Fixed dentures: types, prosthetics on implants
Not all Hollywood stars without prior intervention of a dentist-orthopedist could boast of his perfect white smile. The color of enamel depends on the pigments in the dentin. With age due to Smoking, drinking coffee, tea, enamel a yellowish tint. Let’s see by using any of the designs you can achieve the perfect aesthetics. How is prosthetic implants? And what prostheses have high functionality, which is especially important when the loss of lateral teeth.
The varieties of dentures
Nowadays dentistry has markedly stepped forward. Now there is the possibility of fixed dentures as close to natural teeth in both appearance and functionally. And if others do not understand your teeth or artificial crowns prosthetics was held at altitude!
Consider the types of removable dentures:
- Single crowns:
- solid metal;
- Pin design:
- cultivee tabs solid metal;
- cultivee tabs on the basis of zirconium dioxide.
- solid metal;
Fixed prosthesis on implants.
Tabs of type «overlay».
Tasks of a therapeutic preparation
Before the prosthesis is always shown sanation of the oral cavity. Special attention should be given to treatment of teeth that will be covered by crowns and support the teeth (when using a dental bridge). Now, let’s understand what is meant by the phrase «to treat the teeth before the prosthesis».
- Carious cavity it is necessary to recover the material. If this is not done, the tooth crown is destroyed.
- You also need to treat caries on neighboring teeth on either side of the one that I plan to cover the crown. This would facilitate access, are better able to restore the defect, as well as prevent the development of complications.
- If the teeth are pulpless (channels planirovalos earlier), the doctor determines x-rays. the picture quality of treatment: if the filling traced the ground all along the canal, are there any signs of destruction (bone thinning). If necessary, a second endodontic treatment. The lack of a therapeutic preparation to the stage of prosthetics can cause complications.
It is important to note: now fixed restorations do not require prior removal of the nerves (of the tooth pulp). Prosthetics using metal-ceramic, metal-free crowns, inlays, veneers, Lumineers can be performed on living teeth. This is a big plus, as it manages to keep the «heart tooth».
Echoes of history: the pros and cons of stamped designs
Not long ago, removable dentures were presented only stamped, plastic, composite crowns (metal + plastic), soldered bridge dentures. Of course, all of these options:
- restored to some degree of chewing efficiency;
- prevented the development of deformations;
- retain the damaged teeth.
But the minimal aesthetic of the speech did not go. Only combo design look more natural. The increased blurring of the plastic and the toxic effects of the monomer led to the development of gingivitis. Therefore, plastic dentures today are temporary (they are fixed on the teeth as long as the technician will not give the clinic a finished prosthesis).
Among the disadvantages of the designs stamped to the lack of a properly modeled anatomy of the teeth. Chewing surface looks flat. How much is bad? And because every hill, every fissure in the dentoalveolar system plays its function. The correct restoration of the anatomy of the tooth depends not only on the position of the articular head, the tone of the muscular apparatus, but also functioning digestive system, as well as the condition of the spine.
Fixed dental bridges, in which connection reference crowns with intermediate part was carried out by using solder, cause allergies, galvanos. Patients complained of metallic taste in mouth, burning sensation. To rectify the situation was only possible after the removal of all metal structures.
But along with all the above described disadvantages, stamped non-removable dental prosthesis has a positive side. Many patients today, coming to the dentist just for paraproteinaemia (choose the metal, as it looks more aesthetically pleasing), they say that their «old crown» stood for 30 years and even longer, when this has never been recementation. What is important: very often the crown of the tooth is completely preserved. This is because, unlike metal, under stamped crown removed very little tissue. But a living pulp and the thickness of dentin are a good support for the prosthesis.
Metal-ceramic, metal-free crowns
Crowns fixed prosthesis, which restores the anatomy of the tooth, size and function. General indications:
- Congenital abnormalities (anomalies of color, shape).
- Acquired color changes due to caries, trauma. The use of certain of the filling mass to the obstruction of channels also can stain tooth.
- Increased abrasion of hard tissues.
When using dental bridges, crowns it is necessary to cover the abutment teeth, which limit the defect from both sides.
Fixed prosthetics metal-ceramic crowns includes 3 clinical stages. During the first visit, the doctor conducts the examination, takes impressions. This is followed by fitting the metal frame. And final step is the delivery of design with the fixation of the permanent cement. As mentioned earlier, in the absence of therapeutic indications to fill the canals (if the tooth is alive) before the prosthesis orthopedists do not recommend. After the preparation (grinding) on the stump is fixed with a temporary crown that:
- Protects the tooth from external factors.
