Prosthetic Rehabilitation in Kyiv

WHAT ARE DENTAL PROSTHETICS?

This is the restoration of missing teeth or their fragments using preparatory restorations, fixed structures (veneers, inlays, crowns, and bridges fixed on teeth or implants), and removable dentures (partial, complete removable dentures, immediate dentures, clasp dentures).

Partial prosthetics are considered in case a patient still has remaining natural teeth. If all the teeth are missing, a complete removable denture is fitted. Dentures can be attached to implants, which is called an Implant-Supported Denture. Such dentures can be removable, partial, and cement-retained.

The primary purpose of non-removable prosthetics is to solve a wide range of problems associated with entirely or partially missing teeth in the upper or lower jaw. This method allows restoring the shape and aesthetics of teeth, compensating for missing teeth. The placement of artificial dental structures is required in case a person has the following dental problems:

• increased attrition of enamel;
• diastemas, cracks, chips;

• a dental crown is missing, and there is no other way to restore it;
• one or more missing teeth, as well as edentulism.

Prosthetics solves all mentioned problems and improves the quality of life. All types of prostheses used in dental practice have individual characteristics, advantages, and disadvantages.

Case №1

Failure of Metal-Ceramic Restorations. Zirconia restorations, creating a new smile

A patient did not like the aesthetic appearance of her old metal-ceramic crowns.

Therefore, we performed periodontal treatment, horizontal alignment, prosthodontic treatment with zirconia crowns on the upper jaw and ceramic veneers on the lower jaw after removing the crowns.

The patient was delighted with the result of her new smile.

The final result.

Inlays

Inlays in prosthetic rehabilitation are used to restore the shape of the tooth. This type of dental product is regarded as an analog of fillings, but unlike filling material, inlays are made in laboratory conditions from ceramics; they are durable, fall out less often, and have high wear resistance.

Stump inlays are an intermediate option between the crown and the filling. This type of dental inlays is used in case of significant destruction of the crown part of the tooth. Stump inlays do not require grinding a tooth to a stump, as with artificial crowns.

Veneers

Veneers look like thin plates. This type of prosthesis is used to restore the aesthetic appearance of a smile. The famous Hollywood smile is achieved with the help of veneers. Hypoallergenic materials (composite, ceramics, zirconium dioxide) are used for veneer manufacture.

Veneers and their other type, lumineers, do not treat but radically mask such dental defects as a trema, diastema, cracks, chips, staining, and discoloration of tooth enamel. Veneers are a complete alternative to teeth whitening and can also replace braces.

After placing veneers or lumineers, it is necessary to follow particular service rules since chewing coarse food, and frequent coffee drinking and smoking can damage them. The smile zone with veneers or lumineers has no flaws in terms of both shape and color.

MORE ABOUT VENEERS

Crowns

This type of prosthesis is used to restore decayed teeth, or rather, their crown part. The crowns are mainly indicated when the outer part of the tooth is destroyed by more than 50%. They are made from zirconium dioxide, porcelain-fused metal, and ceramics.

Porcelain-fused metal is more often used for grinding units, as it is more durable. Ceramic micro-prosthetic restorations are suitable for a smile zone, as they have better aesthetic properties. Zirconia crowns can be placed in any part of the dental arch.

Case №2

Rehabilitation of a patient with a zirconia restoration traumatic chipping.

The patient complained of traumatic chipping of crowns. The injury occurred due to diving into the pool.

Objectively, the incisal edges of the zirconia bridges were chipped in the area of the two central incisors.

After an X-ray examination, the old bridge was removed. The tooth stumps were not damaged. The same day, we made temporary crowns and took impressions for new zirconia restorations.

We fixed the new zirconia crowns seven days later.

The patient was pleased with our work’s shape, color, and function.

WHAT ARE COMPLETE DENTURES, REMOVABLE PARTIAL DENTURES, AND BRIDGES?

