Prosthetic dentistry encompasses dentistry methods used to restore the function and aesthetic appearance of missing or damaged teeth. These treatments use specially designed artificial materials, such as crowns, bridges, removable dentures, or dental implants, to replace lost teeth or tissues. The application process begins with a detailed examination and planning based on the patient’s oral structure and needs, followed by the restoration itself, following the steps chosen according to the chosen method. The primary goal is to achieve a natural appearance while improving oral health and function.
What Does Prosthetic Dentistry Actually Mean?
Prosthetic dentistry, or prosthodontics as it is known by specialists, is a specialized branch of dentistry. It deals with the replacement of lost or dysfunctional teeth and oral tissues. These losses can occur due to decay, fractures, or gum disease.
The goal of treatment isn’t just to replace missing teeth. It’s also to enable the patient to chew and speak comfortably, improve their aesthetic appearance, and improve their overall oral health. Specialized, body-compatible artificial materials are used for this purpose. These treatments can repair not only individual teeth but also gums, jawbone, and sometimes even larger facial tissue losses.
Who is a Prosthodontist?
The specialists who perform these treatments are called “prosthodontists.” Prosthodontists undergo an additional 3-4 years of training in this field after graduating from dental school. This additional training provides much more in-depth knowledge and skills in the repair of teeth and oral tissues.
While prosthodontists can perform some procedures performed by general dentists, their primary expertise is in more complex cases. They are specially trained in areas such as aesthetically and functionally challenging treatments involving multiple teeth, implant applications, full or partial dentures, and jaw joint problems.
What is the Training of a Prosthodontist?
To become a prosthodontist, a dentist must complete a highly intensive specialization program after completing their regular dental education. These programs typically last 3 to 4 years and are offered by institutions accredited to international standards.
During this period, specialist candidates learn the intricacies of all prosthetic procedures, including crowns, bridges, implants, and removable dentures. They also specialize in aesthetic dentistry, occlusion, jaw joint disorders, and even correcting facial imperfections with dentures. In short, they master the art of replacing deficiencies in the mouth.
What Are the Aims of Prosthodontic Treatment?
The primary goal of prosthodontic treatment is to improve the patient’s quality of life. This primarily involves restoring function. This means ensuring the patient can chew and speak comfortably. These basic functions, impaired by missing teeth, are corrected with dentures.
Another important goal is to improve aesthetics. Missing, broken, or discolored teeth negatively impact a person’s smile and self-confidence. Prosthetic treatments address the patient’s aesthetic concerns by creating restorations that resemble natural teeth, aiming to achieve a beautiful smile.
What are the Health Benefits of Prosthetic Dentistry?
In addition to aesthetics and function, prosthetic treatments also aim to protect oral health and increase patient comfort. Pain or sensitivity caused by damaged teeth is relieved. Discomfort caused by ill-fitting dentures is eliminated. A well-made denture should function without discomfort in the mouth.
Furthermore, replacing missing teeth with dentures prevents adjacent teeth from shifting into the space. Implants protect bone, and crowns strengthen weak teeth. By ensuring a balanced distribution of chewing forces, other teeth and the jaw joint are protected. All of these factors contribute to a better overall quality of life for the patient.
What is a Crown (Veneer) in Prosthetic Dentistry?
A crown is also known colloquially as a veneer. It is a type of restoration that completely covers a single tooth, fitting over it like a cap. It is frequently used to protect and strengthen teeth weakened by a large cavity, fracture, or root canal treatment.
Crowns can also be placed for aesthetic purposes when we are unhappy with the shape or color of a tooth. Crowns are also used to support teeth on implants. They can be made from various materials, such as porcelain, zirconium, or metal-based porcelain. The material selection is determined by the location of the tooth and the desired aesthetics.
How Do Bridges Work in Prosthetic Dentistry?
Bridges are fixed prosthetics used when one or more teeth are missing. As its name suggests, it bridges the gap between the missing teeth by using healthy teeth (or implants) on either side.
This bridge is a bridge.The supporting teeth are called “abutments.” The part of the bridge that mimics the missing tooth is called the “base” (pontic). The teeth used as abutments usually need to be slightly reduced before a bridge can be constructed. Like crowns, bridges can be made from various materials and fill the gaps between missing teeth, improving both aesthetics and chewing.
What are the Different Types of Removable Dentures in Prosthetic Dentistry?
Removable dentures are “false teeth” that can be placed and removed by the patient. There are two main types. The first is a complete denture, used when no teeth are left in the mouth. They are made separately for the upper and lower jaws and are usually made of acrylic. They are supported by the palate and jawbone.
The second is a partial denture, used when several teeth are missing. These dentures replace the missing teeth and are attached to the existing healthy teeth using clasps or more aesthetically pleasing, precise attachments. They are usually constructed by adding acrylic gums and teeth to a metal framework.
