table of contents
What speaks for and against prostheses?
In dentistry, a basic distinction is made between fixed and removable dentures. Crowns and bridges are fixed dentures. Removable means anything that is not glued to other teeth, cemented in place or firmly anchored in the jaw. Full and partial dentures are included. In the vernacular one speaks also of the “third teeth”, if one means the kind of dental prosthesis, which lies at night in the glass in a cleaning liquid.
The still very common partial and full dentures with metal clasps and palatal rest have disadvantages because they often impair the quality of life of patients. While prostheses in the upper jaw still adhere to some extent due to the relatively large contact surface of the palatal plate, a prosthesis in the lower jaw often slips or wobbles and causes discomfort and uncertainty.
Clear disadvantages of removable dentures are limited chewing function, taste restrictions due to adhesive cream, problems speaking and of course the less appealing aesthetics. Poorly fitting prostheses often cause pressure points and pain, which make relining – and thus numerous visits to the dentist’s office – necessary.
Another serious disadvantage is that the jawbone is not naturally burdened by chewing. This can cause jaw loss, which in turn reduces the prosthesis content.
The advantage of conventional removable partial and full dentures is clearly the relatively low cost. In addition, if necessary, the prosthesis can be quickly extended if the tooth status has changed and further teeth have to be replaced.
Removable prosthesis in the mandible on ball head anchor implantsimage source: ©Nobel Biocare Services AG
Implants as attachments for removable dentures
Implant prosthetics is the term used when prostheses are attached to dental implants to provide them with a firm hold and high stability. These dental bridges on implants also offer improved aesthetics and functionality when chewing and speaking. The simplest option is to use a full or partial denture that already exists as a dental prosthesis and adjust it accordingly.
Today, however, there are also other fastening possibilities in dentistry. These include, for example, the telescopic prosthesis and the bar prosthesis. The names already indicate how these prostheses work. The manufacture is more complex and therefore more expensive, but the wearing comfort is also significantly higher.
How does the telescopic prosthesis work as a removable denture?
In dentistry, telescope work is understood to mean the provision of a telescope bridge or a telescope prosthesis as a removable dental prosthesis.
The telescope prosthesis consists of two parts, which are referred to as the primary and secondary parts. The primary part (also called the inner telescope) is fixed either to the remaining teeth or to implants, which each serve as abutments or supports. As the name suggests, the abutment is telescoped onto the abutment and fits perfectly in the dental laboratory thanks to the latest technology and precision-fit fabrication.
The fixings are invisible. This means that the telescopic prosthesis or bridge is almost invisible as a dental prosthesis. The telescopic work carried by implants is very stable and fits very tightly. Nevertheless, the telescopic mechanism makes it easy to remove the prosthesis for daily cleaning. A further advantage is that it can be easily extended if necessary. In addition, the artificial tooth roots prevent bone loss because the jaw is loaded in a natural way.
Telescopic work as a removable dental prosthesis is aesthetically very appealing and offers even demanding patients a very satisfactory solution, which is however associated with higher costs and is usually only covered to a small extent by statutory health insurance.
The VARIO telescopic crown ® on dental implants offers an ideal solution: The denture is not too tight and not too loose. The reason for this is a special processing technique of the telescopes in the dental laboratory.
The VARIO telescopic crown®: Removable dental prosthesis with optimum hold thanks to special processing technology image source: ©GZFA
How does the bar prosthesis work as a removable denture?
Bar prostheses are also part of removable dentures. They each consist of a firmly anchored and a removable element, which are connected to each other. They can be used in the upper and lower jaw.
Bar prostheses owe their stability and firm fit to a metal bar that connects the implants to each other. In this way, a solid connection is created on which the so-called combined denture is firmly held.
This method has even proven itself in implantology for completely edentulous jaws, but is also suitable for closing gaps. Depending on the individual requirements, at least two – but usually four – implants are inserted to anchor the jaw, which are connected to each other by thin metal rods. The removable prosthesis is attached to these metal bars.
Relatively simple expandability and the possibility of repair if necessary in the dental laboratory and immediate resilience are clear advantages of this supply. However, bar prostheses are relatively expensive to manufacture. In addition, tension and wear can occur on the bar and increase the risk of peri-implantitis, but also the risk of fracture. Another disadvantage is the somewhat difficult cleaning of the basal bar connection. In addition, you sometimes hear patients say that they have a feeling of a prosthesis in their mouth, i.e. they feel a kind of foreign body.
Which possibility of the supply with removable dental prosthesis is the individually right one for you, cannot be said in general terms. The fundamental goal of implant prosthetics is the sustainable improvement of oral and dental health with all functional and aesthetic aspects. This is accompanied by the fact that the best possible restoration with dental prostheses also increases the quality of life!
The exact diagnosis of your dental status is taken as a basis so that the dentist or implantologist you trust can inform you in detail about all the advantages and disadvantages of various options of removable dentures. He will also show you the different materials available, such as titanium, gold, all-ceramic or zirconium oxide, and advise you on the costs involved.
Bar prosthesis as removable denture on 4 implants in the lower jaw image source: Nobel Biocare Services AG