Dental health is directly related to your general health. Tooth loss for any reason has a variety of consequences. When a tooth loss takes place, the neighboring teeth move towards the empty space. This movement leads to misshapen forms and gingival issues. Due to the loss, the chewing function is affected, which leads to malnutrition and digestive issues. This dental loss also leads to an inability to enunciate properly, affecting speech. Facial appearance also changes due to the space in the mouth. The face looks older and more worn up than it is. In addition to tooth loss, untreated decay, broken teeth and crooked shapes may also be observed. These constitute a health risk as well as aesthetic concerns in the patient. Shyness and avoiding a smile due to the unpleasant appearance may also lead to psychological and social issues. Dental prosthesis is used to remedy such issues related to the teeth. Dental prosthesis refers to artificial teeth prepared to replace lost or damaged teeth.
Dental prostheses may vary depending on the material used to make the prosthesis, the number of teeth lost, position of teeth to be treated and the patient’s expectations. The prosthesis used to remedy a single lost tooth and the prosthesis used for multiple teeth and prosthesis for patients without any natural teeth are quite different from each other. Dental prostheses also vary by cost, durability, aesthetics and the comfort of use, depending on the materials used.
The most common type of prostheses used today are the fixed prostheses. They are commonly placed to replace a limited number of lost teeth using neighboring teeth and implants as support or over natural teeth. Compared to mobile prostheses, they offer a more natural and aesthetically pleasing appearance. Fixed prostheses are placed by dentists using a special adhesive and cannot be removed or reattached by the patient. Since they are fixed, they do not move while eating or speaking, offering a more comfortable use for the patient. Fixed prostheses are preferable due to the fact that they are offer adequate resistance to the chewing strength, provide an appearance closest to the natural teeth and are compatible with biological tissue. Fixed prostheses are made of a variety of materials; namely, metal supported and metal unsupported prostheses. Metal supported prostheses offer adequate resistance to the chewing strength, but may cause some aesthetic issues. The biggest issue with the metal supported prostheses is that they are not translucent, and fail to offer a natural appearance. Therefore, porcelain-based prostheses and, more recently, zirconium have become the most commonly preferred and used prostheses. They offer a more aesthetic appearance than metal-supported prostheses. They offer the appearance closest to the natural with their translucent structure. It is also used frequently for front teeth for the same reason. Most prosthesis placed over implants are fixed types. Fixed prostheses are completed in 3-4 sessions. First, the teeth are prepared for the treatment and measured. Then, the trial for the base structure is performed. The porcelain prepared for the base is tried, checking its compatibility with the other teeth, its color and aesthetics. If all is well, it’s polished and fixed on the patient’s tooth.
Crown is the visible part of a tooth in the mouth. Crown prosthesis is the covering of the visible part of a tooth with various materials. For crowning, the tooth is cut and reduced in size. This practice is preferable in a variety of situations. Crown prostheses are used for decayed, broken, overly abraded teeth, misshapen teeth, to fill gaps between the teeth, for discolored teeth, as surface structure for implants and to prevent weak teeth from breaking. For crown prostheses, it is very important to attain aesthetically pleasing and natural appearance. Use of metal-supported base material may cause an undesirable appearance due to opaqueness. Today, reinforced porcelain and zirconium bases are used. Therefore, the crowned teeth have an appearance closest to the natural.
Bridgework prostheses refers to cases of one or more teeth losses being filled by reducing and crowning the adjacent teeth. Therefore, the chewing pressure corresponding to the gap is distributed to the other teeth. For this procedure to be implemented, both teeth adjacent to the gap should be in good enough condition to support the artificial tooth placed in the gap. If the tooth loss cannot be remedied, adjacent teeth begin to move towards the gap. Consequently, the adjacent teeth and the jawbone begin to shrink, gingival and aesthetic issues emerge. Materials used for bridgework may vary depending on the position of the missing tooth and the condition of other teeth. Metal supported bridgework prostheses, zirconium bridgework prostheses and bridgework prosthesis over implants may be used.