Why Are Dental Implants Preferred in Prosthetic Dentistry?
Dental implants are artificial roots made of titanium that mimic the roots of missing teeth. They are surgically placed in the jawbone and gradually integrate with the bone. This provides a very solid foundation for a crown, bridge, or denture.
The most significant advantage of implants is that they can replace a missing tooth without disturbing the adjacent healthy teeth. They also prevent jawbone resorption and provide a chewing sensation and aesthetics closest to those of natural teeth. They are often the best option for those seeking a fixed and comfortable solution.
When Are Veneers Used in Prosthetic Dentistry?
Veneers, or porcelain laminates, are very thin, leaf-shaped restorations used primarily to improve the appearance of front teeth. They are usually made of porcelain and bonded to the front surface of the tooth with special adhesives.
Veneers are often preferred to address aesthetic concerns. Veneers can be used to conceal permanent discoloration, change the shape or size of teeth (e.g., lengthen short teeth), close small gaps between teeth, or correct mild misalignments. They can usually be applied with minimal or no grinding of the tooth.
What is the Difference Between Inlays and Onlays in Prosthetic Dentistry?
Inlays and onlays are more protective fillings used to restore teeth damaged by decay or fracture, but unlike crowns, they do not cover the entire tooth. They are prepared in a laboratory and bonded to the tooth. They are generally considered a more durable alternative to larger fillings.
Their primary difference lies in the area they cover. An inlay, like a filling, is placed between the cusps (tubercles) on the chewing surface of the tooth. Onlays are larger and cover one or more cusps. They are aesthetically pleasing because they can be made from tooth-colored materials such as porcelain or composite. They ensure maximum protection of the healthy tooth tissue.
How Does the Prosthetic Dentistry Process Begin?
Every prosthetic treatment begins with a careful examination and planning. During the first appointment, your dentist or prosthodontist will thoroughly evaluate your oral health. They will examine your teeth, gums, jaw structure, and how your teeth fit together. X-rays or sometimes a three-dimensional tomography (CBCT) scan will usually be requested.
Your symptoms, treatment expectations, and general health status (including any chronic diseases and medications you are taking) will be assessed. Based on all this information, a diagnosis is made, and a personalized treatment plan is developed for you. This plan includes the appropriate treatment, the alternatives, the duration, and the cost. Treatment will begin after the plan is discussed with you and your approval is obtained.
How Are Preparations and Impressions Made for Prosthetic Dentistry?
Once the treatment plan is approved, the preparation phase begins. If a crown or bridge is to be placed, the teeth involved are precisely reduced to accommodate the prosthesis. If an implant is planned, surgery is performed to place the implant. Sometimes, additional procedures such as scaling and filling may be required before treatment.
Once preparation is complete, impressions are taken to ensure the prosthesis fits perfectly in your mouth. In the past, this was done with trays and putty-like materials placed in the mouth. Now, digital impression methods are frequently used. Three-dimensional images of the teeth are transferred to a computer using devices called intraoral scanners. This method is both more comfortable and provides more accurate results.
What is the Laboratory Phase in Prosthetic Dentistry?
After the impressions are taken, the next step is the laboratory phase, where the prosthesis is fabricated. The impressions or digital data are sent to specialized dental technicians. Technicians custom-fabricate the crown, bridge, or prosthesis according to the dentist’s instructions, using precision instruments and specialized materials.
During this process, especially if your teeth have been cut orIn the anterior region, temporary dentures may be fitted until your permanent dentures are prepared. These temporary dentures both maintain the aesthetic appearance and help shape the gums. The laboratory time can vary from a few days to a few weeks, depending on the type of denture.
How Are Dentures Fitted in Prosthetic Dentistry?
The dentures received from the laboratory are first tried in your mouth. This is called a try-in. Your dentist checks the color, shape, and fit of the dentures with your teeth and gums. They also check the bite relationship with the opposing teeth. If minor adjustments are necessary, they are made at this stage.
If everything is in order, fixed dentures (such as crowns, bridges, veneers) are permanently bonded to your teeth using special adhesives. Implant-supported dentures are either cemented or secured to the implants with small screws. Removable dentures are placed in your mouth, any bumps are corrected, and you are instructed on how to use and care for them.
What Materials Are Used in Prosthetic Dentistry?
Many different materials are used in prosthetic dentistry. The choice depends on the location of the prosthesis, the desired aesthetics, durability, and budget. For example, metal alloys (gold or other) are very durable. They are often used on back teeth or as supports under porcelain veneers.
