Prosthodontics

Bridges

A bridge is one of the few options that you have when deciding how to deal with a missing tooth or teeth. The replacement of these missing teeth is necessary in order to maintain the proper mouth functions. Tooth loss can affect the way you eat AND speak.

Types of Bridges

A bridge, by definition, is a link or connection between two permanent structures. A dental bridge is very similar in that it attaches the restorative teeth (bridge) to the natural teeth on either side of the gap. This bridge acts as your new teeth, closing the gap and restoring your smile. Bridges are often constructed of gold or metal foundations with porcelain fused to the foundation. This ensures that the bridge will support the normal functions of the mouth.

There are three main types of bridges:

Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics.
Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth.
Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of porcelain teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth.

Procedure

The procedure begins with preparation of the natural teeth, or abutments. We will shape the abutment teeth so that the ends of the bridge will fit comfortably on each one. The next step is to take an impression of the area. This impression will be sent to our lab where your new restoration will be crafted. While this new tooth is created, we will provide you with a temporary restoration. Our temporary restorations will resemble your natural teeth so that you can continue with your daily life without worrying about a missing or unattractive tooth.

During your second visit to the office, we will proceed with the placement of your final restoration. This bridge will be fitted comfortably into the mouth. We will make every effort to ensure that the new bridge feels exactly like your natural teeth. The final step in the process is to cement the bridge into your mouth, leaving you with a beautifully restored smile.

Full and Partial Dentures

Tooth loss can occur for many reasons (periodontal disease, decay or trauma). Dentures have been used to replace missing teeth for many years now. Alternative methods used to replace missing teeth include dental implants and fixed bridges.

The loss of your teeth can have negative effects on your self-confidence, your ability to chew food and your bite. Since your teeth provide structure and support to your cheeks, tooth loss can result in the sagging of your cheeks and make you appear older than you are. It is essential that your missing teeth are replaced as soon as possible.

Dentures are removable replacements for your teeth, designed to look and function like your own natural teeth and surrounding gum tissues. Modern-day dentures can look very realistic and natural and feel comfortable.

Types of dentures

When all your teeth are missing, a complete denture is used to replace them, whereas if only a few teeth need replacing, a partial denture or overdenture is used. Partial dentures can prevent your existing healthy teeth from shifting following tooth loss.

Dentures are generally fabricated from acrylic resins. With advances in modern cosmetic dentistry, there are a wide variety of materials available for dentures, and your dentist may give you some options, including the latest flexible Valplast cosmetic dentures.

Holding dentures in place

Dentures should be held in place by their natural suction to your gums; sometimes a fixative may also be used. However, they tend to come loose and this can cause difficulties when trying to eat certain foods.

Dentures can be fixed securely in place by dental implants or mini implants, which can give you the confidence to eat whatever you want without having to worry about your dentures coming loose or falling out. More patients seem to be opting for treatment with implants now. Despite their high cost, they have a dramatic effect on improving the quality of life.

How should I look after my dentures?

It is important to keep your dentures clean at all times. You should remove your dentures at night to give your gums “a rest” and the chance to be exposed to your natural saliva, which will keep them healthy. It is highly recommended that you brush your dentures and soak them in a glass of cold water whilst you aren’t wearing them. You can add special cleaning tablets to the water when you soak your dentures.

Always brush your dentures before putting them back into your mouth. If your dentures begin to collect debris or stains that you cannot remove by normal brushing, your dentist or hygienist will be able to professionally clean your dentures for you.

It is important to visit your dentist regularly to ensure that your dentures are in good condition and continue to fit your gums, as the shape of your gums and underlying bone can change with time. Loose fitting dentures can cause irritation and inflammation of your gums and problems with eating and speech.

How long do dentures last?

This depends on many factors, including how you take care of them and also how much you use them in terms of general wear and tear. Over time, dentures can become loose as your gums shrink and your bite changes. When this happens, you may need a new set of dentures, or in some cases, a simple modification of your existing dentures may solve the problem.

