Missing teeth cause a chaos in the bite and lead to different oral cavity problems. The central composition of the face gets distorted, which attracts unwanted attention to the person’s face during contacts with other people. Dental prosthetics is the solution for restoring missing teeth or missing tooth parts. Our goal is to rescue as much as possible of the healthy tooth tissues, therefore in each situation we choose most appropriate materials and replace missing teeth with a fixed or removable prosthesis. To achieve the outcome that restores the function and is aesthetically pleasing, we develop the treatment plan which fits best each patient’s situation and expectations.
Where a tooth is severely damaged because of dental caries, dental injury, abrasion or erosion and where less than approximately 30% of dentin remains, an inlay is used to restore the tooth. The inlay is cemented in the patient's tooth root to create a solid foundation for the restoration of the damaged tooth. Prior to the tooth restoration procedure by way of an inlay, we perform the root canal treatment on the damaged tooth (endodontic therapy). Dental reconstruction can start as soon as the root canal associated inflammation processes are over.
Inlays can be cast (made of metal) or manufactured from precious metals. These two types of inlays do not differ in terms of functionality, but they are different for aesthetic reasons. A metal inlay can shine through the tooth crown, while inlays made from precious metals do not. This is a relevant point when restoration is done on the front teeth. Inlays are fabricated in a dental laboratory for each patient individually. When the inlay is fitted and bonded into the tooth root, a crown or a bridge can be mounted thereon.
Onlays are porcelain fillings manufactured in a dental laboratory. This technique is used when approximately 50% of dental tissue is lost due to the tooth defect. Prior to the procedure, a specialist examines the damaged tooth to assess the scope of damage and, if necessary, apply the endodontic therapy. The specialist removes tooth tissues affected by caries caused by bacteria and takes an imprint, so that a well-fitted porcelain filling (onlay) can be manufactured in the laboratory. The onlay color is carefully selected to match the color of the patient's teeth. In comparison to a regular tooth filling, an onlay is more resistant to the bite pressure and has a longer life time.
If damage to a tooth is small, it can be restored by using a composite material. Where only a small portion of the natural tooth tissues remains, for example, where the tooth has a large filling or a considerable portion of the tooth broke off, an artificial tooth crown is used.
Full cast crowns are made of metal and they have a metallic luster, which is why due to aesthetic considerations they are used as restorative solutions for side teeth.
Cermet dental crowns are made from ceramic fused to a metal frame.
Porcelain crowns are made of ceramic, they are strong and durable and from the aesthetic point of view they are a good choice for restoration of any tooth. A porcelain crown practically does not differ from a natural tooth, and it lets through light beams. The material used in this type of crowns is better compatible biologically and is less allergic.
Zirconia crowns are made from zirconia and visually are identical to the patient’s natural teeth. This type of crowns is the most durable.
Formerly, pressed dental crowns were widely used. Pressed crowns were of standard sizes and were not customized for each patient. Whereas the technology could not offer exact size crowns, this type of crowns is not in use any more.
Prosthetics of dental implants
Prosthetic repair of a separate tooth can start when the implant material has fused with the jaw bone. The implant is covered with a crown manufactured in the dental laboratory. The patient selects material of the crown (cermet, porcelain or zirconia crown), taking into account the expert’s recommendations and his own financial situation. The price, the look and the useful life of the crown depend on the choice of material for the dental crown.
Similarly to prosthetics of one tooth, prosthetic repair of a dental bridge may be done only after the implant has grown into the jaw bone. The process of fusing with the bone differs for each individual and can take up to 3-8 months. A dental bridge as a method of prosthetics can be used in situations where multiple side teeth are lost. Dental implants are not placed in each tooth, but rather a bridge design structure is created.
Where no teeth are left in any of the jaws, it is possible to manufacture a full denture which is held in place by implants. Prior the starting the prosthetic repair, we assess the shape of the jaw and the quality of the bone, which will define how many implants will go into the jaw. When the patient opts for a full denture fixed in place with implants, he can be assured that the denture will not cause any discomfort when chewing food and there will be no embarrassing situations when the denture may fall out during eating or at another inopportune moment.
A dental bridge is a type of a dental prosthesis that is used when a patient is missing one or more adjacent teeth. The dental bridge is fixed to the patient’s healthy teeth, thus replacing the missing teeth. In this situation, natural teeth are re-shaped and the dental bridge fabricated in the laboratory is cemented in place on the teeth. Similarly to crowns, bridges are made from metal, cermet, porcelain, and zirconia.
Removable and combined artificial dentures
A partial denture is made if there is at least one tooth left in the mouth. The partial denture is held in place by a metal clamp. The dentures represent a set of plastic teeth sitting on a plastic base having the same color as the patient’s gums. The color and the shape of teeth are chosen to match patient’s teeth.
A fully removable denture is used for a completely edentulous patient (due to extraction). In case of a fully removable denture a patient needs a longer adaptation period, he has to learn to eat and talk with the denture in his mouth.
An arch denture is of a higher quality than a partial denture, whereas it has a circular metal frame, now also available in white, and the pressure of the bite is distributed partially through the existing teeth with the help of pads. The plastic used in this denture serves as a basis under the artificial teeth, and this basis holds the teeth in place and compensates for the bone loss. The arch denture is easy to take care of and is more resistant to fractures.
An arch with the attachments is technically more sophisticated system of combined prostheses, which is the system where dental crowns and removable arch dentures are brought together. In this case, the removable arch denture is connected to permanently cemented cermet crowns with the help of special keys. The advantage of the denture fixed with the help of attachments is greater stability without visible clamps.
People must take care of their dental and oral health even when the natural teeth are lost. Artificial teeth surfaces are subject to a very quick accumulation of plaque. Also it is necessary to take care and clean dental plates according to the instructions given by the specialist as well as to see a dental hygienist on a regular basis.
In our clinic, we offer immediate manufacture of a dental prosthesis in the event of a tooth loss.