Prosthodontics

Tooth loss can be due to periodontal disease, cavity or dental trauma. If the missing tooth is not restored in a timely fashion, teeth adjacent to the space created by the lost tooth will tilt and drift, and teeth opposite to the lost one will extrude, leading to an unevenness in bite and smile. A prosthesis may be a fixed or removable appliance that replaces removed or non-erupted teeth.

 Fixed Prosthodontics 

  1. Fixed Bridge

If the missing teeth are not too many, the adjacent teeth can act as abutments, being cemented with fixed a bridge.

A fixed bridge is highly demanding (e.g. periodontal membrane area of abutments should not be less than that of the missing teeth, otherwise a heavy burden from biting can hurt the abutments).

  Advantages

A fixed bridge is cemented into the abutments, so it doesn’t need to be removed and cleaned; the whole process is shorter than that of an implant, and the cost falls into the mid-range for removable prosthesis and implants.

  Disadvantages

The enamel of abutting teeth has to be sacrificed partly; if the hygiene of the bridge is not maintained well, or the fabrication of the bridge is not fine enough, the chance of abutments developing cavities will increase.

  2. Maryland Bridge

Usually a Maryland Bridge is used to replace anterior teeth and is cemented directly to the adjacent teeth with little preparation. For patients who want fixed prosthesis but want neither implant nor fixed bridge (because the fixed bridge sacrifices a moderate amount of natural teeth), a Maryland Bridge can be an alternative choice.

  Advantages

The amount of preparation of the natural teeth using a Maryland Bridge is only 1/5 of that of a fixed bridge, and this method is aesthetic, conservative, and economical.

  Disadvantages

Preparation for a Maryland Bridge is highly demanding, and if it is not operated very well, the bridge may fall off.

  3. Implant

Titanium implants act like roots, providing stabilization and retention for the teeth. After they have been fitted and have healed in place, dentures, bridges or crowns can be attached to them. At present, implants are the best way to restore a missing tooth.

 Removable Dental Prostheses 

A removable prostheses can be taken in and out at will by the patient. These devices include full mouth dentures, as well as a replacement for a single tooth, but they are mainly used in cases with multiple teeth loss. Removable dental prostheses are also very demanding techniques, especially for design and dental impression. The procedures involve design, fabrication of customized tray, preparation of abutting teeth, dental impression, finalization of occlusion, and try-on and adjustment. It usually takes 1 month for the whole process.

  1. Elastic Denture (Invisible Denture)

Elastic dentures are a good choice when missing a few front teeth. It has good aesthetic effect, but offers a poor masticatory function.

  2. Cast Frame Prostheses

The masticatory function of cast frame prostheses is relatively good, but the clasp that encircles a tooth may interfere with the smile; it also needs to be taken out after meals for cleaning and regular disinfection.

  3. Complete Denture

Complete dentures are full dentures designed to replace the entire dentition of an upper or lower arch. Because there is no tooth that can be used to help retention, all retention force comes from the negative pressure generated under the denture base and uses help from facial muscles. Good margin sealing, precise alignment of artificial teeth and adjustment of occlusion are keys for success.

  4. Precise Attachment Denture

The retention of traditional removable dentures may not be enough for multiple teeth missing. In these cases, precise attachment dentures usually can provide more satisfying retention through united fixed and removable connections with abutting teeth. Meanwhile, no metal clasps currently exist in precise attachment dentures, which greatly promotes a more pleasing appearance.

  5. Overdenture Supported by Implant

When prosthodontic appliances do not fit properly or are difficult to retain in the mouth, titanium implants may be suggested by the dentist to provide stabilization and retention.