Facing a teeth loss is a great challenge as for patients so as for dentist. By losing teeth patients experience huge changes in their oral cavity. Beside complete or partial loss of teeth, there are changes in residual alveolar ridges. Not only that eating for these patients is different and difficult but these patients have trouble with speech, bite and occlusal relations of jaws that can negatively affect their temporomandibular joints and, of course, esthetic appearance.
Teeth loss may be partial, which means that a certain number of teeth is missing while the rest of teeth, still present in jaws, can stay there and be used for prosthetic rehabilitation. There is also a total teeth loss when not one tooth is left in the mouth. Both conditions may be treated while prosthodontics solutions are available for both scenarios.
THE EDENTULOUS PATIENTS
Loss of all teeth means that teeth in both jaws should be replaced. A common problem in these patients is a loss of bone that supported lost teeth- alveolar bone resorption. Dentists usually need to replace both, the bone and the teeth loss. Prosthetic denture teeth are the only solution to this problem. There are several options for production of ideal denture using different materials. When your dentist provide a detailed analysis of your dental arches, they can properly advise you for the ideal type of denture in your specific case. Unfortunately, dentures in the lower jaw are almost always a great challenge since the anatomy of this area is special in a way that it can seriously affect the stability of dentures.
Types of complete dentures:
1. COMPLETE ACRYLIC DENTURES
are made of polymethylmethacrylate (PMMA), usually called plastic dentures. Base and teeth are made of this material and usually present the simplest and cheapest option in the rehabilitation of complete teeth loss.
2. METAL ALLOYS DENTURES
are actually dentures made of metal alloys that contains aluminum, gallium, copper, iron, platinum, molybdenum or even titanium. These alloys reinforce the acrylic base so it is reinforced and more prone to any mechanical stress during mastication. Since that the denture’s base is thinner this way, these dentures are more comfortable for patients but also more expensive than acrylic or silicone dentures.
3. IMPLANT PROSTHODONTICS
has become part of everyday dentistry and it is usually the most comfortable option for patients. Cooperation of implantologist and prosthodontist is crucial in order to create an ideal individual therapeutic plan for each patient. Analysis of anatomic structures available for implants and design of prosthodontics, so as an assessment of ideal connection of prosthodontics to implants present an important part of the entire procedure. These dentures often require more time until final step in rehabilitation is achieved and the entire procedure is more expensive than previously mentioned dentures.
PARTIALLY EDENTULOUS PATIENTS
Depending on the number and arrangement of teeth present in the mouth, different prosthodontics options are available. Sometimes, possible solutions for partially edentulous patients are ceramic crowns and bridges. However, there are cases when partial removable dentures are the only option. Present teeth may be used as anchors for future dentures. Basically, the partial denture’s base may be the same as for complete dentures i.e. they can be made out of acrylic or metal alloy. The main difference among partial dentures is the type of connection with the teeth present in the mouth.
1. METAL ALLOY WIRE AND CLASPS
is the simplest option to retain dentures for the rest of teeth in patient’s mouth. In this case, the dentures are made of acrylic and the metal wire is integrated into denture’s base. The wire will be adapted to the patient’s teeth and that way the dentures are retained and positioned in the right place. Even though this is often the cheapest and the simplest solution it is not very good option since the stability of this connection is poor and the confidant of patients having this kind of dentures is on a pretty low level. Maybe the greatest flaw of this type of retention is the esthetical aspect. The wire and clasps are usually visible around the teeth and that way present the unpleasant solution in many patients.
are actually the abutments that connect the present teeth with the removable partial denture. They are usually made of different types of metal alloy and prefabricated so they can be easily integrated into patient’s teeth and future denture. They present a reliable connection between teeth as a patient’s natural structure that will hold the artificial teeth in form of a denture. There are many different types of attachments and based on your dentist experience and knowledge, he will choose the right type of attachment for your future denture that will fit in the best possible way. Attachments consist of two parts, male and female. Usually, male part is integrated into patient’s teeth and the female part is integrated into the denture. Attachments may support complete dentures too, whether they are integrated into patient’s teeth or implants. Basically, in partial dentures, patient’s teeth are adapted with special crowns that have male part of attachment integrated. One attachment is usually used for one crown. However, since there are many types of attachments it is good to accentuate the ones that can connect two or three separate teeth or implants with one bar, called overdenture bars. Dentures are fixed to teeth or implants by clicking mechanism that holds dentures tightly in its place. This type of connection is reliable, stable, resistant to mechanical stress and esthetically very acceptable since this kind of connection is hidden and not visible, so no one can know that you have a denture.
3. TELESCOPIC PARTIAL DENTURE
uses a telescopic crown as a connection to existing teeth in patient’s mouth. Teeth are prepared by your dentist for a crown that is a part of your future denture. This is how the denture will be attached to your teeth. It is considered as the best possible solution when we talk about types of connection for partial removable dentures. It is quite an elegant solution since it has the great stability, mechanical resistance, and the best esthetic results. It is almost impossible for anyone to notice a presence of a denture. Besides that, you have every advantage of removable denture so as with all other connective structures. Telescopic crowns may be used on patient’s own teeth, but they can also be used for retention of dentures on implants. Basically, telescopic crowns contain two parts: first is primary full-coverage casting- male telescoping portion that is a part of prepared tooth or implant, and the second part- female telescoping portion that is part of the future denture. What is interesting for this type of retention is that the connection is enabled by the interfacial surface tension between two castings. That is what allows dentures to be removable, but on the other hand stable in the mouth.
Since many people all going to experience a teeth loss in one moment in our lives it is good to be informed for all therapeutic options and to choose the right one for yourself. This is not something that you can do on your own, but through the discussion with your dentist after the detailed examination and analysis of your dental status, you can easily choose the best solution for your case. Luckily, with the progression of dental science, materials, and technologies every one of us can find the most appropriate prosthodontics solution, from dental crowns and bridges over to partial and complete dentures to dental implants. It is not an easy decision, but with a help of your dentist it will be less stressful and the best possible solution for your new and healthy smile.