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Introduction to Dentistry: 1st year

Removable Prosthodontics & teeth denture prosthetics

By: Hummam Rihawi

Removable Prosthodontics & teeth denture prosthetics

 

Prosthetics: is primarily the art & science of supplying artificial replacements for missing parts of the human body (ex. Missing hand, eye, ear Etc.)

Prosthesis: is another term for the actual replacement. It is an artificial replacement for an absent part of the human body

Prosthodontics: is a branch of dental science that pertains to the replacement of missing teeth, oral tissues & craniofacial structures.

From the roots of the word, “Prostho” stands for replacement and “Dontics” represent teeth. It aims on replacing parts of the oral and maxillofacial structure.

Prosthodontics is either Fixed or Removable.

Fixed prosthesis stays inside the patient’s mouth, the patient cannot take it off, (such as fixed crowns or bridges) only the dentist can undergo the required procedures.

Removable, on the other hand can be taken off and placed back inside such as Removable complete prosthodontics & Removable partial prosthodontics.

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Fig 2: An example of Prosthodontics

Fig 1: Examples of Prosthetics

However there is two other subdivisions called Maxillofacial & Implant prosthodontics, these two divisions are overlapped with fixed and removable, for example: a patient can have a fixed/removable crown over a natural tooth or on an implant tooth. This way he has: removable /fixed maxillofacial (which is on the natural tooth) or removable/fixed on an implant.

Maxillofacial prosthodontics is not all about teeth; it can be any part of the face, Jaw, eye, nose etc.

Fixed prosthesis: is something which is cemented in the patient’s mouth (crowns & bridges) Golden crowns were commonly used in the past, but currently patients don’t like the appearance it gives on their anterior teeth, therefore, it is not commonly used anymore.

Another type used is called Porcelain-fused-to metal (PMF), it is a metal core tooth cover with porcelain crown (Porcelain is the closest to the natural fibers of the teeth)

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Fig 3: (on the left) Fixed prosthesis (On the right) Removable Prosthesis.

Bridges are also a common procedure for a patient who is missing one or two teeth. The two teeth in contact with the gap are crowned after being trimmed and the gap is bridged with and artificial tooth.

Not all teeth are required to be trimmed; what a dentist usually does is trimming slightly from the inside toward the palate, he doesn’t touch the outside, and he makes a special bridge that will stick towards the inside of the teeth via an adhesive bridge.

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Fig 4: Types of crowns that are commonly used by dentists.

Fig 5: The process of installing a bridge (From the left).

There is also Implant prosthodontics (restorations placed on implants) these types of implants are cemented in the jaw bone by a titanium nail and covered with a crown, so the patient can either have fixed or removable prosthetics on implanted teeth as much as on natural teeth.

Maxillofacial tooth prosthetics can be supported by natural or implant tooth

The reasons why maxillofacial prosthetics are used are usually: 1- different oral diseases 2- trauma 3- malignancy

 Sometimes prosthesis reaches all the way in the back of the patient’s mouth where the palate is. In this case, the nose is opened with the palate and as we know the palate has many advantages in separating the food & drinks from the nasal cavity, in speaking and in swallowing. Here an artificial stopper is placed in the maxilla. Therefore, it is given the term maxillary obturator and it totally occludes the oral-nasal opening.

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Fig 6: Close comparison between natural and implants.

Dentulous: is a condition in which the complete set of natural teeth are present in the mouth (dentate), and Edentulous is the condition in which the mouth is deficient of teeth (toothless) or Partially Edentulous patients who have some of their teeth. And in the second condition (toothless) dentists apply complete dentures, and as noticed it has a natural looking gum with something like blood vessels.

Removable prosthodontics: We have two major divisions: Complete removable prosthodontics & Partial Prosthodontics.

If a patient is partially edentulous, prosthesis can be made for him, in this case it is partial prosthesis.

But some are completely edentulous as mentioned; due to different oral diseases, severe oral cavities, gingivitis that leads to tooth loss, trauma or rarely born with no teeth buds therefore no teeth growth. In this case a complete prosthesis should be done.

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Fig 7: figures of partially and totally edentulous.

Fig 8: A complete denture set.

Prosthodontics

Fixed

Crowns

Gold Porcelain

Bridges

Removable

Over denture

Immediate denture

Single dentures

However, there are different types of dentures like: over denture, immediate denture and single dentures.

 

Over denture: a denture applied over a tooth by removing the crown and leaving the root, removing a part of the tooth or on an implant and it has its own advantages. 

Immediate denture: a type of denture that can actually be very helpful for the patient. For example if a patient’s tooth has been extracted, it might take weeks and sometimes a month to get his denture ready to be worn, which can affects the patient’s practical life for having no teeth until it is ready, For that there is immediate denture (a removable prosthesis), as a temporary solution.

Single dentures: A complete denture that occludes against some or all of the natural teeth, a fixed restoration, a previously constructed removable partial denture or complete denture (Source: Wikipedia)

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Fig 9: Over denture implantation.

Fig 10: Immediate denture set.

Fig 11: Single denture set.Mind Map:

1- Prosthetics or Prosthesis are primarily the art & science of supplying artificial replacements for missing parts of the human body.

2- Prosthodontics: is a branch of dental science that pertains to the replacement of missing teeth, oral tissues & craniofacial structures and can be either Fixed or Removable.

3- There is two other subdivisions called Maxillofacial & Implant prosthodontics, these two divisions are overlapped with fixed and removable.

4- Fixed prosthesis is something which is cemented in the patient’s mouth (crowns & bridges), Golden crowns or Porcelain-fused-to metal (PMF) are used in this process.

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Summary:

5- Bridges are a common procedure for a patient who is missing one or two teeth next to each other.

6- Dentulous is a condition in which the complete set of natural teeth is present in the mouth (dentate).

7- Edentulous is the condition in which the mouth is deficient of teeth (toothless) or Partially Edentulous patients who have some of their teeth.

8- There are different types of dentures like: over denture, immediate denture and single dentures.

Q1- “………………” were commonly used in the past, but currently patients don’t like the appearance it gives on their anterior teeth.

A) Golden Crowns C) Dentures B) Porcelain Crowns D) Bridges

Q2- When a patient has a missing one or two teeth. The two teeth in contact with the gap should be ………………. after being trimmed.

A) Bridged C) FixedB) Crowned D) Removed

Q3- If a patient comes with a total edentulous case, the best way to deal with his condition is:

A) Using an immediate denture C) Trimming the inside

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Test yourself:

B) Applying a complete denture D) Applying a bridge

Coming together is a beginning; keeping together is progress; working together is success.-Henry Ford

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