- Restores aesthetics (which is very important with dentures front teeth).
- Normalizes the adherence of the gums in the area near the cervix. If you do not use a temporary structure, the gums fall and the time the commit is already permanent crown, it may produce a trauma.
Metal ceramic crown is the best treatment, with which it is possible to achieve good aesthetic characteristics and functionality required. And that is important: data structures acceptable.
Metal free crowns
These crowns contain no metal, but have high strength. They are placed on front and on side groups of teeth. Indicated for patients allergic to metal. And thanks to the superior aesthetic characteristics, this variant of prosthetics today honored leader.
- Biological compatibility of ceramics reduces the likelihood of irritation of gums.
- Also, after the prosthesis is no gray band in pricesnews plot (that sometimes happens in the case of using ceramic).
- Accurate marginal adaptation prevents the development of caries process.
The downside of all-ceramic crowns is the high cost. Consider, what are the steps of treatment in this case.
- Inspection, preparation of the teeth, taking impressions, color definition.
- In the laboratory the digital simulation of the frame.
- Using the milling machine is making the frame made of Zirconia.
- After application of the ceramic mass produce roasting in the oven.
- Fitting of prosthesis fixation.
As well as metal-ceramic and non-removable dentures on the basis of zirconium dioxide can to try and before applying the ceramic phase of the caps.
When bruxism and deep bite, this method is contra-indicated: high risk of chipping.
Can be applied as solid (metal) and metal-ceramic, metal-free options. This design consists of crowns that are made on the abutment teeth and artificial teeth comprising an intermediate part.
Solid bridges due to the poor aesthetic component is often used to restore the anatomy and function of lateral teeth. The lack of solder reduces the likelihood of allergic reactions.
All-ceramic, metal-ceramic prostheses can be applied in case of loss, front and lateral teeth. Bridges put in the absence of up to 4 teeth (front area), and 3 teeth (the lateral area).
This group includes cultivee tabs, which consist of 2 parts: the root and the crown. Can be sectional design and solid. Shown to apply in case of strong tooth decay, but normal root length, no periapical lesions. Earlier produced only the metal structure. Now for this purpose use and Zirconia.
The tab «overlay»
Are a good alternative to composite fillings. Often used when an extensive carious cavities on the chewing surfaces of the molars. The basis is Zirconia, this means that the design has:
- High strength, which is particularly important because of chewing group of teeth with chewing of food has a maximum load.
- Good aesthetics. Border tooth-tab is absolutely not noticeable. This is achieved by precise color matching of ceramic with a color of their own teeth.
- Perfect fit, which prevents the development of secondary caries.
It’s aesthetic design, which are fixed on the outer wall of the front teeth to correct smile lines. Shown in:
- Non-carious lesions of hard tissues (fluorosis, erosion, hypoplasia).
- Increased yellowing of the enamel.
- The change in color due to endodontic treatment.
- The ineffectiveness of restoration and recovery using photopolymers.
A case of pathological attrition, bruxism experts do not recommend using this type of prosthesis. Pathological bite is also among the contraindications.
The thickness of the veneers (ceramic) is 0.3-0.5 mm, have the form of plates (plates). They are made individually after taking impressions.
Lumineers are even more thin, look like petals. Fix with glue. Depending on the clinical situation can be applied standard Lumineers (from a set) and are made individually in the laboratory.
Implant-supported dentures: what is this
Experts distinguish between fixed and removable prostheses on implants. Undoubtedly, implant with fixed prosthesis has a much higher efficiency in comparison with the bridge construction.
- First, an implant does not require additional preparation of the adjacent teeth (what happens when you use a dental bridge).
- Chewing pressure is transmitted most physiological way (loaded root portion of the implant). The use of bridges overloading the abutment teeth.
To determine whether to perform the operation, you must:
- To take a blood test.
- Undergo computed tomography, orthopantomography.
In normal somatic status of an organism, the necessary local conditions, the prosthesis on implants is the best method of treatment.
The more time that passes from the moment of extraction to the denture, the more pronounced become of dentoalveolar deformation (antagonists begin to fall in the direction of the defect, the adjacent teeth lean). And this creates adverse conditions. Now in the case of using a dental bridge parallel support elements is achieved by removing a large number of cells, which automatically leads to a weakening of the stump. So remember: earlier access to a doctor – the key to successful treatment!