Prosthodontics

Dental prosthetics are artificial teeth that are used to replace or repair missing or damaged teeth. They can do a lot more than just brighten your smile. A lost tooth can make it difficult to eat and put you at risk for gum disease. A lost tooth can harm the jaws' bone health and compromise the health of other teeth.

Fixed dental appliances, including crowns and implants, are available, as well as removable devices, such as full or partial dentures, which can be removed as needed.

Prosthodontics Definition

Prosthodontics is a discipline of dentistry that works with the replacement of lost teeth and the soft and hard tissues around them with prosthetics (crowns, bridges, dentures) that can be fixed, removable, or anchored and retained by implants.

A prosthodontist is a dentist who specializes in the use of bridges, dentures, or prostheses to replace lost teeth and adjacent mouth or jaw structures. Following dental school, they complete an extra three years of study to specialize in this profession.

Dental Bridge

A dental bridge is a long-term treatment for replacing a missing tooth or teeth. It's formed of a few components that are linked together to fill the gap left by your lost tooth or teeth.

Partial dentures can be replaced with dental bridges. They provide both practical and aesthetic benefits, allowing you to eat and speak more comfortably while also improving the appearance of your teeth. The bridge could be formed different materials, such as gold, alloys, or porcelain. Porcelain is the material of choice when replacing an anterior tooth since it may be color-matched to your original teeth.

Dental Bridge Advantages

Dental bridges provide several advantages that account for their widespread usage in restorative dentistry.

Replace broken teeth. For instance, dental bridges are a good option for replacing lost teeth in the mouth, since they provide both functional and cosmetic benefits.
Functionality. The bridge allows a patient to bite and eat normally because there is no longer a gap in the jaw, and the bridge can help with food mastication. It can also help people talk more freely by closing the space between their teeth, which can affect the location of the tongue and the way sounds are made in the mouth.
Aesthetic. A dental bridge can adapt to the loss of natural teeth in terms of cosmetics, particularly if the bridge is color-matched to adjacent teeth. This can help individuals who are self-conscious about their image due to missing teeth gain self-esteem and confidence.
Reduce the risk of bite-related consequences. Dental bridges may also be beneficial to the mouth's long-term structure. A gap in the jaw, in normal conditions, causes the teeth to progressively change position and spread out, causing bite problems. When a bridge is used to replace missing teeth, the teeth on either side are held securely in position to decrease the risk of movement and the issues that can result. In addition, the bridge can help to prevent the risk of bone loss in the jaw, which helps to maintain face shape.
Easy maintenance. Dental bridges are also popular among patients because of how they feel in the mouth and how simple they are to maintain. A patient's mouth is normally used to the feel of the dental bridge after a short period of time, after which it is rarely noticed because it becomes a part of the mouth architecture. Bridges, unlike dentures, do not need to be withdrawn for cleaning on a regular basis and can be brushed exactly like natural teeth.

Dental Bridge Types

You are not alone if you have lost one or more of your teeth. Between the ages of 20 and 64, the average adult has three decaying or missing teeth. You have a variety of options for restoring these missing teeth, including dental bridges. Your dentist may propose one of four types of dental bridges.