Over-implant fixed prostheses are screws or prostheses placed into the jaw. They are alternatives to bridgework in case of a single lost tooth. Avoiding any work on the neighboring teeth is advantageous; however, the jawbone should be suitable for such a procedure. It can be implemented in single tooth loss as well as multiple tooth loss.
Mobile prostheses are preferred when fixed prostheses cannot be used due to lack of adequate standing teeth. This type of prosthesis can be removed and reattached by the patient and can move inside the mouth. It presents a variety of difficulties in usage. It can move when the patient eats and eats, negatively impacting such actions. Mobile prostheses applied to the lower jaw are difficult to remain in place as the tongue, the cheek and the lips apply force to the prosthesis, making it difficult to remain in position, which disturbs the patient. It should be removed at night before sleep to ensure the soft tissue supporting the prosthesis is rested. The prosthesis is kept in a special container. Prostheses should be removed and cleaned with a special toothbrush after eating. Mobile prostheses can comprise acrylic and metal-supported structures. They can be classified as total prostheses, partial prostheses and precise holder prostheses.
Total prostheses are applied to the upper and lower jaws when there are no natural teeth left. They support the lips and the cheek to help prevent facial collapse. The teeth are lined by aesthetic rules to attain a pleasing appearance. When first used, prostheses may cause certain inconveniences. It may result in bruises and wounds in certain areas, inability to eat or difficulty in speaking. These complaints will disappear over time as the prosthesis settles in. In particular, the grip on the lower jaw is a known issue. Tongue, cheek and lip movements make it difficult for the prosthesis to remain fixed.
This treatment is used when a part of the natural teeth are lost. The prosthesis is connected to the natural teeth using metal crochets. It is supported by the tissue holding the prosthesis and the adjacent teeth, distributing the force to the teeth and the tissue. It eliminates functional disorders resulting from dental loss as well as facial collapse due to tooth loss. Metal crochets used as holders may cause aesthetic issues. These crochets may also lead to plaque accumulation and dental abrasion.
They are used in the loss of multiple teeth. Precise holder prostheses can be preferred to avoid the aesthetic issues, plaque and abrasion caused by the metal crochets of partial prostheses, particularly in the front teeth. The teeth adjacent to the space are crowned and precise holders are placed into the crowns. It is more advantageous in terms of holding strength and aesthetics.
Over-implant prosthesis is a treatment used for single or multiple tooth loss. The patient should have appropriate jawbone structure for this treatment. It prevents bone loss in the location of the lost teeth and does not cause abrasion in the adjacent teeth, which are the most significant advantages for the patient. Designed to fit into the patient’s mouth, they satisfy expectations in proper lining of teeth, smile design and aesthetic appearance. While variable due to bone structure, they usually offer a long usage life. They can be designed to be removed only by the patient or as removable by the patient. Over-implant prostheses are categorized in two groups; namely, fixed prostheses and mobile prostheses. The dentist determines the type of prosthesis to be used in line with the patient’s oral and dental structure, number of teeth and the bone structure.
Over-implant fixed prosthesis is applied as porcelain crowns over one or more teeth. Tek kron olabileceği gibi tüm protez şeklinde de olabilir. It is selected in line with the patient’s complaints, oral, dental and bone structures. Measurements are made accordingly to prepare prostheses that will provide an aesthetic appearance and the functionality of the lost teeth.
Over-implant mobile prostheses are applied in the case of full dental loss. Mobile prostheses present certain challenges in use, making this option more preferable to the patient. Compared to mobile prostheses, they are easier to maintain and use. The implants are placed in the jawbone and used as support for the prosthesis. The number of implants to be placed in the jawbone is determined by the physician considering the patient’s condition.
Dental prosthetic surgery prices vary by a number of factors. Patient’s health insurance, the organization performing the surgery, the surgeon performing, the city and even the neighborhood, the methods and materials used in the surgery are some of the factors. Even if the patient has health insurance, the Social Security generally does not cover intraosseous implants, except in certain cases. There may also be additional charges involved in university hospitals. The Turkish Dental Association publishes an annual price list; but this list serves as the minimum threshold. The price may increase due to the reasons mentioned above.
