Prosthodontics, also known as prosthetic dentistry or dental prosthetics, is the branch of dentistry that focuses on dental prostheses. It is one of 12 dental specialties recognized by the American Dental Association (ADA), Royal College of Surgeons of Edinburgh, Royal College of Surgeons of England, Royal College of Surgeons of Glasgow, Royal College of Surgeons of Ireland, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons.
Prosthodontics as a branch of dentistry deals with the replacement of missing teeth and the associated hard and soft tissues by prostheses (dentures, crowns and bridges), which may be removable or fixed or supported by implants.
Fixed Prosthodontics is the branch of Prosthodontics that focusses on permanently fixed dental prosthesis. Such dental restorations include crowns bridges, fixed dentures onlays, inlays and veneers. The above mentioned restorations are made in the dental laboratory on the basis of an impression of the mouth and a detailed description made by the Prosthodontist.
The dental technician then fabricates the desired restoration as per the description. The finished product is then cemented in the mouth using various cements.
A crown covers the whole tooth or a part of the tooth and is commonly referred to as a ‘cap’. Different materials can be used to prepare the crown depending on factors such as patient preference. function/aesthetics and the condition of the tooth.
This is a dental restoration used to span or ‘bridge’ an edentulous area (space where teeth are missing). A bridge is made of two or more crowns for the teeth adjacent to the missing tooth. These anchoring teeth are called abutment teeth with a false tooth in the middle. The false tooth or pontic can be of different materials like porcelain, ceramic, gold, depending on the size of the gap, aesthetics and function.
Removable prosthodontics, also referred to as dentures is concerned with prosthesis which replace the soft tissues and teeth.
These can either replace all the missing teeth (Complete dentures) or replace some of the teeth (Partial dentures). They can be completely made of plastic (acrylic) or can be made of a combination of metal and plastic. Both of them can be replacing either or both the upper or lower arch.
Preparation of these prosthesis can take up to six visits to the dentist and involve both clinic and laboratory steps. Prosthodontists require considerable experience both as a clinician and the technician to obtain a predictable outcome
Maxillofacial Prosthodontics is concerned with the rehabilitation of patients with acquired of congenital defects in the face or mouth. Congenital defects usually relate to cleft palate and lip. Acquired defects usually occur due to cancer of the face or mouth and due to neurological defects, such as stroke.
The prosthesis fabricated tends to fill up or correct these defects. They are typically in the mouth and may include prosthesis such as Palatal Lifts, Speech Bulbs, Obturators, Palatal augmentation device to name a few; however, this branch also includes facial prosthesis like eye, ear, nose, facial, and other body parts like hands, fingers etc.
Maxillofacial prosthodontists are accustomed to working cooperatively in a multi-disciplinary team usually consisting of maxillofacial surgeons, ENT surgeons, Plastic surgeons, neurosurgeons, speech and language pathologists and Clinical Oncologists. The overall goal is to improve the patient’s quality of life.
A dental implant is an artificial device usually made of titanium or titanium alloys.
It acts as a substitute to the tooth root and is usually shaped as a screw or cylinder. A successful implant provides a rigid and stable structure for support or retention of a denture, bridge or a maxillofacial prosthesis.
Implants have a high success rate and offer much satisfaction to the patient if placed properly and good oral hygiene is maintained. The treatment planning process for implant placement is highly crucial and needs to be comprehensive for a successful outcome.
Older patients occasionally express concern that their age will not permit them to enjoy the benefits of dental implants. health is however a more important factor than age. If you are healthy enough to have a tooth extracted, you are probably healthy enough to receive dental implants. Certain chronic diseases may suggest the failure of the dental implant treatment. Your dentist will determine if you are a candidate for dental implants after a careful evaluation of your dental and health history and necessary radiological scans.
Improved appearance: When you lose the entire tooth – crown and root – the jaw bone shrinks making the face look older. Dental implants can stop this process but traditional denture or dental bridge cannot.
Preserve natural teeth: Teeth adjacent to missing teeth are normally ground down to be used as anchors for a dental bridge. Dental implants often eliminate the need to tamper healthy teeth.
Permanent solution: The dental implant is comfortable and stable. No adjustment is required after placement. With proper maintenance and routine checkups, implants will serve its owner for life.
The appearance, comfort, and function served by dental implants are very likely to exceed your expectations. It is often nearly impossible to tell dental implants from your natural teeth, given the high-quality materials used while preparing the patient’s crowns or bridges.
Yes. While it might take a brief period to adapt and adjust to the new structure planted in the mouth, chewing capacity is comparable to that of natural teeth.
Yes. Missing teeth not only affect your dental health but also lead to drastic changes in your appearance. The many problems that missing teeth can cause include:
Difficulty in speaking
Difficulty chewing leading to TMD and/or poor nutrition
Dentures may replace some of the teeth or all the teeth. The dentures that replace all the teeth are known as complete dentures and they rest on the gums that cover the jawbones. The retention and stability of dentures can be improved by attaching them to dental implants. Dentures that replace only some of the teeth are known as partial dentures. The denture attaches to the teeth that are still present and also cover and rest on the gums where the teeth are missing.
Dentures may replace all the teeth or only some of the teeth. The dentures that replace all the teeth are known as complete dentures and they rest on the gums that cover the jawbones. The stability and retention of these dentures can be improved by attaching them to dental implants. Dentures that replace some but not all of the teeth are known as partial dentures. They attach to the teeth that are still present and also cover and rest on the gums and bone where the teeth are missing.
Yes, some prosthodontists can create a crown “while you wait” with equipment such as the CEREC. CEREC uses 3D technology to carve a custom crown out of a block of dental ceramic. It takes two to three hours for the entire process to complete. This approach is met with mixed reviews from prosthodontist and patients. It requires the prosthodontist to have significant experience with crown fabrication to achieve the desired results.
A poorly fitted single-visit crown is bound to experience premature failure and may cause discomfort. Many prosthodontists would rather have the job handled by a master lab technician at a good quality dental laboratory to ensure the highest quality results. The patient will be asked to come in for a second appointment to get the crown fixed. If you wish to have a crown placed in a single visit, look for a prosthodontist who has been using in-office crown fabrication technology for some time to make sure you experience a satisfactory outcome.
Maxillofacial Prosthetics is a subspecialty of Prosthodontics that involves rehabilitation of patients with disabilities or defects that were present at birth or developed due to disease or trauma. Prostheses are often needed to replace missing areas of and restore oral functions such as speech, swallowing, and chewing. In other instances, a prosthesis for the face or body may be indicated for cosmetic and psychosocial reasons. Prosthetic devices may also be created to position or shield facial structures during radiation therapy. Patients that typically desire prosthetic care are those that have been in an accident, have had surgical removal of diseased tissues, or have a neuromuscular disorder from ALS or a stroke. Children can also be born without full development of teeth, palate or ears and need specialized care.