Prosthetic Dentistry

The restoration or replacement of teeth.
 
The main areas that are included when we think of prosthetics in dentistry are:

CROWNS - Full coverage restorations of the teeth.
Typically, porcelain crowns are placed when a significant amount of tooth structure is lost and when placing a filling would jeopardize the integrity of the tooth or compromise the aethetics or strength. Generally, they cover the top of the tooth and go down the side of the tooth, holding it together to prevent further damage to the teeth. Traditional crowns have gold inside of them with porcelain bonded to the outside for aethetics. These are sturdy and durable and hold up well to the 200 pounds of pressure put on them during chewing function. The newer porcelain crowns are called "second-generation" materials because they are stronger all ceramic (no metal) and more durable than the original porcelain type materials that were used thirty years ago. These new materials have better wear, more translucency to match the natural color of your teeth and they bond better.


BRIDGES - Replacement of a missing tooth or teeth.
These are placed when there are one or more teeth missing and the objective is to stabilize the bite, prevent the adjacent teeth from tilting, and prevent the opposing teeth from dropping down into the space that has been lost. There are a few different types of bridges including the Maryland Bridge, which can be placed conservatively in the areas that have low torque and two teeth that have never been touched.


DENTURES - Replacement of a missing teeth or a full arch.
DENTURES generally refers to the replacement of an entire arch of teeth with a removable appliance with either plastic or porcelain teeth on it. If there are a few teeth left, then it is referred to as a PARTIAL DENTURE. This will either have acrylic base holding it in place, or it will have metal clasps to secure it to the adjacent teeth. Generally when a denture is placed for the first time, it takes a while to get used to it, since it is a foreign body in your mouth. Dentures should be brushed just like you would your natural teeth because they can build up tarter on them as well. Newer generation materials have created high impact yet flexible dentures which appear more natural and are more comfortable to wear.


IMPLANTS - Replacement of one or more missing teeth.
An IMPLANT is typically a titanium screw that is placed into the jaw bone in the area that a tooth is lost. It is left in the bone for a period of approximately 4-6 months to let it "fuse" with the adjacent bone. At this point, a metal top is placed on the screw post to create a hole in the gum for the crown to emerge from. After that has been in the tissue for a short while, then a crown can be placed over that post. It is either cemented or screwed in, depending upon the type of implant system.
Advantages of implants are that they don't involve the adjacent teeth and therefore are more conservative in that respect. In addition, should something happen to the implant (porcelain chip, adjacent teeth turn darker over time) the crown can usually be easily removed and sent back to the lab for a touch-up to correct anything.