Dental prosthetics

Dental prosthetics (fabrication of artificial teeth) is performed when teeth are missing or treatment with fillings is no longer sufficient to restore chewing, aesthetics and clear pronunciation of sounds (phonetics) acceptable to the patient. Dental prostheses are manufactured from alloys of noble and base metals, various types of ceramics (porcelain), medical plastic.

Prosthetics is a final stage in dental treatment performed after surgical, periodontological, therapeutic or orthodontic treatment ensuring the stability and longevity of the results of the treatment performed. It is one of the most complicated areas in dentistry requiring a detailed preparatory treatment: planning of other professionals’ work, careful selection of teeth for prosthetics and most importantly a far-sighted forecast, i.e. how long will it last?

Types of dental protheses

Kiekvienam pacientui protezai parenkami individualiai, pagal esamą burnos būklę ir pageidavimus bei Dental prostheses are selected individually for each patient, depending on the current oral health condition, wishes and possibilities. Two major groups of dental protheses are distinguished based on whether they are removed from the mouth or not:

• Fixed dental protheses (laminates, inlays, onlays, crowns, bridge dentures);

• Removable dental protheses (dentures with metal framework aka “bugels” and veneers).

Removable dental protheses have to be constantly taken out from the mouth in order to clean food from them. They are most difficult to get used to due to a larger size, lack of stability in the mouth, a distinct feeling of a foreign body, increased secretion of saliva, likely nausea and disturbed pronunciation of sounds. It is difficult to chew food with removable dental protheses because they press gums. These dental protheses are the most inconvenient, yet they are fabricated faster and are most economical.

Fixed dental protheses are cemented on teeth with special cement. Patients do not feel any discomfort and inconveniences differently from removable dental protheses because there is no need to take them out. Their fabrication takes longer and is more complicated; therefore, they are more expensive.

The material which will be used for fabricating these dental protheses depends on the type of prothesis, the desired aesthetic result and financial means. Temporary crowns (used until permanent crowns are fabricated), removable dental protheses (full, partial veneers and dentures with metal framework) are made of medical-grade plastic.

Major advantages of this material: aesthetic enough, easy to repair, economical. Its disadvantages: fragility, i.e., it breaks, wears off faster than natural teeth, changeability, i.e., change in colour, accumulates more plague and bad odours, irritation, i.e., may cause gingival inflammation or even allergy.

Individual crowns and bridge dentures can be fabricated from pure metal. Alloys of noble metals (gold, platinum, palladium) or base metals (chromium and cobalt, chromium and nickel, titanium) can be used for this purpose. All-metal dental protheses have been seldom fabricated recently because they do not look good. Yet they have several advantages: the tooth is subjected to little shaving, the prothesis is the firmest and the most long-lasting, the prothesis is more economical than porcelain-fused-to-metal dental protheses. Normally, porcelain-fused-to-metal crowns or bridge dentures are used. Ceramics (porcelain) is ‘baked’ on a cast metal frame (alloys of noble and base metals can be used) in a special furnace. Dental protheses manufactured in this way are aesthetical and firm enough.

Disadvantages: cracking. i.e., ceramic finish may fracture, price, i.e., more expensive.

Pure ceramics is used for fabrication of crowns, inlays, onlays, and laminates. All-ceramic crowns can be used for both incisors and lateral teeth.

Advantages: the highest degree of aesthetics obtained, great compatibility with natural teeth, very strong adherence to dental tissues by using special cements. Disadvantages: occasional cracks of ceramics, restorations are most expensive.

Fixed dental protheses

Dental laminates

Where only the front surface is affected, teeth may be restored by means of laminates (veneers). They are thin all-ceramic shells which are bonded on the front surface of teeth by means of special cements. It is a highly aesthetical and minimally invasive method of treatment. As all ceramic dental protheses, laminates must be used properly because they may fracture or come off.

Dental inlays and onlays

Where much of dental tissue is lost due to decay or other causes, it may be restored by means of large fillings. It is a fast and economical method. However, a higher-quality and longer-lasting solution is the use of micro prostheses, i.e. inlays and onlays. Inlays and onlays are firm fillings made of alloys of ceramics or gold in the laboratories fabricating dental protheses.