Prosthetic aesthetic dentistry

Which denture?

As there are many possible dentures, the orthodontist will evaluate the best solution to renovate the patient’s smile, depending on his/her needs. In order to have a better understanding, we will now present the main types of dentures.

Mobile prosthetic dentures

Mobile prosthetic dentures are removable appliances used to replace missing natural teeth. This type of denture represents a more traditional and low-cost choice, usually used for elderly patients or as a temporary solution in treatment plans which require a bone regeneration. It is faster during the intervention and to create the appliance, but it has a lower comfort level compared to other possible solutions and it requires a progressive adjustment period of the mouth and the patient needs to remove it daily to perform an oral hygiene.

It can be:

• total when the dental arch is completely missing all the dental elements and remains attached to the mucosa because of a suction effect. It can sometimes be attached to the residual roots or to two or more implants
• partial and, in this case, it is made of a metallic structure called removable partial denture which is anchored to natural adjacent teeth through hooks, even invisible ones

What are the disadvantages of a mobile-bearing prosthesis compared to a fixed-bearing one?

Partial prostheses linked to natural teeth can overload support teeth and make them unstable, thus facilitating dental cavities.

Total prostheses rub the mucous membrane during the normal chewing movement and therefore reabsorbe the bone and increase the necessity of continuous rebasing.
Mobile-bearing prostheses are not advised to young people because of the severe bone reabsorption which can occur over time.
Partial prostheses appear mediocre due to the difficulty of concealing anchorage hooks, while total prostheses do not always result natural.

Why should mobile-bearing prostheses be monitored over time?

Our face, mouth and bones change over time, thus damaging the prothesis´ aesthetics and stability.

In patients who lose much weight during their life, the prosthesis seems to become out of proportion.
The gradual bone reabsorption can also require constant rebasings which, in time, make the prosthesis thicker, thus limiting the ability to speak.

I am an edentulous patient and my mobile-bearing prosthesis is no longer stable, what can I do?

The prosthesis’ stability can be improved with a mini-invasive intervention using two-three implants, which can also be done in elderly patients
Implants can be immediately used and are linked to the prosthesis with automatic buttons.
We are often able to reuse our old prosthesis.
Should the mobile-bearing prosthesis represent a problem in your social life, then you will be able to change to a completely fixed-bearing Mogul one.

Fixed prosthetic dentures

This kind of denture is permanently screwed or cemented to teeth and implants and can be removed only by the dentist. Therefore, it does not require the patient to arrange for its removal for everyday oral hygiene, nor to pay particular attention to the food being chewed, as the chewing capacity is equal to the one of natural teeth. It can be replaced by dental crowns, dental bridges screwed to implants or cemented to adjacent natural teeth, conveniently prepared and limited (reduced to fragments, they will act as natural supports for the bridge) or dental facets, to be considered hardly invasive aesthetic dentures.

What are the advantages of a fixed-bearing prosthesis?

It guarantees the same function of natural teeth.
Even in the case of fixed dental prostheses we talk about:

• implant prosthesis: screwed or cemented
• prosthesisthat replaces teeth leaning on the suitably prepared natural ones

Fixed-bearing crowns on single teeth or implants.

Single crowns are used when teeth are too damaged to be rebuilt with fillings or inlays. We use the root and the entire healthy part of the tooth emerging from the gum. In case of loss of a dental element, we make use of artificial roots called implants.

In some rare cases, to restore a missing tooth, we have to proceed with a dental bridge, by refining its neighboring teeth.

Dental bridges or crowns

Dental bridges are those structures which link one or more teeth with one another in order to repristinate missing teeth.

Blockades are bridges between neighboring teeth.
Bridges on natural teeth are less and less frequent because it is preferable to restore the empty space with one or more single tooth implants, as to repristinate normal dentition.
We talk about bridges when we join two or more implants far from each other.

Are crowns screwed or cemented to implants?

In the Vignato Dental Clinic, crowns and bridges are always screwed to implants.

The reason is simple: they are easy to remove and clean.
In some cases, however, anterior teeth must be cemented to implants.

Prosthetic dentures on implants

Fixed dentures on implants are able to completely restore the lost chewing capacity thanks to a safe, aesthetically natural and long-lasting solution able to minimize the loss of natural elements or bone gingival imperfections.
In this case, we sum the personalized precision of the dental lab, our expertise and the most advanced surgical methodologies with the latest generation materials.

Visit the page dedicated to dental implantology

Aesthetic or minimally invasive prosthetics

This type of fixed prosthesis includes veneers, inlays and minimally invasive crowns. They are prostheses with a predominantly aesthetic function because they aim to modify the tooth in shape or color because it is not harmonized with the adjacent healthy natural teeth.

• Veneers modify the aesthetics of the tooth if the shape or color does not harmonize with the adjacent teeth.
  It is a treatment with less functional value but which can drastically improve the appearance of our smile.
  
  
• Inlays are large fillings that are fabricated in a laboratory and then cemented in the mouth onto the remaining healthy tooth.
  They have the function of re-establishing the occlusion, very often avoiding devitalizing the tooth.
  
  
• Minimally invasive crowns serve to restore the occlusal table especially in cases of severe wear of the tooth surface. They can be performed on vital or devitalized teeth and save a large part of the healthy tooth from filing.

Hybrid prostheses 

They are totally mobile-bearing prostheses fixed to residual teeth or implants. Hybrid prostheses are a halfway solution which make the prosthesis function safer. They are particularly recommended to the elderly.
Implants can be linked to prostheses individually by using an o-ring or a precision bar.