Porcelain (ceramic), on the other hand, is preferred for high aesthetic expectations, especially for front teeth, because it is tooth-colored. Crowns, bridges, and veneers can be made from porcelain. They offer a very similar appearance to natural teeth, but are somewhat more fragile than metals.
Where Are Zirconium and Composite Used in Prosthetic Dentistry?
Zirconium is a special type of ceramic that is both very strong and tooth-colored. This characteristic makes it safe for use in crowns and bridges on both front and back teeth. Because it contains no metal, it offers aesthetic advantages.
Composite resins are essentially tooth-colored filling materials. They can also sometimes be used in the production of inlays, onlays, or veneers. They are more economical than porcelain, but their color can change over time. Acrylic is often used in the pink gum areas of removable dentures, while titanium, due to its biocompatibility, is used in the fabrication of dental implants.
What is the Role of Technology in Prosthetic Dentistry?
Technology has significantly changed and improved prosthetic dentistry in recent years. Digital technologies, in particular, have made treatments more precise, faster, and more comfortable for patients. One of these is intraoral scanners. Instead of the putty impression materials used in the past, they use a small camera to create three-dimensional images of the teeth.
Another important technology is CAD/CAM systems. This refers to computer-aided design and manufacturing. A prosthesis is designed on a computer (CAD) using images captured from an intraoral scanner, and then fabricated according to this design using specialized devices (CAM). This makes it possible to complete restorations such as crowns in a single appointment.
What Does 3D Imaging Provide in Prosthetic Dentistry?
Three-dimensional imaging methods, particularly Cone Beam Computed Tomography (CBCT), provide significant convenience in prosthetic treatments. They allow us to visualize the height, width, and quality of the jawbone, as well as important structures such as the nerves that pass through it, in great detail, especially if implants are to be placed.
This detailed imaging allows planning the placement of implants in the most accurate and safe location. Furthermore, with digital smile design methods, it is possible to see the completed treatment on a computer screen before starting the treatment and show it to the patient. This allows for better management of expectations.
What Does the Success of Prosthetic Dentistry Depend on?
For a prosthetic treatment to provide many years of trouble-free service, many factors must come together. The first step to success is accurate diagnosis and sound planning. A thorough understanding of the problem and selecting the most appropriate treatment method are crucial.
Additionally, the knowledge and experience of the treating dentist, the quality of the materials used, and the expertise of the dental technician who prepares the prosthesis directly affect the outcome. High-quality materials and workmanship ensure that the prosthesis is both more aesthetically pleasing and more durable. The harmony between the dentist and the technician is also critical to success.
What are the Patient Factors in Prosthetic Dental Treatment?
The patient plays as significant a role in the success of treatment as the dentist and technician. Oral hygiene is the most important patient factor. No matter how well the treatment is performed, problems can arise if the teeth and dentures are not cleaned regularly and correctly. Plaque accumulation can lead to cavities, gum disease, or implant infections.
The patient’s general health is also important. For example, uncontrolled diabetes can slow healing. Smoking, in particular, negatively impacts implant success. Furthermore, habits such as clenching or grinding can damage the dentures. Therefore, such situationsIt also needs to be controlled.
How Should Oral Care Be Performed After Prosthetic Dentures?
After treatment, careful attention to oral care is essential to protect the health of the dentures and the remaining natural teeth. Teeth and fixed dentures should be brushed at least twice a day with fluoride paste. The edges where the dentures meet the gums should be cleaned especially thoroughly.
Brushing alone is not enough. The spaces between teeth, under bridges, and around implants should be cleaned with dental floss, interdental brushes, or special flosses. This is because plaque accumulates most in these areas. Your dentist will advise you on the most appropriate cleaning methods and tools. Mouthwashes can also be helpful, but they are not a substitute for mechanical cleaning.
How Should Removable Dentures Be Cared for During Prosthetic Dentures?
Removable denture wearers must take extra care. Dentures should be removed after each meal and brushed under water to remove food residue. They should also be thoroughly cleaned once a day with a special denture brush and denture-cleaning tablets or unscented liquid soap. Regular toothpastes can scratch the dentures.
It is generally recommended to remove dentures at night and store them in clean water. This prevents the dentures from drying out and allows the oral tissues to rest. Because dentures are susceptible to falling, being careful when cleaning them, such as filling the sink with water, reduces the risk of breakage.
Why Are Diet and Checkups Important After Prosthetic Dentistry?
After treatment, some attention to eating habits may be necessary, especially in the early stages or with some delicate restorations (e.g., veneers). Avoiding very hard or sticky foods may be beneficial. Eating small pieces and chewing on both sides prolongs the life of dentures.
Regular dental checkups are just as important as oral hygiene. These checkups, usually every six months, examine both your natural teeth and dentures, provide professional cleaning, and identify potential problems before they become serious. These checks ensure the long-term success of your treatment.
