Dr. Renato Valente
Aesthetics And Oral Rehabilitation | Fixed And Removable Prosthodontics | Occlusion
The loss of teeth can have various causes, including tooth decay, trauma and gum disease, the latter being the main cause. Generally, people seek to have their teeth treated when aesthetics is compromised. The absence of a tooth goes beyond this issue, as it represents a compromise of the integrity of the masticatory system.
When teeth are missing, those next to and opposing teeth tend to move into the free space, causing all kinds of imbalance in the dental arches.
In order to restore chewing, aesthetic and phonetic functions and minimise these effects, the so-called dental prostheses are made.
There are two types of prosthesis:
Fixed dentures and removable dentures.
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What is a removable denture?
With dental prostheses it is possible to give the individual a good quality of life. With dental prostheses the aesthetics and good functioning of the dental structure is recovered and the problems caused by missing teeth are avoided.
A removable prosthesis is a dental prosthesis which can be removed and repositioned for cleaning, and which rests on the mucous membranes and gums.
As already mentioned, this type of denture is increasingly out of use. Since they rest on the mucous membrane and the underlying bone, and in some cases are supported by some teeth, part of the chewing forces provoked are cushioned by these tissues, leading to a gradual aggression of the bone tissue and its resorption over time, as well as an overload of the teeth which hold it in place.
In addition, the discomfort felt and the movements while speaking or eating make many of the users of these prostheses opt for treatment with implants, where the prosthesis is fixed.
Over time, removable prostheses suffer a maladjustment, so that constant visits to the professional specialist are almost mandatory when some time has passed since they were placed. Many of these people resort to fixing prosthesis, with the discomfort that this entails, whenever these glues stop working.
Removable prosthesis, although they improve chewing function, they do so to a lesser extent than the fixed ones. Durability and comfort are also two factors that tip the balance in favour of fixed prosthesis.
Dental implants can change your life, both aesthetically and chewing, when they replace removable dentures.
However, if your dental conditions do not allow for dental implants and/or fixed dentures, removable dentures can be a good solution.
Types of removable dentures
Removable partial dentures
They can be removed for cleaning, they rest on the mucous membrane and gums and can have retention clips on some teeth.
With advances in materials and technology, this type of prosthesis is increasingly out of use and these dentures are normally replaced by dental implants. These dental implants are fixed and therefore much more aesthetic and comfortable.
Total removable prosthesis
This is the complete prosthesis for people without teeth and is exclusively supported by the mucous membranes and the palate.
Like the previous type of prosthesis, they are practically out of use. They are only recommended in a minimum percentage of cases in which implants cannot be fitted, so that each individual can live a relatively normal life.
The problem with these prosthesis lies in their instability when it comes to eating or speaking, so that people eventually resort to fixing them with “glues” indicated for this type of case, with the inconveniences that this entails.
What is a fixed prosthesis?
Fixed prosthesis, as the name indicates, are prostheses that cannot be removed by the person in everyday life.
They can only be removed by the specialist using special drills. This group includes single crowns (only one tooth), bridges (a set of teeth) and full-arch prosthesis. Single crowns can be applied on teeth or on implants.
Fixed prosthesis on teeth
Teeth are worn down in order to place crowns and false teeth bonded to them.
This is a very interesting option when the tooth has been damaged by trauma or decay, for example. The prosthodontist prepares the tooth so that it can house a coping that restores its functionality, both aesthetically and in terms of chewing. There are a large number of materials that offer a wide range of options to provide a solution to the problem.
Fixed prosthesis on implants
Either for entire jaws that have been left without teeth, or to replace several or a single tooth. These teeth are the ones placed on the implants, which have been previously placed by the surgeon.
To place them, the prosthodontist must carry out several tests in the person’s mouth to ensure that the colour and shape, among other things, are the most correct. Just like prosthesis on the individual’s own teeth, crowns on implants also offer a multitude of possibilities for rehabilitation. The specialist’s training in this field will be fundamental in order to be able to show the latest advances at the moment.
Removable implant-supported or semi-fixed prosthesis
Complete dental prosthesis which is mounted on a bar, which in turn is attached to two or three implants.
These prosthesis are used when the surgeon is forced to place few implants in an individual without teeth, usually due to a lack of bone. An edentulous mouth (without teeth) can be rehabilitated with 4 implants in the upper part or 2 in the lower part and a prosthesis that will cover the entire mouth.
This type of prosthesis is fixed on these implants, although the person will be able to remove it for proper hygiene. The fact that it is placed on these implants means that the prosthesis does not have any type of movement inside the mouth.
How long do you have to wait between the placement of an implant and the placement of a dental prosthesis?
The correct osseointegration (integration of the implant into the bone) of the implants requires 2 to 4 months before they can receive normal masticatory forces.
After this time, the definitive prosthesis can be fabricated. In anterior aesthetic areas or in cases of full jaws, immediate provisional prosthesis can be manufactured for the person’s comfort.
The implantologist will establish the time necessary to be able to rehabilitate the implant placed. In most cases, the time will depend on the state of the bone where the implant has been placed and the type of implant placed.
An implant placed in bone with an acceptable quantity and quality will allow the time needed to place the prosthesis to be shortened.
In the case of a bone that is narrow or of poor quality, these times will have to be extended as the implant will need a little more time to integrate into the bone.
Without doubt, respecting the integration times of the implants placed will ensure that when the prosthodontist rehabilitates these implants, they will be perfectly integrated in the jawbone.
What special care do dental prosthesis require?
Dental prosthesis need to be cleaned daily in detail, since dental plaque enters the mouth every day.
People who wear dentures should be instructed to clean them thoroughly and should visit the professional at least once a year to have them checked and cleaned in detail.
Often people tend to think that once dentures are in place, they need virtually no maintenance. Nothing could be further from the truth, dentures require similar care to that received by teeth. Adequate hygiene is essential to ensure that the work carried out is in perfect condition for many years in the mouth.
In addition, periodical checks, as indicated above, are essential for the professional to check that both the fit and the state of the soft tissues are correct.
See the before and after cases of fixed and removable prosthesis treatments made by our partners.
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