Firmly seated and yet removable – The secret of beautiful teeth

New as an alternative to implants and bridges – the combined dental prosthesis

More and more people are affected by the loss of several teeth and are choosing dental prostheses to restore chewing function, aesthetics and speech formation. The classic dental prosthesis sits firmly in the mouth or can be removed completely.

Fixed or removable alternative?

Unfortunately, no general answer can be given to this question. Each variant has its advantages and disadvantages. Whether one chooses a prosthesis supported on one’s own teeth or an implant as an independent solution depends on the initial situation and the state of health of each patient.

In principle, a bridge is almost always possible for small irregularities and gaps in the mouth. However, if the gaps are very large, only a removable prosthesis makes sense, since a bridge would lead to an overloading of the widely spaced teeth.

Both the advantages and the disadvantages result from the type and technique of the therapy:

Advantages of a fixed denture:

  • Dental prosthesis is firmly fixed
  • Dental treatment is routine
  • Low effort
  • Overview of costs and fixed subsidy from the statutory health insurance funds
  • Function and aesthetics guaranteed
  • Treatment success flawlessly

Disadvantages of a fixed denture:

  • The patient’s own healthy teeth must be removed
  • Risk of tooth death
  • Early tooth loss due to overloading
  • Possible caries development

Removable dentures include both partial clasps and full dentures made of plastic as well as more complex partial dentures. This variant also offers advantages and disadvantages and depends on the individual case.

Advantages of a removable denture:

  • Production is uncomplicated
  • The costs are low
  • Routine measure

Disadvantages of a removable denture:

  • Quality of life is low
  • Psychological inhibition threshold
  • Articulatory disorders are possible
  • Chewing ability is partially diminished
  • The full mandibular prostheses do not last long.
  • Limited aesthetics
  • Overloading of the abutment teeth

Combined dentures as an alternative to bridges and implants?

In addition to bridges, implants and prostheses, there is a new comfortable solution that brings safety and esthetics – the combined denture. Combined dentures are only used if the prosthesis contains fixed components and a removable prosthesis.

A combined denture is useful when there are large gaps in the dentition that cannot be corrected with the help of a bridge, provided that stable tooth roots are present in the remaining teeth. Different anchoring systems are used to fix a combined prosthesis. Depending on the individual case, patients can choose between attachments, telescopic crowns, conical crowns or bar prostheses. Before careful planning and treatment with the combined denture, a detailed discussion takes place between the patient and the dentist in which the expectations of the patient and possible alternative treatment therapies are clarified. The whole procedure is divided into several treatment steps between the dental practice and the dental laboratory. The work between the dentist and the dental technician is very precise in order to reproduce, adapt and combine in detail all the necessary elements for the combined prosthesis. In this case, the procedure is very time consuming compared to a bridge.

The procedure:

  • The existing teeth are precisely moulded
  • A function-analytical measurement (values over the jaw and dentition) is carried out.
  • The more exact tooth colour is determined
  • The newly fabricated frameworks are tried on, correction and over impression follow.
  • Installation of the new combined denture

Advantages of combined dentures:

  • The combined denture can be tried for a while.
  • The crowns and partial prostheses are then firmly integrated.
  • Very good hold and support on the remaining teeth
  • High aesthetics and wearing comfort, retaining elements not visible
  • Better protection against caries compared to a normal partial denture
  • Reduced overloading of individual teeth

After the detailed planning, the precision work of the dentist or dental technician and the fitting of the combined denture, the patient has a long period of acclimatization after the final integration. It is possible that pressure points may form during this period of acclimatisation. Depending on the individual condition, the anchoring elements, which fix the denture to the patient’s own teeth, may have to be adjusted more tightly or loosely. The subsequent aftercare at the dentist is very important to control the new prosthesis and the adjacent tissue. Possible stresses or damage to the supporting teeth are thus detected and treated at an early stage. During these check-ups, the patient learns how to solve his dental prosthesis on his own. Even if it is partially stuck, it must be removed for care. This care and the patient’s own oral hygiene significantly extend the durability of the combined prosthesis. However, if something should break, it can usually be repaired quickly and easily.

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Christina Cherry
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