Depending on the conditions in the oral cavity, we use different types of prosthetic restorations. They can be divided into two main groups:
- Fixed restorations,
- Removable restorations,
Fixed restorations are structures permanently attached to the patient’s own teeth. These include crowns and core-root posts, crowns, and bridges.
Removable restorations are structures that the patient can independently remove from the mouth. Furthermore, they should do so after each meal for hygiene purposes. These include frame dentures, overlay dentures, partial dentures, and full removable dentures.
Similar to those described above, implant-supported restorations are those anchored by dental implants (described in the Implants section).
Crown inserts (inlay, onlay, overlay)
When a tooth is damaged to such an extent that its reconstruction using conservative methods, i.e. using a filling (commonly called a seal), is impossible, then a crown is made, i.e. a replacement of the lost tooth fragment, made in a prosthetic laboratory, most often from porcelain or the latest generation of composite materials.
Crown-root posts
In cases of significant or complete damage to the tooth crown, a prosthetic structure in the form of a post and core is used. A prerequisite for qualifying a tooth for this solution is properly performed root canal treatment. Post and core strengthen the tooth in which they are embedded and serve as a support for the prosthetic crown. In a period of rapid technological advancements, individually cast post and core structures in the laboratory are increasingly being replaced by standard post and core structures made of glass fiber.
Prosthetic crowns
A crown is a prosthetic structure permanently attached to a tooth (including one that has undergone root canal treatment and been reinforced with a post and core) or an implant. It faithfully recreates the anatomical shape of a tooth damaged by caries or fractured. It also allows for corrections to the shape and color of the tooth and its position in the dental arch.
An aesthetic prosthetic crown is composed of two structures: a framework, or cap, and porcelain fused to this cap, which replicates the shape and color of the tooth. This framework can be made of metal (precious or non-precious) or special hard porcelain (zirconium). Most restorations are made using state-of-the-art CAD/CAM technology.
Prosthetic bridges
A bridge is a prosthetic structure that replaces the missing tooth or several teeth. It is permanently attached to the teeth adjacent to the gap or to implants.
Skeletal prostheses
These are removable (removable) restorations used when a patient has partial missing teeth, so extensive that they cannot be replaced with permanently fixed bridges. Frame dentures are metal-acrylic prostheses. The basis of the structure is a metal base molded to the shape of the patient’s oral cavity. The metal frame is additionally supplemented with metal protrusions resting on the tooth surfaces. This transfers bite forces to the mucosa and, through the teeth, to the jawbone (this is beneficial because it does not cause the same bone loss as with the removable dentures described below). The elements that hold frame dentures on the teeth are metal clasps. Sometimes, these can be replaced with precise elements that do not compromise aesthetics (clasps, telescopes, or latches). These claspless frame dentures provide greater comfort when speaking and eating. They also offer aesthetic comfort because they are completely invisible (ask a specialist at the Dr Łyszczarz Clinic Stomatology Center for details).
Partial and complete dentures
Dentures are used to replace teeth when teeth are completely missing (complete dentures) or when there are extensive partial dentures. Various types of plastics (most often acrylic) are used to make them. These dentures transfer pressure directly to the gums. This, in turn, limits the chewing force to approximately 25% of that achieved with natural teeth (which, of course, impairs chewing and food grinding capabilities). Over time, these dentures “settle” as the bone beneath the gums recedes, requiring new dentures at least every 5 years. A much more beneficial solution, from a comfort perspective, is to support these types of dentures (especially complete dentures) with dental implants. Especially in the case of edentulous lower jaw (mandible), the insertion of even two implants greatly stabilizes the complete denture and improves chewing and speaking capabilities, giving the patient incomparably greater comfort.
Overdentures
Overdentures are a modern prosthetic solution that combines the advantages of removable restorations with the stability of fixed restorations. They are placed on the patient’s existing tooth roots or implants, significantly improving their retention in the oral cavity. This prevents the denture from shifting during speaking or eating. Furthermore, their comfort is significantly higher than with traditional fixed dentures.
The use of overdentures also helps reduce bone loss, as chewing forces are partially transferred to the implants or tooth roots. This solution is especially recommended for edentulous patients who desire greater stability and comfort in everyday life.
Implant-based restorations
Implant prosthetics are one of the most advanced methods of restoring missing teeth. They involve placing a crown, bridge, or denture on previously implanted implants, which act as artificial tooth roots. This solution achieves a result as close to natural teeth as possible – both aesthetically and functionally.
Implant-supported restorations are characterized by high durability, stability, and comfort. They do not require grinding down healthy adjacent teeth, unlike dental bridges, which is an additional advantage. Thanks to them, patients can enjoy full chewing power and a natural-looking smile.
How to choose the right prosthetic restoration?
Choosing the right prosthetic solution depends on many factors, such as the number and location of missing teeth, the condition of the remaining teeth, the amount of bone tissue, and the patient’s expectations. A thorough diagnosis and consultation with a specialist are crucial, as they will propose the best treatment plan.
Modern prosthetics allow for an individualized approach to each case. Using advanced technologies and high-quality materials, it is possible to achieve results that are not only aesthetically pleasing but also durable and functional.
The importance of regular checkups and hygiene
Regardless of the type of restoration used, proper oral hygiene and regular checkups are crucial. They help maintain dentures in good condition, prevent complications, and extend their lifespan.
Proper care includes both daily cleaning of the restorations and maintaining the health of the gums and remaining teeth. For removable dentures, regular removal and thorough cleaning are essential. However, for fixed dentures, thorough brushing, flossing, and irrigators are crucial.
Properly selected and properly maintained dentures not only restore a beautiful smile but also significantly improve quality of life and the health of the entire oral cavity.