All removable dentures consist of a pink plastic base on which plastic, composite or ceramic teeth are fixed.

The type of manufacturing material classifies the following options for removable dentures:

Nylon. Such material is completely biocompatible and suggests maximum aesthetics.

Plastic. This type of removable denture can be manufactured from the following materials: acrylic, Spofadent, IvoBase, Vertex, and Deflex.

With metal fasteners (clasp).

HOW REMOVABLE DENTURES ARE ATTACHED

Several factors influence the way the removable dentures are fixed. Such factors include:

degree of mobility, size, and position of the tongue in the oral cavity;
some anatomical features of the prosthetic bed, palate, and alveolar ridge;
lack of dental precontact.

The following types of fixation methods are used to fix removable dentures in the oral cavity:

Attachments or locks. This fixation method is not often used when installing removable dentures, but it is often used when installing fixed structures. Attachments can be used for partial edentulism when there are no more than two teeth in the patient’s mouth. The patrix or fitting part of the attachment can be located in the root or crown part of the abutment tooth.

Clasps and hooks. ТThis type of fitting is used mainly for removable prosthetics, and the fixing devices and the dentures are made of similar material. Acrylic, polyurethane, and nylon dentures have fixation devices, while removable clasp dentures are equipped with metal hooks.

Suction cup or flexible dentures. This method of attachment is used when installing a complete denture or overdenture. The attachment mechanism of such devices is based on the adhesion or natural vacuum effect of suction.

Implants. Removable implant-retained dentures can be fixed by a bar or ball attachment.

Benefits of complete dentures:

Fast manufacturing.

Feasible for almost every patient.

Suitable in case of poor oral hygiene.

Disadvantages of complete dentures:

–

The denture in the upper jaw blocks the palate, which can result in a partial loss of the taste sense and sometimes a feeling of nausea.

–

A complete removable denture is fixed only with glue; it is not particularly stable and can move during chewing; this can negatively affect speech and mastication.

–

It should be brushed after every meal.

For the reasons stated above, we mainly use them as temporary solution.

Removable partial dentures are used when the spaces between the remaining teeth are so large that they can no longer be covered with one or more bridges.

Bridges are made when there are two abutment teeth and a maximum of two adjacent teeth missing. Bridges are much more comfortable than removable dentures. They are fixed on the abutment teeth and have a long service life.

The indication for the dental bridges is the absence of no more than two teeth in a row. The bridges are popular due to their relatively low cost and availability.

Such structures are fixed on the adjacent abutment teeth, while the area of fixation withstands double masticatory load. This can eventually lead to the rapid destruction of the supporting dental units.

Different types of dentures can be used depending on the size of the gap or attachment options, namely:
• one-piece bugel prostheses;
• telescopic prostheses;
• implant-supported prostheses.

A combined support using the various elements of the mentioned options is also possible.

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A telescopic denture – is also a removable denture attached to natural teeth and implants. Unlike the bugel prosthesis, it does not have clasps or locks. It has the so-called telescopic crowns consisting of two parts, allowing fixing it. The primary crown (inner telescope) is attached to a natural tooth or implant and is made of metal. The secondary crown (outer telescope) is embedded in the partial denture and is fitted over the primary crown along with the denture.

A bugel prosthesis – is a removable partial denture attached to the remaining natural teeth by cast metal clasps or locks. This prosthesis frame is a pink plastic base with attached plastic, composite or ceramic teeth is welded made of an alloy for medical applications.

Case №3

A patient came to the dental clinic with a request to improve the appearance of his teeth and get a beautiful “Hollywood smile”.

A physical examination revealed a large number of teeth affected by noticeable and extensive tooth decay, generalized periodontitis, poor hygiene, deep bite, retrusive profile, and traumatic occlusion.

The dentists set the task of changing the dental bite, shape, color, and dentition.It was also necessary to determine which teeth will be removed. The patient refused from orthodontic treatment. He lives in Italy and could visit the clinic regularly.