The Procedure

On your first appointment, your dentist will assess your needs and thoroughly examine your mouth for suitability for dentures. Some of your existing teeth may need to be extracted first or you may need treatment to get your gums into good health before commencing any treatment.

An impression (mould) of your gums will be taken and used as a model to fabricate your dentures to fit the contours of your mouth exactly. A dental technician will make your dentures to your dentist’s exact specifications.

Immediate dentures

In cases where teeth need to be extracted, the structure of your gums and surrounding tissues needs to heal before your final dentures are made. In such cases, an immediate denture will be placed to enable the gums and surrounding tissue to heal properly. Immediate dentures can be easily modified during the healing process, which could take several months.

CROWNS AND BRIDGES OVER IMPLANTS

Another option for the replacement of missing teeth is the use of dental implants. These are used not only in patients that have lost teeth due to caries and periodontal diseases, but also to restore form and function in patients treated for trauma, hereditary tooth defects, and other abnormalities.

Where there are no natural teeth, implants can be used to anchor or support individual crowns.

They may also support bridges, which can replace several missing teeth.

Replacing a Single Tooth


Before		After

If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.

What are the advantages of a single-tooth implant over a bridge?

A dental implant provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported fixed bridge, requires that adjacent teeth be ground down to support the cemented bridge.

Because a dental implant will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

In the long term, a single implant can be more esthetic and easier to keep clean than a bridge. Gums can recede around a bridge, leaving a visible defect when the metal base or collar of the bridge becomes exposed. Resorbed bone beneath the bridge can lead to an unattractive smile. And, the cement holding the bridge in place can wash out, allowing bacteria to decay the teeth that anchor the bridge.

How will the implant be placed?

First, the implant, which looks like a screw or cylinder, is placed into your jaw. Over the next two to six months, the implant and the bone are allowed to bond together to form an anchor for your artificial tooth. During this time, a temporary tooth replacement option can be worn over the implant site.


Before	After

Often, a second step of the procedure is necessary to uncover the implant and attach an extension. This small metal post, called an abutment, completes the foundation on which your new tooth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.

There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.

Finally, a replacement tooth called a crown will be created for you by your dentist and attached to the abutment. After a short time, you will experience restored confidence in your smile and your ability to chew and speak. Dental implants are so natural-looking and feeling; you may forget you ever lost a tooth.

Replacing Several Teeth

If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

What are the advantages of implant-supported bridges over fixed bridges or removable partial dentures?

Dental implants provide several advantages over other teeth replacement options. In addition to looking and functioning like natural teeth, implant-supported bridges replace teeth without support from adjacent natural teeth. Other common treatments for the loss of several teeth, such as fixed bridges or removable partial dentures, are dependent on support from adjacent teeth.

In addition, because implant-supported bridges will replace some of your tooth roots, your bone is better preserved. With a fixed bridge or removable partial denture, the bone that previously surrounded the tooth root may begin to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.

In the long term, implants are esthetic, functional and comfortable. Gums and bone can recede around a fixed bridge or removable partial denture, leaving a visible defect. Resorbed bone beneath bridges or removable partial dentures can lead to a collapsed, unattractive smile. The cement holding bridges in place can wash out, allowing bacteria to decay teeth that anchor the bridge. In addition, removable partial dentures can move around in the mouth and reduce your ability to eat certain foods.

How will the implants be placed?

First, implants, which look like screws or cylinders, are placed into your jaw. Over the next two to six months, the implants and the bone are allowed to bond together to form anchors. During this time, a temporary teeth replacement option can be worn over the implant sites.


Before	After

Often, a second step of the procedure is necessary to uncover the implants and attach extensions. These small metal posts, called abutments, complete the foundation on which your new teeth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure. Dental implants are so natural-looking and feeling; you may forget you ever lost a tooth.

Finally, replacement teeth, or bridges, will be created for you by your dentist and attached to the abutments. After a short time, you will experience restored confidence in your smile and your ability to chew and speak.

Maryland Bridge

What is Maryland Bridge?