Traditional dental bridges. The most common kind of bridge is a traditional bridge. These bridges are held in position by dental crowns and consist of one or more pontics (artificial teeth). These dental crowns, also known as abutments, are glued into the teeth on either side of your missing tooth. When you have natural teeth on both sides of the gap caused by your lost tooth, traditional bridges can be utilized. Bridges can even be used to replace molars. Traditional bridges have the disadvantage of requiring your dentist to remove enamel from surrounding teeth to make room for the crowns that will be placed on top. Because enamel does not regrow, crowns will be required to protect these teeth in the future, even if you pick a different type of bridge.
Cantilever bridges. Another option for restoring missing teeth is a cantilever bridge. They are comparable to traditional bridges, except only one side of the pontic is supported by an abutment, rather than both sides. A bridge can be secured even if there is just one natural tooth close to the gap. Your dentist will need to remove the enamel from the next tooth to support the bridge, much like with traditional bridges. These restorations may function as a lever in some circumstances because they are only supported on one side. Complications such as cracked teeth or loosened crowns may result.
Maryland bridges. Traditional bridges are replaced by Maryland bridges, which are considered more conservative. A pontic is attached to a metal or porcelain framework, which keeps the bridge in situ. The backs of the two teeth next to the lost tooth are glued to the framework. The surrounding teeth do not need to be filed because this type of bridge is not fixed in place by crowns. Maryland bridges are more conservative than standard bridges, however, they do have drawbacks. Because the strength of the resin that holds the bridge in place is limited, it may not stay in place in parts of the mouth where the teeth are exposed to a lot of biting pressure, such as the molars. Your gums and bite may also be hampered by the framework.
Implant-supported-bridges. Another option for restoring missing teeth is implant-supported bridges. They can be utilized if you are missing more than one tooth. These bridges are not supported by crowns or frames, but rather by dental implants. Typically, one implant is inserted for each missing tooth, and the bridge is held in place by a series of implants. If inserting one implant for each lost tooth is not practicable, the bridge may consist of a pontic hanging between two implant-supported crowns. These bridges are incredibly stable and pleasant since they are supported by implants, just like the original teeth they replace. A good toothbrush, much like your actual teeth, is required to maintain your mouth healthy. One disadvantage is that placing the implants necessitates two procedures, the first to insert the implants and the second to insert the bridge. So, anticipate waiting at least five months for your completed bridge.

Dental bridges are a way for your dentist to fill in the gaps in your teeth. With so many different types of dental bridges to choose from, you can rest assured that your dentist will find the best solution for your missing teeth.

Dental Bridge Procedure

Assessment

The first step in the dental bridge procedure is to determine whether lost teeth require restorative dental care and whether a dental bridge is the best solution. Dental crowns and dental implants are two more restorative dental treatments that may be more suitable in some instances.

To acquire a complete picture of the condition and make the best option, the dentist will usually examine the area and take X-rays of the jaw. Patients should be informed about the various options available to them, including the type and style of the bridge so that they are aware of the benefits and drawbacks of each choice.

Teeth Preparation and Temporary Bridge Placement

Most bridges are supported by abutment teeth, which are healthy teeth on each side of the gap. To prepare these teeth for the insertion of a dental bridge, they must first be shaped for the bridge that will be used. During this procedure, a local anesthetic is administered to keep the patient comfortable.

The initial step is to shape the abutment teeth so that the bridge may be installed properly. After that, imprints of the shaped teeth are taken and submitted to a dental laboratory for bridge construction. For aesthetic reasons, the prosthetics should be color-matched to the surrounding natural teeth, hence a sample color should be taken.

A dental implant may be required to secure the bridge in some circumstances, especially if the teeth on each side of the gap are not strong enough to hold it on their own.

Some patients may be given a temporary bridge, which is often formed of filling material and serves to protect the shaped teeth while the final bridge is being made. When the final bridge is ready to be installed in the mouth, this can be removed.

Permanent Bridge Placement

The second appointment in the dental bridge procedure can come as quickly as the one-of-a-kind device is ready to be put in. To ensure the patient's comfort, a local anesthetic is routinely administered at the start of the appointment.

The temporary dental bridge should be eliminated and, if required, the underlying teeth cleaned before the permanent dental bridge can be fitted. The dental bridge can then be fixed in place on the abutment teeth using dental cement.

After that, the patient can see the results and feel what it's like to gently bite their teeth together. While it's natural for the bridge to feel strange at first, this usually fades quickly. In some circumstances, a few additional adjustments to the bridge may be required.

Follow Up

Following up on the dental bridge procedure is essential to ensure that the patient understands what to expect and how to care for their permanent dental bridge. As a result, the dentist should spend some time explaining the specifics of the dental bridge, such as how to care for it and when to get dental advice. A dental bridge can last for more than ten years if properly cared for.

Dental Crown

Your teeth might get compromised over time. This can occur for a variety of causes, including tooth decay, trauma, or frequent use. Your teeth's shape and size can deteriorate. Dental crowns are tooth-shaped covers that fit over your original tooth. Consider it a head cap for your teeth. The crown improves the shape, size, strength, and appearance of the tooth.

The dental crown is a cap that covers the upper obvious section of your tooth and is fixed into place.

