Fixed Prosthodontics (Crown and Bridge/Implants) | Removable Prosthetics (Dentures)
Fixed and Removable Prosthetics
The Center for Dental Excellence is proud of the quality of work it produces in prosthodontics for its patients. Quality prosthodontics brings together the elements of an ideal shape for maximum gingival health, precise design of the chewing (occlusal) surfaces for balanced function, durability and comfort in the mouth and jaw joint, and beautifully designed ceramics to create natural illusions of radiant, beautiful smiles. All restorations create the greatest value for the patient: durable comfort, beauty and health.
Fixed Prosthodontics (Crown and Bridge/Implants)
Fixed prosthetic dentistry means the final restorations are not removable from the mouth and it involves the application of crowns, bridges and/or implants to restore multiple damaged or missing teeth. Whenever the natural teeth are available for treatment, they are often the best choice on which to place the final fixed restorations. If teeth are missing, implants can be used to replace them. Implants are the equivalent of tooth roots. They are restored with crowns and bridges in fixed prosthetics, as well as used with overlying partial and complete dentures. Teeth and implants cannot be joined together into a single fixed bridge because of the different levels of rigidity. Implants are rigid, teeth are less so because of the ligaments that support them in the bone. Dental cements will not hold in such circumstances.
An attractive woman about 30 years of age suffered with the embarrassment of an unaesthetic smile that originally used a removable bridge to replace the two missing upper lateral incisor teeth. The result was irregular, discolor, improperly shaped and showed uneven gingival tissue. All these features created a smile that was in poor function and visually out of balance. The mouth was restored using Dr. Prus' standard protocol of Panadent mounted study models, photos and diagnostic wax-up to create the template of the final design. The temporary crowns were made to allow for gingival tissue recontouring which recreated the visual balance that was missing. Two implants replaced the missing lateral incisors. They were placed with the computer designed surgical guide created from the CT Scan to optimize precise placement. All-ceramic Emax crowns were used to restore all teeth to a proper functional design. Comfort, beauty and a younger, healthier smile was the result. A mouth that is in balance will last for many years if properly maintained.
Removable Prosthetics (Dentures)
Dentures are removable prosthetic appliances. They can replace all or part of the teeth in an arch. If all the teeth in an arch are replaced it is called a complete denture. If only some of the teeth are replaced it is called a partial denture.
A partial denture is retained by some or all of the remaining teeth through a variety of clasps or clips or by the use of implants. Stability and retention comes mostly from the teeth. A complete denture replaces all the teeth in an arch. An upper full denture is retained by a suction effect. It rests on the tissues of the roof of the mouth and is sealed by the marginal fit for stability and retention and is a low cost restorative alternative if all the teeth are compromised and cannot be saved. The firmness of the supporting soft tissues greatly determines the stability of the denture. A proper, balanced bite during chewing is also important. Lower full dentures do not have the suction retention of an upper and require precise fit and a balanced bite for proper stability.
To assist in retention Dr. Prus suggests to his patients to use implants to which full or partial dentures, upper or lower, can be attached.
Using a combination of effective periodontal therapy, selective crowns on supporting teeth to support the partial denture framework, and aesthetic tooth recontouring, this patient's entire personality and attitude was, as the images show, changed forever. Teeth that were originally diseased and loose were cleaned and the patient was taught to maintain them on a daily basis to heal the gums. The choice as to which teeth are retained and which are removed is done on an individual basis. Dr. Prus' clinical judgement, acquired after many years of patient care, allows for the best possible outcome. Total soft tissue and bone support healing around the teeth allowed the treatment to progress. Tooth decay and pulpal infections were treated (root canal therapy) and the teeth were restored in various ways to to allow them to accomplish different functions; aesthetic shaping was achieved with composite bonding. Combined with the removable partial denture, a fully restored aesthetic and functional result was obtained; all at the most reasonable cost to the patient. The patient's smile says the rest.
Start Full upper denture plus lower tooth bonding Finished Upper Denture and cosmetic bonding
Completed full upper denture
Patient had many heavily decayed upper teeth and financial constraints limited opportunities to restore her smile. The patient selected the Full denture option which allowed her to enjoy an attractive smile while she planned her next level of dental care. From here, she could choose a full denture or fixed bridge supported by implants.