Why is it necessary to replace missing teeth and restore the correct shape of teeth?
When to recommend something?
Crowning
Is the coating of a tooth with a permanent material that restores the strength and beauty of a tooth. To make a crown, the tooth must be sanded down 1.5-2 mm all around in order to make room for the crown material. The crown is fixed to the tooth using special adhesive and cannot be removed from the mouth.
Coating a tooth with a crown is recommended, when:
- The tooth has had root canal treatment
- The tooth consists largely of filling
- Restoring tooth height
- Correcting tooth position and colour
Pinned Teeth
If only a tooth root is left, it can also be successfully restored under certain conditions. For this a fiber pin or a metal or zirconium pin made in the laboratory is glued to the root of the tooth to support the crown.
Bridge
Is a prosthesis intended to replace a missing tooth, that rests on adjacent teeth and is firmly fixed (glued to teeth). To make a bridge, adjacent teeth have to be sanded and coated with a crown, which is a disadvantage of a bridge.
A bridge is recommended, when adjacent teeth need coating with a crown, the patient doesn’t wish to replace a tooth with an implant or an implant cannot be placed.
Bugel Prosthesis
(So-called finer type of removable prosthesis)
A bugel prosthesis has a metal frame and is smaller in dimensions than a conventional all-plastic prosthesis. Metal clamps gripping around teeth help to hold the prosthesis in place. The prosthesis has to be removed from the mouth for cleaning and greater inconvenience should be taken into account compared to fixed prostheses.
Plate Denture (Removable Prosthesis)
Is an all-plastic prosthesis, that does not rest on teeth at all, but only on gingiva. Is made when all or most teeth are missing. Since this prosthesis accelerates bone loss and negatively impacts gingiva, it is not recommended for long-term use, but is nowadays used as a short-term temporary prosthesis. Needs to be checked and adjusted frequently.
Combined Prosthetics
Different types of prostheses are combined. For instance, some teeth are restored with crowns or bridges and others are replaced with a removable prosthesis. Ease of use is very good compared to completely removable prostheses. Combined prostheses are recommended, when it is not possible to replace all teeth with removable prostheses.
Laminates
Are thin ceramic “shells” that help to improve the position or colour of teeth (if whitening doesn’t help). To make a laminate, the front side of a tooth has to be sanded down 0.3-0.6 mm.
Lab-made Fillings i.e. Inputs
Lab-made fillings i.e. inputs cemented in the tooth by a doctor, are considerably more durable than regular fillings. Inputs are made from gold alloy and ceramics.
Prostheses with Implants
Implants are the best option for replacing a missing tooth. Implants help in case of few as well as all teeth missing.
Advantages of prostheses with implants:
- Preservation of bone
- Achieving and maintaining vertical occlusion height
- Preservation of facial aesthetics (muscle tone)
- Improvement in aesthetics
- Better phonetics
- Better occlusion
- Higher success of the prosthesis
- Higher chewing efficiency
- Smaller dimensions of the prosthesis (palate, edges of prosthesis)
- Greater stability of removable prostheses
- Longer exploitation life
- No need to damage adjacent teeth
- More durable restorations
- Better mental state
- Durability of implants (survival rate) is 90-98% after 5 years and 89-95% after 10 years.
- Success % is slightly smaller.
Several risk factors increase failure: low bone density, excessive load, smoking, some systemic diseases