Dental Crown Uses

A dental crown may be required for different causes, including:

Protecting a weak tooth from breaking (perhaps due to decay) or keeping a weak tooth together if sections of it are fractured.
Restoring a tooth that has been damaged or significantly worn down.
Using a big filling to cover and support a tooth that has very little tooth left.
Using a dental bridge to keep it in place.
Covering teeth that are misshapen or extremely discolored.
Covering a dental implant.
Covering a tooth that has had a root canal treatment.

Dental Crown Types

Permanent crowns are found in different materials. These resources may contain the following:

Metals. Palladium, gold, nickel, and chromium are some of the metals that can be utilized to form dental crowns. Metal crowns are the least likely to chip or break, last the longest in terms of wear, and need only a minimal amount of tooth removal. They're also resistant to biting and chewing. The biggest disadvantage of this kind of crown is the metallic color. Metal crowns are a good choice for molars that are hidden from public view.
Porcelain-fused-to-metal. The color of the teeth adjacent to the crown can be matched with this kind of dental crown. The color of their teeth is more natural. However, the metal behind the porcelain cover of the crown occasionally shows through as a dark area. Other disadvantages include the possibility of the porcelain piece of the crown chipping or falling off, as well as the crown wearing down the teeth facing it in the mouth. The teeth that come into contact with the crown on the top and bottom of your mouth while it's closed are especially affected by this wear on the other teeth. For anterior or posterior teeth, porcelain-fused-to-metal crowns can be a good option.
All-resin. Dental crowns formed of resin are less costly than other types of crowns. However, unlike porcelain-fused-to-metal crowns, they deteriorate over time and are more vulnerable to fracture. When compared to other crown options, all-ceramic or all-porcelain dental crowns have the best natural color matching. They're also a wonderful option if you're allergic to metals. They are not as durable as porcelain-fused-to-metal crowns. They can also outwear the teeth on the opposing side of the mouth more than metal or resin crowns. For anterior teeth, all-ceramic crowns are a good choice.
Pressed ceramic. Dental crowns formed of pressed ceramic have a firm inner core. The metal liner used in the all-ceramic crown-making technique is substituted with pressed ceramic crowns. Porcelain crowns are capped with pressed ceramic crowns for the best natural color match. Furthermore, they survive longer than an all-porcelain crown.

Dental Crown Procedure

In most cases, preparing a tooth for a crown necessitates two visits to the dentist: the first is spent evaluating and preparing the tooth, and the second is spent placing the permanent crown.

Examining and Preparing the Tooth (First Visit)

Your dentist may take a few X-rays at your first visit to evaluate the roots of the tooth having the crown and the surrounding bone in preparation for a crown. A root canal treatment may be performed initially if the tooth has considerable decay or if there is a risk of infection or trauma to the tooth's pulp.

Your dentist will anesthetize the tooth and the gum tissue around it before beginning the crown-making process. To make room for the crown, the tooth receiving the crown is contoured along the chewing surface and sides. The quantity of mass removed is determined by the type of crown employed. If a considerable portion of the tooth is missing (due to decay or damage), your doctor will build up the tooth using filling material to support the crown.

Your dentist will often use a paste or putty to produce an impression of the tooth to receive the crown after reshaping it. However, digital scanners are sometimes used to create impressions. To ensure that the dental crown will not impact your bite, imprints of the teeth above and below the tooth to get the crown will be taken.

The impressions or scans are delivered to a dental lab, which constructs the crown. In two to three weeks, the crown is normally returned to your doctor's office. If the crown is made of porcelain, your dentist will match the color to the neighboring teeth as closely as possible. Your dentist will build a temporary crown during this first office appointment to surround and protect the prepared tooth while the crown is being produced. Temporary crowns are often made of acrylic and secured with temporary cement.

Receiving the Permanent Dental Crown (Second Visit)

At the second appointment, your dentist will extract the temporary crown and examine the permanent crown for fit and color. If everything looks good, the tooth will be anesthetized with a local anesthetic before the new crown is properly put in place.

Dentures

Dentures also referred to as false teeth, are removable dental appliances used to replace lost teeth. They are removable because they are formed of prosthetic or artificial teeth that are simply attached to a supporting structure. They are far less expensive than dental implants or bridges, making them the most cost-effective way to replace missing teeth.

