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Prosthodontics – when and what kind of dental restoration is needed?

Dental restorations are used only when a tooth can’t be treated the conservative way – with fillings or when the teeth are severely worn-out and a full-mouth rehabilitation is indicated. Also they are used in case of full or partial tooth loss and they can be fixed (permanently attached) or removable.

In the presence of severe defects when it is impossible to restore the tooth with fillings partial porcelain restorations (inlays/onlays/partial crowns) are indicated. They allow to preserve the tooth’s vitality and protect the remaining tooth tissues. In such cases a crown isn’t a suitable form of treatment because it spoils the remaining tooth tissues and there is a risk of damaging the tooth’s vitality. When there is only very little dental tissue left usually after root canal treatment the crown is restored with glass fibre post and porcelain, metal ceramic or zirconia crowns.

Besides the removable individual micro-restorations (inlays/onlays/partial crowns) full crowns or bridges can be produced. Bridges are used when the patient has lost one or more teeth. The neighbouring teeth are then prepared and crowns with a transitional part that fills the place of the defect are fixed onto them.

Crowns and bridges can also be cemented onto implants so there is no need to take them out they become a part of the dental arch. Patients can choose from zirconia, ceramic or metal ceramic crowns and bridges.

In case of high aesthetic requirements uneven discoloured front teeth can be straightened with porcelain veneers or metal-free ceramic crowns. If allowed by indications in the front teeth area very thin porcelain veneers – thinner than 0,5 mm ceramic laminates – are used and they are much more superior and lasting than the popular “aesthetic” dental fillings.

In case of tooth loss (full or partial) two kinds of treatment are possible: removable dentures of different kinds and dental implants.

Dental implants allow to restore individual tooth defects or toothless jaws. If the patient chooses dental implants the surgeon screws in the necessary implants into the jaw bone and the prosthodontist places a chosen bridge construction onto them. The main advantage of dental implants is that the prostheses are fixed and there is no need to take them out. Also the patient has aesthetic and functional dentures that restore the chewing function.

Removable partial dentures are not fixed on tooth tissue so they can be removed from the mouth. Dentures of this kind are attached to the soft tissues – gums, the roof of the mouth, cheeks are held in place by the tongue. There are cast metal/bioplast partial dentures flexible dentures or tooth flippers. A disadvantage of these dentures is the insufficient fixation especially if the jaw anatomy is unfavourable. To fix this problem one or a few implants can be used.

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