What are fixed dentures?
Fixed dentures allow missing or damaged teeth to be replaced. They are fixed because they are permanently affixed, that is, they cannot be removed independently.
They are cemented to natural teeth.
Fixed dentures
Replaces missing teeth.
Restores destroyed teeth.
Improves aesthetics.
The types of fixed prostheses
Crowns.
Bridges.
Veneers.
Inlays.
Maryland bridge.
California bridge.
What are the advantages
Aesthetic and functional.
The benefits
Fixed prosthetics has the primary function of restoring full function to the existing tooth and replacing it if it is missing.
It improves and perfects aesthetics. It is the details that make the difference.
It facilitates daily oral hygiene by improving the anatomical shape of teeth.The best material for making fixed dentures is zirconium-ceramic: zirconium for the inner layer, ceramic for the outer layer.
The materials
It is a biocompatible material that provides solidity and strength to the prosthesis and, thanks to its translucency, is practically the same as a natural tooth.
Zirconium-ceramic capsules do not have black edges and it is very difficult to distinguish them from natural teeth.
In some cases lithium disilicate (inlays), a material very similar to zirconium ceramic, is used. Only in very rare cases is metal-ceramic (gold) used.
Types of fixed dentures
Single crown
The crown is a prosthesis for a single tooth that has lost a lot of tooth substance but still has a root. It is cemented to the appropriately prepared tooth (abutment). The crown makes it possible to recover a destroyed tooth and preserve it for many years.
Bridge
The bridge allows the rehabilitation of areas where a tooth has been lost by taking advantage of those still present. The bridge can be applied in a space between two existing, anatomically sound, firmly rooted teeth (bridge abutment teeth) that have been properly prepared.
The application of the bridge is an established technique without surgery. In cases where the abutment teeth are compromised, treatment and filing are necessary.
When applying a single block, daily hygiene may be more difficult but should be carried out thoroughly on a daily basis, using toothbrushes and super floss. It is important to maintain healthy abutment teeth.
Veneers
Veneers are thin ceramic foils that are cemented onto the outer (vestibular) surface of teeth that are visible when smiling.
The natural teeth are suitably prepared, with a light filing, to accommodate the veneers, removing a light layer of enamel, while retaining the larger part of the teeth.
Other types of fixed prostheses
Veneers
Veneers are thin ceramic foils that are cemented onto the outer (buccal) surface of teeth visible when smiling.
Natural teeth are properly prepared, with light filing, to accommodate the veneers, removing a light layer of enamel while retaining the major portion.
Inlay
Is applied to posterior teeth (molars and premolars) when they have lost more than half of their crown. It is a minimally invasive technique that allows the missing part of the tooth to be reconstructed in the laboratory and then cemented over the remaining part.
Maryland Bridge
This is a special type of bridge indicated in cases of single-element loss in the anterior area of the dentition. It is bonded to the inner part of the abutment teeth with micro-alignments. It is a simple, fast, aesthetically very good prosthetic intervention. In 15 days it is possible to have one's tooth back.
It can be an alternative to an implant, especially if there is a lack of bone.
California Bridge
Has the same characteristics as the Maryland Bridge and is used in the posterior area of the dentition. Micro-alignments are bonded into the chewing part. The California Bridge can also be an alternative to the implant, especially in cases of lack of bone.
Temporary resin crowns (temporary teeth)
Before finishing the work perfectly, provisional elements must be applied with a special cement that can be easily removed in the intermediate stages of control and intervention.
The temporary remains in the mouth for 2 to 6 months because it
it helps tissue healing;
immediately rehabilitates functionality and aesthetics;
covers limited teeth, preventing sensitivity and caries;
it serves to test the parameters for the definitive work.
During this period it is necessary to monitor the situation. If movement is felt, timely intervention is necessary to restore proper cementation.
In more complex cases, more than one set of temporary teeth may be required.
Clinical cases
The phases of the route
Impression and analysis
The impression, analog or digital, is used to build the "study model" to understand what the future situation in the mouth will be. Analysis of the impression allows the future state to be visualized and the first temporaries to be made.
1
Final impression
After the expected results are obtained and teeth and gums are in optimal condition, the final impression, the one on which the permanent prosthesis will be built, can be taken. In the case of an analog impression, high-performance and precise materials are used. For digital impressions, on the other hand, an intraoral scanner (specific camera) is used. The goal is to obtain an exact copy of the teeth and gums. The dental technician uses the impression to build the exact model of the mouth on which he or she will then make the final work.
3
Prosthesis trial
The trial is necessary to verify accuracy, functionality and aesthetics of the prosthesis. The temporary is removed, the prosthesis is inserted, and, together with the patient, the result is evaluated and whether any changes are needed. If necessary, additional impressions are made. The temporary is reassembled, so as to give the patient maximum comfort while waiting for the final delivery.
5
Placement of the resin crown (provisional)
The teeth are prepared for the insertion of the resin crown. Although made to size, the crown must be adapted to the actual state of the mouth (relining). The clinician defines the time required for the temporary to produce the desired effects. Checkups are necessary during the period.
2
The fabrication of the prosthesis
The dental technician makes the precise "heart" of the prosthesis using biocompatible materials (zirconia, ceramic, disilicate). This "core" must fit perfectly to the margin of the tooth and gingiva. At this point, the tooth is 90% completed for the first try-in.
4
Final examination and delivery
The dental technician completes the prosthesis on the indications received. If necessary, a second trial is made. Otherwise, the finished work is delivered. After the removal of the provisional, the final prosthesis is cemented in, often permanently but sometimes with temporary cement to allow for a better fit. After about 10 days, an initial check is made to verify proper closure and function.
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