Dentures Types

Complete Dentures. Complete dentures are formed of a colored plastic base that supports a complete set of plastic or porcelain teeth and is designed to seem like gum tissue. The traditional complete denture is held in place by the gums forming a seal. They can also be secured in place by dental implants, which are surgically implanted in the jawbone. The cost of this therapy is significantly more than that of a traditional complete denture.
Partial Dentures. Partial dentures are created with either a plastic or metal base that supports the number of teeth that need to be restored. Clasps and rests are carefully tailored to the natural teeth to keep them in the mouth. Due to the stiffness and strength of metal, the traditional partial denture design incorporates a metal framework. Plastic partial dentures have traditionally been used as emergency or temporary tooth replacements, allowing the gums and bone to heal before obtaining a permanent restorative treatment. Various materials, such as Valplast, have recently been designed to give long-lasting, flexible alternatives in specific conditions.
Immediate dentures. As the name implies, these are dentures that are placed right after natural teeth are extracted. When broken teeth must be removed before dentures can be fitted, they are utilized. The healing of the gums and jaw, as well as the manufacturing of a custom-fit denture, usually takes a few months. Patients who receive immediate dentures can live a regular life for the following few months while waiting for their dentures.
Implant-retained dentures. Dentures with titanium abutments that are anchored to the jawbone are known as implant-retained dentures. Dentures that are implant-retained are more secure than traditional dentures, yet they are still less expensive than implant restorations.

Dentures are also divided into categories based on the type of material used to make them. Metal, plastic, acrylic, porcelain, ceramic, or a mixture of these materials can be used to make dentures.

Dental Implants

Despite advances in dental treatment, millions of Americans lose teeth, most of which are caused by tooth decay, periodontal disease, or trauma. Bridges and dentures were the only treatment options for anyone losing teeth for many years. Dental implants, on the other hand, are now available.

Dental implants are artificial dental roots that are used to replace missing teeth. Fixed (permanent) or removable replacement teeth that are designed to match your natural teeth are supported by implants.

Dental Implants Candidates

Anyone healthy enough to have a standard dental extraction or oral surgery can be suitable for a dental implant in the majority of circumstances. The patient must have intact gums and good bone mass to support the implant. They must also be committed to maintaining good oral hygiene and visiting the dentist on a regular basis. Heavy smokers, those with uncontrolled chronic diseases like diabetes or heart disease, and patients who have had head/neck radiotherapy should all be evaluated individually. If you're thinking about getting implants, consult your dentist to determine if they're a good fit for you.

Dental Implant Procedure

The establishment of a customized treatment plan is the initial stage of the dental implant procedure. The plan is personalized to your specific needs and is developed by a team of specialists with extensive experience in oral surgery and restorative dentistry. This multidisciplinary approach ensures that you receive coordinated care depending on the implant choice that is right for you.

The tooth root implant, a small titanium post, is then inserted into the bone socket of the lost tooth. The jawbone expands around the implanted metal post as it heals, securing it in the jaw. It might take anything from six to twelve weeks for the body to heal.

After the implant has connected to the jaw, a small connector post called an abutment is added to the post to hold the new tooth securely in place. Your dentist takes imprints of your teeth and produces a model of your bite (which captures all of your teeth, their type, and arrangement) to create new teeth. This model is used to create the new tooth or teeth. The abutment is then fitted with a crown, which is a substitute tooth.

Some patients may have attachments put on the implant to keep and support a removable denture instead of one or more separate crowns. Your doctor will also match the color of your formed teeth to your existing ones. The replacement teeth appear, feel, and function much like your original teeth since the implant is fixed within the jawbone.

Prosthodontics Salary

In 2020, the median compensation for prosthodontists was $207,000. That year, the top 25 percent earned $207,000, while the bottom 25 percent earned $119,500.

Conclusion

A prosthodontic surgery might be a life-changing decision. A prosthodontic may improve your smile and how you feel about yourself, as well as your oral health, and help you prevent issues like nutrition, digestion, gum disease, and jawbone loss.

Consult a dentist to begin the process of determining the best prosthetic option for your dental needs, as well as which option is ideal for your health and budget.