Fixed Prostheses

Prosthesis is the process of artificially repairing the deficiency of an organ or part of it and improving its function. In dentistry, dental prosthesis is a personalized procedure that replaces missing teeth and atrophic parts of the gums. There are two main types of dental prostheses : fixed and removable prostheses. [one]

What is a prosthesis?

prostheses are needed to restore damaged, unaesthetic or dysfunctional teeth or to replace one or more missing natural teeth .

this restoration is to rehabilitate the patient's chewing function . This means that the individual geometry of dental prostheses is necessary to establish appropriate and efficient occlusal contacts.

dental prostheses to be long-lasting and high-performance, attention should be paid to factors such as durability, fatigue resistance and intra-oral aging resistance. In addition, signs of pulpitis or other negative conditions in the natural tooth should be taken into consideration before treatment .

dental prostheses, the wear level and wear resistance of the opposing natural teeth are also among the factors that need to be evaluated. Excessive wear of dental tissue by dental prostheses should be prevented as it may endanger the health and function of adjacent natural teeth.

An important parameter used to evaluate the success of dental prostheses is the patient's comfort. From this perspective, it can be easily noticed that fixed dentures are preferred over removable dentures . [2] At this point, what is important is to make patient-specific preferences; sometimes the general health condition and patient-specific factors may require the preference of removable prostheses .

What is Fixed Prosthesis?

Fixed prostheses ; It refers to non-removable dental restorations such as crowns, bridges or implants applied to replace missing teeth in the mouth. Unlike removable dentures that can be removed and installed by the patient , fixed dentures can only be installed and removed by dentists. [3]

prostheses , which are considered the gold standard for eliminating tooth deficiencies ; It can be applied to replace the entire row or single teeth or both in the upper or lower jaw. Fixed dentures are carefully designed to resemble the patient's own natural teeth with a realistic appearance. [4]

Fixed prostheses allow teeth to be restored using restorations that are fixed to the patient's mouth. Fixed dentures, also known as indirect restorations , can be used to restore and repair single or multiple teeth or to eliminate relatively small gaps between teeth. [5]

What are the Types of Fixed Prosthesis?

Tooth loss due to various reasons can occur at any age. Tooth loss can damage chewing functions and cause the patient's appearance to deteriorate aesthetically.

, it may be necessary to make fixed prostheses using the best materials and with a good design that will complement the aesthetic appearance of the patient . Fixed dental prostheses used to replace missing or damaged teeth cannot be removed by the patient because they are bonded to natural teeth or artificial roots. There are different types of fixed dental prostheses . [6]

crown

Over time, due to various reasons, teeth can be damaged due to decay, trauma or simply use. Accordingly, deformation may occur in the shape or size of the teeth. Dental crowns are tooth-shaped coverings that can be placed on the tooth in such cases.

Crowns, which are a new coating for damaged teeth, can be made with metal-supported porcelain or zirconium. Crowns, which are prostheses that mimic natural teeth, are placed on damaged or decayed teeth.

Providing long-term and effective solutions for chipped, worn or cracked teeth, crowns are considered a relatively permanent solution. The lifespan of crowns, also called veneers, is around 10 years if they are properly maintained. [7]

Crowns can be placed on implants or natural teeth. These features add a versatile quality to crowns. They require significant shaping of the surface of the healthy tooth before they can be cemented correctly .

They play an important role in fulfilling chewing functions as well as in aesthetics. One of the biggest advantages of crowns is that they naturally fit into the mouth and do not cause the patient to feel uncomfortable about using a prosthesis . [8]

Crowns placed on damaged teeth are generally applied to protect and cover the teeth and thus regain their former shape when filling treatment does not solve the existing problem. Dental crowns, which can be made of metal, porcelain, resin and ceramic, typically do not require special care other than regular, correct and adequate oral hygiene . [9]

Bridge

can be defined as a type of prosthesis made of one or more false teeth called pontics, which are fixed to the natural teeth at both ends of the gap in order to close the gaps caused by missing teeth .

Bridges are usually made of zirconium or porcelain to resemble natural teeth. Dental bridges; There are different types such as traditional bridge, winged bridge and Maryland bridge.

Traditional bridges, the most popular type of bridge, consist of a denture or teeth held in place by dental crowns that are cemented onto each abutment tooth. It is a method that can be used if there are natural teeth on both sides of the gap created by the missing tooth.

Winged dental bridge is similar to traditional bridges, but the missing tooth is supported by the abutment tooth on only one side. To make a winged bridge, it is sufficient to have only one natural tooth next to the missing tooth gap.

A Maryland dental bridge is a similar alternative to traditional bridges. In this method, two natural abutment teeth are used, one on each side of the gap. While dental crowns are used on the abutment teeth in a traditional dental bridge, a metal or porcelain framework is used behind the abutment teeth in the Maryland dental bridge. Again, like traditional dental bridges, it can only be applied if there is a natural tooth on both sides of the missing tooth or the gap caused by the teeth.

Fixed Implant Prosthesis

Implant -supported fixed prostheses are at the forefront with their benefits both functionally and aesthetically. They are very similar to the patient's own natural tooth structure. There is a significantly reduced mass compared to other types of fixed dentures , and since no mucosal support is needed, patients can chew with more force and consume a wider range of foods with comfort. [10]

An implant- supported dental bridge uses dental implants , as opposed to crowns or frames . Implants are surgically placed for missing teeth . Implants keep the bridge in place. An implant is not required for every missing tooth , and in these cases, the bridge may have a pontic or pontics suspended between two implant- supported crowns .