Dental prostheses should be cleaned regularly to have proper oral health. Regardless of the type of prosthesis, failure to clean the prosthesis will lead to bacterial accumulation between the prostheses, leading to gingival issues, decay, staining and bad smell. The area under moving prostheses are moist and ideal for microorganisms; failure to care for the prostheses properly may lead to oral fungal infections. These issues will negatively impact the aesthetic and medical condition of the patient.
Dental prostheses mean regaining lost functions as well as ensuring aesthetic appearance and pleasing smile. Neglecting the cleaning and care of the prostheses, regardless of the type of prosthesis, will lead to certain issues. Some of these issues affect the appearance of the prostheses. The surface of prostheses is more gripping than dental surfaces. Thus, they are prone to plaque formation. Prostheses, if not cared for and cleaned, will lead to bacterial proliferation and staining. This disrupts the aesthetic appearance of prostheses.
Neglecting the care of prostheses leads to the proliferation of microorganisms and tartar. These lead to oral infection. It causes oral rashes, dry mouth and burning. Swallowing and chewing becomes harder. Gingiva may swell and occasionally bleed. For mobile prostheses, the soft tissue under the prosthesis is moist, making it suitable for microorganisms. Neglecting the care and cleaning of the mobile prosthesis may lead to fungal infections. In such cases, the prostheses may have to be re-made.
While foul breath may stem from many reasons, improper care of prostheses may be one of those reasons. When prostheses are not cleaned, bacteria, various infections and tartar formation follow. This leads to bad breath. Bad breath disturbs the patient and makes them isolate from social life and feel bad.
Oral hygiene cannot be ensured when the prostheses are not cleaned. This causes a variety of lesions in the mouth. These lesions cause pain, oral bleeding and may be infectious and recurring. Generally, these are harmless and will recover on their own within 2 weeks.
The time of dental prosthesis operation depends on the number of teeth being treated, gingival health, the method used in the operation and the type of prosthesis used. For example, it may take from 30 minutes up to 2 hours depending on the number of teeth receiving an implant and the patient’s bone structure.
In surgery, local anaesthesia, general anaesthesia and sedation methods are used. The type of anaesthesia used depends on how calm the patient is, the extent of the operation and the oral structure. Local anaesthesia is most commonly used in these surgeries. General anaesthesia or sedation is preferred, with expert assistance, in large-scale surgeries where multiple operations are to be performed at once, where oral structure is problematic or for patients with mental disorders or persons who are very scared. The patient’s health should be appropriate for general anaesthesia.
After the dental prosthesis surgery, the patient should first be informed of possible side effects and take precautions accordingly. In case of pain, the painkillers prescribed by the physician should be available. Due to possible difficulty in opening and closing the mouth and chewing functions after the surgery, hard and solid food should be avoided, porridge and similar food is more suitable. After the surgery, sucking, mouth-washing, spitting and similar actions that may cause bleeding should be avoided. To minimize swelling, cold press should be applied during the first 24 hours after surgery. Special attention should be paid to oral hygiene. Patients should start brushing their teeth and using antiseptic mouthwash a day after the surgery. The prostheses should be cared for and cleaned regularly. Doctor visitations must not be neglected.
Dental prosthesis treatment can be used for anyone with proper general health. It can be used for patients who lost all their teeth, patients with a single lost tooth and partial tooth loss, patients with misshapen teeth and patients with worn-out teeth. The only requirement is for the patient to have the appropriate bone structure.
Partial prostheses are mobile prostheses used to fill in the space of missing teeth. They can be removed and cleaned by the patient. They can be made of acrylic or metal materials. Some varieties are connected to adjacent teeth for support. Partial prostheses made of acrylic do not contain metal hooks. Metal hooks (crochets) cause an aesthetically unpleasant view.
The fixed prosthesis procedure takes a few sessions. After the oral examination, x-ray imaging and treatment decision-making process, the tooth to be treated is cut, prepared and measured. The prostheses are produced per measurements and tried on. If there are no issues, and no changes are required in the prosthesis, they are sent off for polishing. The polished prosthesis is fixed on the patient’s tooth with special adhesives.