the models obtained from the measurements. With these wax templates, the patient’s vertical closure distance and lip support where the teeth will align are determined. During the tooth trial phase, the patient approves the color and arrangement of the teeth in front of the mirror. In the final stage, the wax form is converted into acrylic, and the prosthesis is delivered to the patient.

How Many Stages Can Prosthetic Dental Treatment Be Completed In?

Clinical stages are divided according to the technical requirements of the material. In fixed crown or bridge applications; the first stage involves tooth trimming and measurement acquisition, the second stage involves fitting a metal or zirconium framework, the third stage is the fitting of porcelain (matching the original color and form of the tooth), and the final stage is polishing (glaze) and permanent bonding (cementation).

In complete (total) prostheses, the process requires more detail because the lack of teeth results in lip support and occlusal height being built from scratch. The first and second measurement stages are organized with sessions including base fittings, wax-up tooth fittings, and finishing, scheduled at specific intervals. In the case management at Avrupadent, the treatment begins with a schedule determined according to the patient’s case.

What Should Be Considered Before Dental Prosthesis Treatment?

For the prosthesis to fit the tooth and gum perfectly, there should be no bleeding in the area where measurements are taken. If active gingivitis (gum inflammation) is present during the measurements, the tooth margins may not be clearly visible due to bleeding. This condition can cause the prosthesis produced in the laboratory not to fit the tooth properly. Therefore, it is clinically important for patients to maintain maximum oral hygiene before the procedure.

Additionally, since local anesthesia will be used in the procedures, patients are advised to come to the appointment on an empty stomach. Having the radiological examinations requested by the dentist prepared in advance ensures that the treatment plan can be initiated smoothly.

What Should Be Considered After Dental Prosthesis Treatment?

The addition of a new volume to the oral structure means a new environment for the tongue, cheek, and lip muscles to adapt. For patients fitted with fixed crowns or bridges, it may take several days for the new tooth to habituate to chewing pressure. During this stage, a slight feeling of fatigue may be experienced in the teeth or jaw joint. However, if there is an excessive contact (high point) with the opposing tooth, an immediate dental check is necessary, as elevated restorations can cause trauma to the underlying tooth.

For patients with removable denture prosthetics, the adaptation process takes a bit longer (averaging 2-4 weeks). It is clinically normal for small pressure points (bruises) to form in the areas where the prosthetic sits against the palate during the first week. The patient should not stop wearing their prosthetic, and it is essential for them to attend appointments to have the bruised areas adjusted (conformed) by the dentist.

How Should Oral Care Be Performed When Using Dentures?

Prosthetic teeth do not decay; however, the natural tooth roots and the gum tissue surrounding the prostheses are quite defenseless against bacteria. If plaque accumulates along the junction lines where fixed crowns connect with the gums, gum retraction may begin, leading to the loss of natural tooth beneath the prosthesis due to decay. Brushing with fluoride toothpaste twice a day and using dental floss is a standard part of routine care.

Patients using removable (denture) prostheses should remove them at night while sleeping, as this benefits the tissues by allowing them to receive oxygen and rest. Removed prostheses should be stored in liquid (water or cleaning tablet solutions) to prevent deformation. Instead of abrasive toothpaste, liquid soaps that do not harm the acrylic surface or special cleaning pastes should be preferred for cleaning the prosthesis.

How is Measurement Taken in Prosthetic Dental Treatment?

An impression is the basic map that determines how the artificial tooth will fit into the jawbone and with other teeth. In traditional impression techniques, the dentist waits for a fluid silicone paste that copies precise details around the prepared tooth to harden, placing a more viscous paste on top. This negative mold obtained is filled with plaster in the laboratory to create the patient’s jaw model (positive mold).

In modern prosthetic approaches, CAD/CAM technologies come into play, providing comfort for patients with gag reflex (nausea). With pen-sized cameras, all surfaces of the teeth are scanned and transferred to a digital medium within seconds. This method, which eliminates physical errors such as contraction and expansion of impression materials, increases the marginal fit of the prosthesis at a micron level.

What Materials Are Used in Prosthetic Tooth Treatment?

Different biological materials are used according to the patient’s gum structure distribution and aesthetic expectations. In long bridges in the back area, porcelain with metal infrastructure that has the highest fracture resistance is a classic approach, while with the advancement of technology, zirconium-based restorations that combine aesthetic light transmittance and durability have come to the forefront. In the restoration of anterior teeth, full ceramic (e-max) applications that contain no metal/zirconium and are very close to the transparency of natural enamel are mostly preferred.

In removable dentures (both total and partial) that are placed and removed by the patient, pink acrylic (plastic-based) materials mimicking the gum tissue are used. In partial dentures, the metal frameworks embedded within these acrylic structures prevent the denture from flexing, increasing its durability and forming hooks (clasps) that ensure retention on existing natural teeth.