Replacement of Missing Teeth

SINGLE TOOTH/MULTIPLE TEETH- REMOVABLE PARITAL DENTURE:

In some cases a single tooth is extracted or multiple teeth are removed. If there is inadequate height and width of bone, or patient is medically compromised or adjacent teeth are weak, then a removable partial denture is fabricated for the patients. This can be removed or worn by the patient and ideally should be removed at night. This is nmade up of acrylic teeth and denture base, which rests on the jaw bone in areas of the missing teeth. Even though it is rarely used, in some cases, it is used as an interim arrangement for teeth replacement either to maintain the ridge dimensions and occlusion or for esthetics.
A removable partial denture is a denture for a partially edentulous patient who desires to have replacement teeth for functional or esthetic reasons and who cannot have a bridge for any number of reasons. RPDs possess clasps of cobalt-chrome metal or plastic that clip onto the remaining teeth, making the RPD more stable and retentive. Parts are Major connector, minor connector, direct retainer, indirect retainer, physical retainer, base teeth.

COMPLETE DENTURE

This is a treatment modality for replacement of all the missing teeth following total extraction. Complete dentures are worn by patients who are missing all of the teeth in a single arch. Process of fabricating a denture usually begins with an initial dental impression of the maxillary and mandibular ridges. The initial impression is used to create a stone model that represents the maxillary and mandibular arches of the patient’s mouth. Then a custom tray is made for accurate impression of the patient’s ridges. A wax rim is fabricated to assist the dentist in establishing the vertical dimension. After this, a bite registration is created to marry the position of one arch to the other. Once the relative position is known, the wax rim is used as a base to place the selected teeth in correct position. After the occlusion has been verified, the denture is processed.The complete denture bases are generally resins, which undego a olymerization reaction after which they set and then are polished and finished. There is good colour match with the soft tissues.

CAST PARTIAL DENTURE

A cast partial denture is removable or permanently attached and replaces one or more missing teeth, receiving support and retention from underlying tissues and some or all of the remaining teeth. The underlying structure is made from casting metal to give it strength and rigidity.

FIXED PARTIAL DENTURE- CROWN N BRIDGE

Crowns And bridges are fixed prosthetic devices for replacing missing teeth. Unlike removable devices such as dentures, which can be taken out cleaned daily, crowns and bridges are cemented onto existing prepared teeth or implants, and can be removed only by a dentist, with an instrument.

Crown

A crown is used to entirely cover, crown or cap a tooth, which is root canal treated, damaged, discoloured, or poorly shaped. Besides strengthening a tooth, a crown can be used to improve its appearance, shpe or alignment. A crown can also be placed on an implant to provide tooth-like shape and to restore function. The crowns are made of different materials, Nickel crome, gold, acrylic, ceramic. The most natural appearance is achieved with porcelain.Most common is porcelain fused to metal because it is stronger.

A crown is fabricated after the tooth is prepared to a smaller size after reducing it with drills and then an impression is made which is sent to the lab, where the crown is fabricated.A shade guide is also used to match the shade with the adjacent teeth, so as to get an ideal colour match. This is usually done for porcelain crowns. Following this it is sent back to the dentist, where it is cemented, using various cements.

Bridge

Bridges are generally used for replacing missing teeth, as gaps left by missing teeth , if not restored will lead to shifting of adjacent teeth into those spaces and gum problems, TMJ disorders etc. Bridges span the entire area of missing teeth, and are cemented onto existing teeth called as abutments.The part of the bridge used to replace missing teeth is called pontics. As with crowns, bridges are also made of diferent materials.

Crowns and bridges can last for several years, however, they can sometimes become loose and fall out, or break. In case a crown becomes loose or comes off, it can be preserved and recemented by the dentist. Repeated episodes of crowns coming off suggest that there are problems either in the biting forces or the height of the prepared crowns may be less, for which further adjustments are required.

LAVA CROWNS

All ceramic crowns and bridges provide excellent long term esthetic solutions for patients. They have:

  • High stability and precise fit.
  • Biocompatibility and long term esthetics.

Lava zirconia based restorations have zirconia copings and frameworks which provide the strength while the veneering ceramic provides the esthetics. Milled from a presintered Lava zirconia block, each framework is coloured using one of eight VITA shades. After sintering for 10 hours to gain strength and fracture resistance, the framework is layered with feldspathic Lava Ceram porcelain. The final lava restoration demonstrates exceptional marginal fit, life-like transclucency and long term durability.