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Prosthodontics
Tooth


Prosthodontics (Dentures, Crown and Bridge)

Prosthodontics involves procedures which deal with replacing missing teeth which have been lost due to extraction, trauma or disease.

A permanent tooth once lost is a loss forever.

Tooth loss can be due to

  1. Congenital reasons
  2. Extraction of grossly decayed tooth
  3. Trauma
  4. Periodontitis

Replacement of a missing tooth is crucial to ensure proper chewing, aesthetics and to prevent erratic movement of adjacent and opposing teeth.

Replacement methods include providing a partial or complete denture.

Dentures

They are removable appliances, shaped like teeth, which are inserted for eating and can be removed later if they need to be cleaned. They can be complete or partial, i.e., replacing a few, or all of the teeth.

Partial dentures can be fixed or removable.

Fixed dentures can bridge the missing tooth by taking support from the adjacent tooth. Bridges can be made from chromium alloy or ceramic which is the same colour as of the teeth.

Removable partial dentures can be provided as an alternative for periodontially compromised teeth or lack of adjacent teeth on one side of the denture. But this is slightly uncomfortable as it hampers the movement of the tongue.

Complete dentures are required if all or most of the teeth are missing. Patients often require psychological motivation and have initial adjustment problems. They are overcome over a period of time.

Crowns and bridges are fixed appliances which cannot be removed by the patient once they are fitted with a strong cement.

Crowns

Crowns can be required when a tooth is fractured or has a large old filling, or is severely damaged by decay or is a root canaled tooth.

Crowns strengthen the remaining part of the tooth and protect it from further damage, improving the appearance and function of the tooth.

Crowns can be of the following materials:

  1. All metal crowns. ( NiCr or Nickel Cromium alloys)
  2. Ceramic (porcelain) fused to metal crowns. They are tooth coloured.
  3. Gold.
  4. Full ceramic crowns.

Fitting a crown requires at least two visits.

During the first visit, decay is removed and tooth is shaped to accept a crown properly.

An impression of that section of the mouth is taken.

A temporary crown of plastic or acrylic is formed and fitted to the reshaped tooth.

In the next sitting, the temporary crown is removed and a permanent crown is fixed with a strong cement.

Bridges

Bridges are recommended when one or more teeth are missing but are surrounded by firm, healthy teeth on both sides.

1st visit The teeth on each side of the space are shaped to receive crowns and an impression of the area is made.

A temporary bridge is fixed to the area.

2nd visit During the next visit, the temporary bridge is removed and a permanent bridge is fixed, adjusted and cemented in place.

Now the teeth can be used for chewing (mastication). The bridge also improves the physical appearance of the face.


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