Dental prostheses

Description of the service

Dental prostheses are intended to replace missing teeth and restore significant losses in the hard tissue of the patient’s teeth, which are caused by caries, mechanical trauma or periodontal disease. They allow to regain the right functionality and aesthetics of the oral cavity. Dental prostheses can also be used to improve the shape and colour of natural teeth. Modern prosthodontics is available to patients of enel-med medical centres throughout Poland.

There are many classifications of dental prostheses. In general, they can be divided into fixed and removable ones. Fixed dental prostheses are permanently fixed on the patient’s abutment teeth or on implants, and cannot be removed, whereas removable dentures can be inserted into the oral cavity by the patient themselves and then removed.

Fixed dental prostheses include:

• root inlays,
• crown-root inlays,
• veneers,
• dental crowns,
• dental bridges.

These solutions ensure very high durability, excellent functionality, and great aesthetics. Most patients do not associate them with typical dental prostheses, but rather with modern dental restorations.

Removable dentures – types

Most patients think that dental prostheses are equivalent to removable dentures that can be independently removed and placed in the oral cavity. These can be divided into complete, partial and combined dentures.

Complete dentures are used by people who have lost all their teeth, in order to replace them.

On the other hand, a partial denture may be made in the case of partial losses when clinical or financial conditions do not permit other types of restorations.

Removable dentures include:

• Acrylic denture: made of acrylic. They consist of a base covering the edentulous alveolar processes and (in the maxilla) also the palate. The artificial teeth are embedded in the base and, in the case of partial dentures, additional elements are also designed to keep the denture in place in the oral cavity. In the case of such dentures, most of the chewing forces are transferred through the mucosa and/or the periosteum to the bone. Acrylic dentures are broadly available and affordable, so patients often choose them. However, they are massive, hard and stiff, and can irritate the mucosa at the site as well as cause abrasions or sores. Therefore, the adaptation period to acrylic (partial or complete) dentures may be prolonged in some patients. An acrylic denture is often offered to patients as a temporary prosthesis while they wait for the final denture to be made.
• Frame denture: removable partial denture. It consists of a base, teeth, clasps, connectors and occlusal rests. It is partly made of metal and partly of acrylic. The chewing forces are transferred to the bone not only by the mucosa and the periosteum, but also by teeth. The proper design of this denture helps limit the size of the base, making it easier for the patient to adapt to the foreign body in the oral cavity. Frame dentures are strong, stable and more comfortable than acrylic dentures
• Nylon dentures: an alternative to acrylic dentures, made of thermoplastic material (nylon), characterised by excellent flexibility and strength. Nylon dentures also do not contain any metal elements. The parts holding the denture in place have the colour of the tooth or gum, ensuring the right aesthetic results. The adaptation period to the nylon denture is short due to the fact that it is light and thin. Nylon dentures discolour easily, and absorb unpleasant smells from the oral cavity. Therefore, the patient must pay special attention to oral hygiene
• Overdenture: a denture fixed in the oral cavity on implants or roots of the patient’s natural teeth, using specially prepared structures (clasps, ball attachments, telescopic crowns, bar connections). It is an excellent solution if the patient has lost all their teeth, and if there are good conditions for placing at least two implants in the dental arch. This type of denture provides much higher comfort in comparison to a complete denture. It can be fixed very firmly in the oral cavity, which prevents it from moving. Overdentures are made of lightweight acrylic, provide high functionality and excellent aesthetic results.

Removable dentures require several visits to the practice. The patient’s own teeth have to be prepared, and impressions of the upper and lower arch must be taken. Base on these, the lab technician recreates the occlusal conditions in the patient’s oral cavity on a plaster model, and proceeds with individual stages of planning and preparation of the finished denture. Sometimes, several fittings are necessary at the dental practice before the denture is ready, and then the finished denture might also need adjusting.

Consequences of no restoration of lost teeth:

• Missing teeth mean that the chewing forces during daily functioning are not evenly transmitted to all teeth in the dental arch. This may lead to their overload, excessive abrasion, and devitalisation of the pulp and the need for root-canal treatment, whereas in some cases also to loosening of teeth and the consequent loss.
• Missing teeth can cause or worsen already existing temporomandibular joint dysfunctions, which manifest in crackling, limited or disrupted gliding path of the mandible, pathological wear of the crowns in the patient’s own teeth, frequent loss of fillings or their damage, discomfort in the temporomandibular joint area, unexplained headaches, and tinnitus.
• As a result of missing teeth, other teeth might become rotated, shift along the dental arch, leaning towards the gap or protrude from the opposite arch. Such situations very often prevent future prosthetic or implant-prosthetic work without having to undergo orthodontic or surgical treatment.
• The action of the cheek and tongue muscles while speaking and eating leads to the atrophy of the alveolar bone at the site when the tooth/teeth was/were lost, which often makes implant procedures impossible without complicated and expensive surgical treatment for bone reconstruction.
• Missing teeth can result in improper crushing and chewing of food, leading to various disorders
• Missing front teeth can result in slurred speech and impaired articulation of sounds.
• Missing teeth also cause changes to facial features: the cheeks sink in and the corners of the lips drop; therefore, the patient looks older.