The patient was satisfied with the aesthetic and functional outcome of his implant treatment.

We extracted the teeth numbered from 15 to 25 and from 35 to 45. We left only eight molars (16, 17, 26, 27, 36, 37, 46, 47), immediately placed six dental implants into each jaw, and after a few days, we fixed temporary crowns. The remaining teeth were treated and replaced with temporary crowns.

Four months later, the patient had his dental impressions retaken and zirconium screw-retained permanent crowns were manufactured.

Implant-Supported Prosthesis

Implant-supported prostheses are used when there are few or no natural teeth left. Dental implants are artificial tooth roots that are implanted into the jawbone. Depending on the condition, a crown, bridge, or prosthesis can be attached to the implant.

This prosthetics option can be applied in case of partial and complete edentulism. The implant-supported prosthetics technique is based on introducing artificial roots into the jawbone, after which crowns are placed on the artificial roots. Fixed implant-supported prostheses are the radical and most effective way to restore dentition and chewing function and eliminate facial asymmetry resulting from tooth loss.

Alternative methods of prosthetics such as “All-on-4”, “All-on-6” help gain a beautiful smile and restore chewing function. Compared to the standard process of implantation, which provides for installing an artificial post for each tooth separately, the prosthetic structure is retained by four fused implants in the case of the “All-on-4” concept. If there are no contraindications, prosthetics can be performed in a single visit to the dentist.

A similar procedure is performed using the All-on-6 procedure when six implants retain the prosthetic structure. Both methods are safe, low-traumatic, and are not associated with a high risk of complications. It is possible to place a tooth implant in Kyiv performing an All-on-4 or All-on-6 procedure, immediately or in several stages, at an affordable price with complete restoration of the dentition. All-in-4 and all-in-6 procedures are the best alternatives to both removable dentures and conventional implants.

1. How long does it take to fit a prosthesis on a dental implant?

There are several types of implant load. We often use a protocol for loading the lower jaw after 2 months and the upper one - after 4-6 months. Sometimes we apply immediate loading: prosthesis connected to the dental implant right after the implant placement. This method is used most often for esthetic reasons important for a patient. This allows preserving the anatomy of the soft tissues around the teeth and feeling comfortable. In case we use Trabecular Metal Implant from Zimmer Biomet, we can fix the crowns six weeks after the implant surgery.

2. How long can a temporary crown last?

Here the name "temporary" says it all, meaning you can only use it for a short period. It is used until a permanent crown is made. If during this time it comes off (the temporary crown is fixed to the tooth with temporary cement), you will need to contact your dentist for re-cementation. If you cannot get your temporarily installed crown replaced with a permanent one, please note that you should not have it for more than a month. However, this figure can vary. And it all depends on the case. Since the temporary structure cannot correctly perform all tooth functions, it is not worth delaying it by replacing it with a permanent tooth.

3. How long does it take to make an implant crown?

Depending on the clinical situation, we will make a crown for you within 3-8 days.

4. Fixed or removable dental restoration?

Dentures can be fixed, overdenture, and removable. Fixed dentures are always a high-quality, reliable, and durable solution. With such a prosthesis, the patient's jawbone is preserved, and the prosthesis itself provides excellent stability and makes a patient feel confident. The only drawback is the inability to remove them after the initial installation easily. An overdenture restoration is retained by natural teeth or dental implants and is a good option if a sufficient number of implants for a fixed restoration cannot be placed. If an overdenture is implant-retained, it will also preserve the jaw bone. Such prostheses are removable, easier to repair, and clean professionally. Removable dentures are fitted in cases it is impossible to install fixed or overdenture restorations for various reasons. The advantage of removable dentures is that the patient can remove them without assistance, affordable price, and ease of manufacture.

This service is provided by doctors:

Volodymir Duda

Head doctor. Top-level dentist, surgeon, orthopaedist

Galina Matiyuk

Top-level dentist, orthodontist

Dental prosthetics