PROSTHETIC DENTAL TREATMENTS

1- Fixed Prostheses

Fixed prosthesis is the most commonly used type of prosthesis to replace missing teeth in today's oral and dental health field. These prostheses, which help to replace the missing teeth, are applied with the help of a dental implant or a dental bridge on the adjacent teeth.

People with missing teeth face the problems of not being able to speak properly and staying away from aesthetics, especially the chewing function not working properly. The methods used to overcome such problems have made progress in parallel with the developments in the world of medicine and technology from the past to the present.

Fixed prosthesis is a conventional method and one of the most commonly used methods. The facts that the materials used in prostheses are resistant to chewing force, have aesthetic properties and show a good level of adaptation to the tissues are among the main reasons for its preference.

This type of prostheses are applied by using patient's own teeth. Abrasions are made on the teeth and these prostheses are placed on the teeth as veneers. These veneers are adhered in the mouth with a special dental bonding material. While fixed prosthesis is being made, it may be required to make some teeth in the mouth smaller in order to support prostheses. With fixed prostheses, chewing will be easier and more comfortable. In fixed prostheses, single crowns are applied as a cap on the single tooth. Dental bridges, on the other hand, are applied by covering the missing teeth and supporting it with adjacent teeth.

Types of fixed prostheses:

2- Metal-supported prostheses: Although this type of prosthesis is durable in terms of chewing force, it is not a very preferable option in terms of aesthetics. This is mainly because the light passes directly through the tooth. This may cause problems in terms of aesthetics.

Can it be used as an abutment in every dental bridge prosthesis?

It cannot be used as an abutment in every dental bridge prosthesis. First of all, the physician must examine the x-ray imaging of the patient and accordingly make a decision. It is necessary that the roots of the tooth to be used as a dental bridge foot are long and the level of support is good.

Can Fixed Prostheses be used as abutment of a single dental bridge?

Canine teeth are rarely used as abutment of a single dental bridge. This type of prosthesis used in the restoration of lateral teeth is called "Maryland bridge". In this type of prosthesis, it is of big importance that the roots are long and the bone is solid.

Should all dental bridges be supported by two adjacent teeth?

Although all dental bridges are generally made with the support of two adjacent teeth, this may vary depending on the number of tooth gaps and bone structure. The course of action is determined by the dental specialist.

Is it possible to use dental bridge prostheses while eating?

Dental bridge prostheses, which are durable and have an extremely strong chewing force, can be used while eating, just as natural teeth.

Do dental bridge prostheses cause bad breath?

Properly applied dental bridge prostheses do not cause any bad breath, provided that attention is paid to daily oral hygiene. Bad breath problems do not occur in people who perform daily oral and dental care.

3- Removable Prostheses

The removable prosthesis is a dental restoration treatment that allows it to be removed from the mouth at will. It is a type of treatment applied to patients in cases where dental bridge prostheses cannot be applied due to the fact that too many missing teeth are available. Removable prostheses are divided into two as full prostheses and partial prostheses. Especially in full prostheses, the patient's adaptation to the prosthesis occurs over time. In this process, bumps or redness may occur in some areas and this is quite normal. Removable prostheses are applied depending on the number of teeth, not on the age. There is a general opinion among the public that this type of prostheses are made in the old age and are related to age. But this is completely about the number of teeth. Depending on how many missing teeth you have, a removable prosthesis can be preferred. Of course, it is mostly used in the elderly, as tooth loss occurs when we get old.

4- Total Prostheses

They are mainly intended for edentulous patients.

5- Partial Prostheses

They are applied to partially edentulous patients. Retention is provided with attachments and hooks on the teeth.

6- Precision Attachment Partial Prostheses

They are intended for partially edentulous patients. They are aesthetic prostheses that do not have any visible apparatus such as hooks. In cases with suitable tooth and bone structure, aesthetic defect caused by clasps is prevented by placing sensitive attachments.

Advantages of precision attachment partial prostheses:

- A better aesthetic appearance
- More comfortable use and adaptation than conventional prostheses
- Better retention and stability

7- Implant-Supported Prostheses

Fixed type:  It refers to dental bridges and crowns, which are supported by dental implants.

Removable type:  Preferred in patients with insufficient bone support, this type of prostheses is similar to total prostheses with very high retention, which are supported by dental implants.

Implant-Supported Prostheses

Patients who are edentulous and have a healthy bone structure can use implant-supported prostheses. In cases where removable prostheses are used, dental implants are used in completely edentulous patients to support the bone structure and increase the chewing force.

Patients with missing teeth mostly use implant-supported prostheses among prosthesis options. In this type of prostheses, fixed or removable prostheses placed on the dental implants and supported by dental implants are used. This treatment, which can vary according to the patient's health status and demand, is decided by the physician. Patients who are edentulous and have a healthy bone structure can use implant-supported prostheses. In cases where removable prostheses are used, dental implants are used in completely edentulous patients to support the bone structure and increase the chewing force. With the use of dental implants, it is aimed to achieve a more comfortable use of prostheses.

