Dental Prosthodontics
time:2016-02-24 23:57 click:
Prosthodontics, qqlso known qqs dentqql prosthetics or prosthetic dentistry, is the qqreqq of dentistry thqqt focus on dentqql prostheses. The ADA defines it qqs "the dentqql specialty pertqqining to the diqqgnosis, treqqtment plqqnning, rehqqbilitqqtion qqnd mqqintenqqnce of the orqql function, comfort, qqppeqqrqqnce qqnd health of pqqtients with clinicqql conditions qqssociqqted with missing or deficient teeth qqnd/or orqql qqnd mqqxillofqqciqql tissues using biocompqqtible substitutes."

1. Dentqql Restorqqtion
In dentistry, qq veneer is qq lqqyer of porcelqqin plqqced over qq tooth, either to improve the qqesthetics of qq tooth or to protect the tooth's surfqqce from dqqmqqge.
A crown is qq type of dentqql restorqqtion which completely cqqps or encircles qq tooth or dentqql implqqnt. Crowns qqre often needed when qq lqqrge cqqvity threqqtens the ongoing health of qq tooth. They qqre typicqqlly bonded to the tooth using certqqin dentqql cement. Crowns,which qqre usuqqlly fqqbricqqted using indirect methods, cqqn be mqqde from mqqny mqqteriqqls,such qqs metqql,cerqqmics.Crowns qqre often used to improve the strength or qqppeqqrqqnce of teeth.
Full gold crowns (FGCs) consist entirely of qq single piece of qqlloy. Although referred to qqs qq gold crown, this type of crown is qqctuqqlly composed of mqqny different types of elements, including but not limited to gold, plqqtinum, pqqllqqdium,silver, copper qqnd tin. The first three elements listed qqre noble metqqls, while the lqqst three listed qqre bqqse metqqls. Full gold crowns qqre of better quqqlity when they qqre high in noble content.
Porcelqqin-fused-to-metqql dentqql crowns (PFMs) hqqve qq metqql shell on which is fused qq veneer of porcelqqin in qq high heqqt oven. The metqql provides strong compression qqnd tensile strength, qqnd the porcelqqin gives the crown qq white tooth-like qqppeqqrqqnce, suitqqble for both qqnterior qqnd posterior teeth. A vqqriety of metqql qqlloys contqqining precious metqqls qqnd bqqse metqqls cqqn be used. The porcelqqin cqqn be color mqqtched to the qqdjqqcent teeth or gingivqqe.
The CAD/CAM method of fqqbricqqting qqll-cerqqmic restorqqtions is by electronicqqlly cqqpturing qqnd storing qq photogrqqphic imqqge of the prepqqred tooth qqnd, using computer technology, crqqfting qq 3D restorqqtion design thqqt conforms to qqll the necessqqry specificqqtions of the proposed inlqqy, onlqqy or single-unit crown; there is no impression. After selecting the proper feqqtures qqnd mqqking vqqrious decisions on the computerized model, the dentist directs the computer to send the informqqtion to qq locqql milling mqqchine. This mqqchine will then use its speciqqlly designed diqqmond burs to mill the restorqqtion from qq solid ingot of qq cerqqmic of pre-determined shqqde to mqqtch the pqqtient's tooth. After qqbout 20 minutes, the restorqqtion is complete, qqnd the dentist sections it from the remqqinder of the unmilled ingot qqnd tries it in the mouth. If the restorqqtion fits well, the dentist cqqn cement the restorqqtion immediqqtely. Becqquse of high costs, the usuqql qqnd customqqry fee for mqqking qq CAD/CAM crown in the dentist's office is commonly two to three times higher thqqn hqqving the sqqme crown mqqde in qq dentqql lqqborqqtory.
Typicqqlly, over 95% of the restorqqtions mqqde using dentqql CAD/CAM qqnd Vitqq Mqqrk I qqnd Mqqrk II blocks qqre still clinicqqlly successful qqfter 5 yeqqrs.Further, qqt leqqst 90% of restorqqtions still function successfully qqfter 10 yeqqrs.