What is the Most Preferred Type of Fixed Dental Prosthesis?

Although the most preferred fixed dental prosthesis is the bridge, implant- supported fixed prostheses stand out with their advantages in many aspects. However, what is important is to choose and apply the fixed dental prosthesis that will provide the highest efficiency according to the patient's structural characteristics and needs .

In Which Situations Is Fixed Prosthesis Applied?

Fixed prosthesis ; It is applied in cases where the patient has a single tooth deformation, a single tooth missing, or more than one tooth missing, provided that there are teeth on the side(s). However, whether the patient is suitable for fixed prosthesis applications is determined on an individual basis as a result of detailed examination and x-ray imaging.

How Many Teeth Are Required for a Fixed Denture?

a fixed prosthesis may vary depending on which type of fixed prosthesis will be applied. Although fixed prostheses generally require a strong and long-rooted tooth to hold the prosthesis on both sides of the gap, there are also types of fixed prostheses that can only be applied to a single tooth.

How to Attach a Fixed Denture? What are the Stages of Fixed Prosthesis Construction?

The construction stages and attachment methods of fixed prostheses may differ depending on the type of fixed prosthesis chosen. However, there are certain criteria that must be followed during the construction stages .

fixed prostheses are installed, the teeth adjacent to the tooth subject to treatment must be prepared. In this context, if there is decay in the teeth, the decay should be cleaned and prepared for fixed prosthesis applications.

Necessary measurements should be taken on the teeth to be restored and a model should be created in a laboratory environment. Color determination must be made to obtain the image closest to the patient's natural teeth.

Then, the relationship and compatibility of the fixed prostheses prepared in the laboratory with the neighboring teeth and tissues should be checked and the patient's approval should be obtained. Fixed dentures sent to the laboratory for polishing should be tested once more in the mouth before being fixed. If there are no problems, the prostheses should be fixed and the process should be completed.

Is Fixed Dental Prosthesis Painful?

fixed dental prosthesis application, no pain or suffering is felt during the treatment. However, temporary pain may be felt during the adaptation process after the treatment . In such a case, the pain problem can be eliminated by using painkillers recommended by dentists.

How many sessions does it take to complete fixed prostheses?

fixed dentures may vary depending on the scope of the treatment to be applied, which material will be used, whether coating will be applied or not, and similar factors. Fixed prosthesis treatment is usually completed in 3 to 4 sessions.

Things to Consider Before Fixed Prosthesis Treatment

fixed prosthesis treatment, a detailed dentist examination must be performed. Thus, it is possible to accurately evaluate the patient's oral and dental structure and needs. If there are treatments that need to be applied before fixed prosthesis treatment, pre-prosthetic surgical procedures can be applied. After the fixed prosthesis treatment is planned according to the patient's needs, the application phase begins.

Things to Consider After Fixed Prosthesis Treatment

Very cold and hot drinks should not be consumed and solid foods should not be eaten for the first hour following the permanent bonding process performed within the scope of fixed prosthesis treatment. If local anesthesia was applied during gluing, care should be taken not to bite soft tissues such as tongue, lips, and cheeks until the numbness subsides.

fixed prosthetic teeth are installed, the consumption of foods that require excessive pressure on the area, such as nuts, cracking peanut shells, opening bottle caps with the teeth, should be avoided.

Temporary cold-hot sensitivity may be experienced after fixed dentures are installed. In order for fixed dentures to be used for a long time and healthily, attention should be paid to oral and dental care.

What are the advantages of fixed prostheses?

Dental bridges have several positive effects, which explains their frequency of use in restorative dentistry. First, fixed dentures are an effective solution for replacing missing teeth in the mouth, offering both functional and aesthetic correction.

In terms of function, fixed dentures allow the patient to chew and eat normally as there is no longer any space in the jaw. It can help the patient speak unimpeded by filling dental gaps that can change the placement of the tongue and the way sounds are produced in the mouth.

Aesthetically fixed dentures can compensate for the loss of original teeth, especially if the color matches the surrounding teeth. This can help increase self-esteem and confidence in patients who are distressed by their appearance due to missing teeth.

Fixed dentures can also provide benefits for the long-term health of the mouth. Under normal circumstances, the gap in the jaw can cause the teeth to gradually change position and spread, causing biting problems.

In contrast, when fixed dentures are used to fill the gaps of missing teeth, the teeth on both sides are held firmly in place to reduce the risk of movement and related biting problems. Additionally, the risk of bone loss from the jaw is reduced and the facial structure is preserved.

Many patients prefer fixed dentures because they provide comfort in the mouth and are easy to maintain. It usually takes a short time for the patient to get used to fixed prostheses . Later, they are hardly noticeable as part of the mouth structure. Fixed dentures do not need to be removed regularly and can be cleaned by brushing like natural teeth.

What are the Disadvantages of Fixed Prostheses?

There are also several disadvantages associated with the use of fixed dentures in restorative dentistry . After fixed dentures are installed, in some cases, the healthy abutment teeth that hold the pontic in place and are located on both sides of the gap may be damaged. If bridges and crowns do not fit well and do not allow plaque and bacteria to penetrate underneath, there is a risk of decay. In addition, the structure of the teeth may change after the placement of crowns and bridges.

In some patients, the supporting abutment teeth are not strong enough to hold the bridge and may collapse. This may cause additional problems that need to be addressed and may make the situation worse. In more severe cases, it may be necessary to replace the abutment teeth with dental implants .