Dentures, crowns, bridges, prostheses
The following information includes dental prosthesis designs such as crowns, bridges, partial dentures, and total restorations, as commonly found on both natural and artificial teeth. Special features of dentures in the esthetic zone
Crowns and bridges
Crowns are technically rings, which are usually used to hold damaged tooth substance together and / or serve as an anchor for fixed and removable bridges or partial dentures. Bridges are accordingly constructions for the replacement of one or more teeth, in which the missing parts of the teeth are firmly connected to the artificial crowns. Crowns can replace the original tooth enamel partially (partial crown) or completely (full crown). Fixed crowns are cemented or glued, so they are not removable for the patient.
To make crowns, they must always be reduced in volume to the extent that corresponds to the layer thickness of the crown. For this purpose, the tooth is ground and a model obtained (via an impression of the teeth), which is used for further laboratory technical steps. Depending on the effort, the time required in practice and in the laboratory is between one and three weeks. An alternative way is the digitalization of the defect, as it can be performed in reconstructions of milling ceramics on the patient.
In the age of all-ceramic rather rare are crowns with ceramic shoulders and Galvanokronen.
In ceramic shoulders, a cast metal framework is slid back in the cervical area, ie at the junction with the pristine root, to achieve aesthetic optimization. These crowns lack the metal edge, so that the illusion can be created, the crown would come “as grown” from the gums. For the production of ceramic shoulders several separate steps are required: a more accurate preparation (use of magnifying glasses), because increased demands are made on the model and a separate fire of ceramics in the laboratory, because first the cantilevered shoulder must be made before the actual veneering is possible.
Galvanocrowns differ in terms of the metallic substructure of “normal” cast crowns. While in conventionally cast crowns the shape of the future metal is modeled in wax and the casting technique for church bells is cast in a lost form, the pure gold layer in galvanic crowns in the galvanic bath bears on the stump model.
Full ceramic crowns (veneers), all-ceramic crowns and all-ceramic bridges:
All-ceramic restorations are used in patients with increased aesthetics and in patients with allergies to metals.
Adhesive bridges – bridges without crown anchor:
Adhesive bridges (“Maryland” bridges), mostly used in adolescents, where the tooth substance is to be spared, are glued to the anchors (teeth) via small wings from the inside. They serve as a very long-term intermediate solution, but can also be used as a provisional in the context of an implant treatment, during the healing phase.
Removable bridges
Removable bridges are special constructions that combine the advantages of the grace of fixed bridges with those of the remodeling of removable partial dentures. In principle, removable bridges are similar in shape and appearance to the fixed ones, the only difference is that they are not cemented to the teeth but instead are placed on an additional intermediate crown in the form of a cylinder.
The inner crown may consist of a ceramic (first example) or a metal alloy, is firmly connected to the tooth and the actual bridge attached to this base. Removable bridges are only removed for cleaning, they can also be veneered with ceramic materials in color. Design elements such as mucous membrane-covering saddles and palate plates or under tongue straps are often completely missing.
Removable bridges are particularly well suited for periodontally weak teeth and / or the connection of own teeth with artificial tooth roots (dental implants).
Special versions:
Inner crowns made of ceramic, non-precious metal constructions and ceramic veneers are special shapes. Please contact us.
Removable partial dentures
Partial dentures are dental prosthesis designs that replace not only teeth, but also gums and jawbones. So they are mainly characterized by plastic saddles, which almost always have connections to the opposite side of the jaw. The plates and temples are made of metal. The remaining dentition serves as an anchor and ensure the maintenance of the construction. Partial dentures have the great advantage of simple conversion in case of tooth loss, but are by design always much larger than just the row of teeth alone it would be.
To anchor teeth or crowns are brackets, double crowns, attachments, anchors and others. With partial dentures an increase of the supporting teeth by implants is possible.
Total dentures
Total dentures are used to restore a system of chewing when all the teeth in the jaw are missing. They are usually made of special plastics, but may also have additional metal reinforcements.
Total denture with metal reinforced base (palatal plate)
Total dentures find their support in the upper jaw predominantly through the base (palate plate), which develops a suction depending on the construction or uses adhesive forces, in the lower jaw at a much smaller base often additional forces through the surrounding muscles.
Please note: Dentures are always custom-made, which means that there are always many solutions that can only ever be worked out individually.
A constructional special form represents the so-called Stable base Prosthetics is.
© 2019 Andreas Stein, Dentist, Oral Surgery Wiesbaden
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