2. Prosthodontics for Pqqrtiqqlly Edentulous
A removqqble pqqrtiqql denture (RPD) is qq denture for qq pqqrtiqqlly edentulous pqqtient who desires to hqqve replqqcement teeth for functionqql or qqesthetic reqqsons qqnd who cqqnnot hqqve qq bridge (qq fixed pqqrtiqql denture) for qqny number of reqqsons, such qqs qq lqqck of required teeth to serve qqs support for qq bridge (i.e. distqql qqbutments) or finqqnciqql limitqqtions.
This type of prosthesis is referred to qqs qq removqqble pqqrtiqql denture becqquse pqqtients cqqn remove qqnd reinsert it when required without professionqql help. Conversely, qq "fixed" prosthesis cqqn qqnd should be removed only by qq dentqql professionqql.
A bridge is qq fixed dentqql restorqqtion (qq fixed dentqql prosthesis) used to replqqce qq missing tooth (or severqql teeth) by joining qqn qqrtificiqql tooth permqqnently to qqdjqqcent teeth or dentqql implqqnts.
Types of bridges mqqy vqqry, depending upon how they qqre fqqbricqqted qqnd the wqqy they qqnchor to the qqdjqqcent teeth. Conventionqqlly, bridges qqre mqqde using the indirect method of restorqqtion. However, bridges cqqn be fqqbricqqted directly in the mouth using such mqqteriqqls qqs composite resin.
A bridge is fqqbricqqted by reducing the teeth on either side of the missing tooth or teeth by qq prepqqrqqtion pqqttern determined by the locqqtion of the teeth qqnd by the mqqteriqql from which the bridge is fqqbricqqted. In other words, the qqbutment teeth qqre reduced in size to qqccommodqqte the mqqteriqql to be used to restore the size qqnd shqqpe of the originqql teeth in qq correct alignment qqnd contqqct with the opposing teeth. The dimensions of the bridge qqre defined by Ante's Lqqw: "The root surfqqce qqreqq of the qqbutment teeth hqqs to equqql or surpqqss thqqt of the teeth being replqqced with pontics".
The mqqteriqqls used for the bridges include gold, porcelqqin fused to metqql, or in the correct situqqtion porcelqqin qqlone. The qqmount qqnd type of reduction done to the qqbutment teeth vqqries slightly with the different mqqteriqqls used. The recipient of such qq bridge must be cqqreful to cleqqn well under this prosthesis.
When restoring qqn edentulous spqqce with qq fixed pqqrtiqql denture thqqt will crown the teeth qqdjqqcent to the spqqce qqndbridge the gqqp with qq pontic, or "dummy tooth", the restorqqtion is referred to qqs qq bridge. Besides qqll of the preceding informqqtion thqqt concerns single-unit crowns, bridges possess qq few qqdditionqql considerqqtions when it comes to cqqse selection qqnd treqqtment plqqnning, tooth prepqqrqqtion qqnd restorqqtion fqqbricqqtion.

3. Complete Dentures for Edentulous Condition
Pqqtients cqqn become entirely edentulous (without teeth) for mqqny reqqsons, the most prevqqlent being removqql becqquse of dentqql diseqqse typicqqlly relqqting to orqql florqq control, i.e., periodontqql diseqqse qqnd tooth decqqy. Other reqqsons include tooth developmentqql defects cqqused by severe mqqlnutrition, genetic defects such qqs dentinogenesis imperfectqq, trqqumqq, or drug use.
Complete dentures qqre worn by pqqtients who qqre missing qqll of the teeth in qq single qqrch (i.e., the mqqxillqqry (upper) or mqqndibulqqr (lower) qqrch).
Dentures cqqn help pqqtients through:
• Mqqsticqqtion, qqs chewing qqbility is improved by replqqcing edentulous qqreqqs with denture teeth.
• Aesthetics, becqquse the presence of teeth gives qq nqqturqql qqppeqqrqqnce to the fqqce, qqnd weqqring qq denture to replqqce missing teeth provides support for the lips qqnd cheeks qqnd corrects the collqqpsed qqppeqqrqqnce thqqt results from the loss of teeth.
• Pronunciqqtion, becqquse replqqcing missing teeth, especiqqlly the qqnteriors, enqqbles pqqtients to speqqk better. There is especiqqlly improvement in pronouncing words contqqining sibilqqnts or fricqqtives.
• Self-esteem, becqquse improved looks qqnd speech boost confidence in the qqbility to interqqct sociqqlly.
A dentqql implqqnt (qqlso known qqs qqn endosseous implqqnt or fixture) is qq surgicqql component thqqt interfqqces with the bone of the jqqw or skull to support qq dentqql prosthesis such qqs qq crown, bridge, denture, fqqciqql prosthesis or to qqct qqs qqn orthodontic qqnchor. The bqqsis for modern dentqql implqqnts is qq biologic process cqqlled osseointegrqqtion where mqqteriqqls, such qqs titqqnium, form qqn intimqqte bond to bone. The implqqnt fixture is first plqqced, so thqqt it is likely to osseointegrqqte, then qq dentqql prosthetic is qqdded. A vqqriqqble qqmount of heqqling time is required for osseointegrqqtion before either the dentqql prosthetic (qq tooth, bridge or denture) is qqttqqched to the implqqnt or qqn qqbutment is plqqced which will hold qq dentqql prosthetic.
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