Who is the ideal candidate for implant-supported prostheses?

According to the size of the jaw, placement of 4-6 dental implants in the lower jaw and 6-8 dental implants in the upper jaw is considered to be sufficient for edentulous patients. For removable prostheses, fewer dental implants are sufficient. For removable prostheses, placement of 2-4 dental implants in the lower jaw and 4 dental implants in the upper jaw is considered to be sufficient. For implant-supported prostheses, a minimum of 2 and a maximum of 8 dental implants can be considered to be sufficient.

How to care for implant-supported removable prostheses?

• The implant-supported removable prostheses should be cleaned twice a day and should be removed at night to feel comfortable while sleeping.
• The surrounding of the dental implant and attachments also need to be carefully brushed.
• Prostheses are supported by rubbers, but they can lose their retention over time.
• Implant-supported removable prostheses should be cleaned and maintained by a dental specialist every 3-6 months throughout the year.

How to care for an implant-supported dental bridge?

• Implant-supported dental bridges should be brushed twice a day, just like regular dental care.
• The cleaning of the intermediate part between the prosthesis and the gingiva should be done with an interface brush.
• It is recommended that the patient see the dentist every 3-6 months throughout the first year in which the patient starts wearing the prostheses.

All on 4 Prostheses

All on Four is a more practical and faster method than other conventional dental implant treatments. If the required conditions are met and the dentist approves that the patient has the appropriate bone structure, all procedures can be completed within one day.

All on Four is a dental implant technique developed by Nobel Biocare. Being active in this sector since the 1960s, Nobel Biocare is one of the largest and most well-established companies, considering both European and world markets. The dental implants produced by Nobel Biocare are accepted all over the world and are used safely.

The All on Four technique was first tested by Nobel Biocare in 1998 and has since been used safely in hundreds of thousands of edentulous patients. Up to that date, there were two major disadvantages of dental implants. Firstly, edentulous patients had to pay very high prices for dental implant treatment. Secondly, it was often difficult for dentists to find a bone in suitable conditions where the dental implant would be placed. All these problems have been a thing of the past since the invention of the All-on-Four technique.

How is the All-on-Four Technique Applied?

Contrary to what is thought, All on Four is a much more practical method compared to other known methods. If the required conditions are met and the dentist approves that the patient has the appropriate bone structure, all procedures can be completed within one day.

First of all, it is determined by the dentist that the necessary conditions are met for the application of the All-on-Four technique. In order to complete these determinations in a healthy way, the use of computerized tomography and dental film may be required. If the patient is deemed suitable for this procedure, the second step is started.

In the second step, 4 implants, two of which are straight and two of which are inclined at an angle of 45 degrees, are placed in the jaw where the procedure will be performed and fixed. In the last step, the pontics are aligned with the dental implants and inserted in place. A dental implant applied with the All-on-Four technique can be completed in as little as half an hour if the necessary preparations are provided completely.

What are the Advantages of All on Four Technique?

• It is more affordable. Compared to conventional techniques, dental implant applications made with the All on Four technique are much cheaper.

• The time required for application is less. Thanks to the 45 degree inclined dental implants, the need for bone grafting, which takes a very long time, is eliminated. However, the use of the appropriate bone naturally found in the jaw and palate gives a great momentum to the treatment process.

• It is healthier than other techniques. Since it does not interfere with the natural structure of the body and bones, it has no negative effects on general health.

• It provides a fast healing process. In dental implant applications performed with the All on 4 technique, the patient usually gets used to their new teeth on the day of the surgery. Functions such as speaking and eating are restored to their former healthy situation from the first day.

• A perfect adaptation is achieved. Dental implants made of titanium ensure a perfect fusion with the natural structure and show a compatibility of 100%. They are welcomed as if they were a part of the body.

• Dental implants remain solid for many years. Long-term use tests have been carried out on thousands of patients for dental implants applied with the All on 4 technique. During the 5-year period, 98.3% of the patients did not make any complaints. In a longer study of 10 years, 95.8% of the patients stated that they did not have any complaints.

Cleaning of Removable Prostheses

Daily cleaning and upkeep of your prostheses is important in order to prevent plaque, food residue and tartar formation. Regular care is essential to protect the health of the tissue under the prosthesis and to prevent infections. After meals, wash your prosthesis in water to remove food residues. Before going to bed, you should brush your prosthesis using water, various toothpastes or prosthesis care products. Abrasive powders should not be used in the brushing process, as abrasive powders may cause damage to the surface of prostheses. Special prosthesis brushes or normal toothbrushes can be used for brushing. In addition to daily brushing, chemical weekly care for prostheses should also be performed using special effervescent denture cleaning tablets. Despite all this care methods, stains and tartar that penetrate into the denture over time can only be cleaned with ultrasonic tools and the polish of your denture is renewed by your dentist. Please note that you should visit your doctor regularly every six months, so that you can use your prostheses as they were on the first day for a long time.