Prosthodontics

Prosthodontics is the branch of dentistry that involves replacing missing teeth with fixed prostheses according to your remaining dentition and the technical possibilities in the following ways :

• Veneers
• Crowns (caps)
• Bridges
• Implants
• Implant supported complete dentures

Certain situations require us to use removable dentures. The options are: complete dentures, implant supported complete dentures, and removable partial dentures (RPDs).

This category includes removable complete dentures and removable partial dentures (or “partials”).

A complete denture is a removable denture made from acrylic and is used in edentulous patients, ie. patients who have no remaining teeth in their dental arch.

Removable partial dentures are also used to replace teeth, but are indicated when the patient is not completely edentulous. They are held in by metal clasps that grip onto the remaining teeth. They are removed for hygiene measures and also at night. This is a solution to replace missing teeth in patients who cannot have dental implants. It’s also one of the less expensive options.

All removable dentures are fabricated in a dental lab. In order to do so, a mould of your mouth is taken. This process can be quite lengthy and requires multiple appointments and try-ins before processing and finishing may be done.

Complete dentures are proposed when there aren’t enough remaining healthy teeth to consider another option. There has been a lot of progress in this field of dentistry and our complete dentures will fill out your needs.

Finally, there’s the option of implant-supported removable dentures. Exploring this as an option requires a lengthy prosthodontic exam, which includes taking moulds to articulate models and taking a 3D scan called a CBCT. Implants improve mastication and comfort.

Fixed prostheses include any indirect restoration that is cemented directly onto healthy tooth structure and include: crowns, veneers, onlays, inlays, or bridges. Bridges may be tooth-supported or implant-supported.

Endodontically treated teeth (teeth with RCTs) are more fragile than non-endodontically treated teeth. To avoid fractures, and to increase resistance to the forces of mastication on this tooth, we suggest crowning these teeth.

At Centre dentaire Birca, we use CEREC CAD/CAM technology to fabricate custom-made crowns and bridges in one sole appointment so that the patient may save time. Forget multiple local anesthesia injections and messy impression materials! Our intra-oral camera captures the prepped area and a 3D virtual model is created on the computer. This data is transferred to a machine that is programmed to mill the crown from a block of ceramic.  It is then glazed in a specialized oven, which can reach a temperature of up to 1000ºC, to give the tooth a natural-looking shade. Then, the crown may be delivered and cemented on the appropriate tooth with a durable cement.

Bridges, or fixed partial dentures (FPDs) are used to replace one or multiple missing teeth. They are composed of abutment crowns, which are supported by teeth or implants, and pontics, which replace the missing teeth.  If the bridge is tooth-supported, then the teeth on which it rests must be prepped in the same way a tooth is prepped to receive a crown.

When a tooth is lost, it’s best to replace it sooner rather than later. This avoids the adjacent teeth from tipping and filling in the edentulous space. Another possible problem is extrusion of the opposing teeth and a loss of the vertical dimension of occlusion. These consequences may destabilise mastication in a slow and insidious process which may become very problematic long-term.

Generally, the best way to replace a missing tooth is with an implant-supported crown. This way, there’s no need to touch the adjacent teeth, which is especially important if these teeth are intact and have no restorations on them. For this reason, there is a lower biological cost for implants than for bridges. Hygiene measures are remarkably easier to maintain with an implant-supported crown in comparison to a bridge because the teeth are separated.  The long-term prognosis for implant-supported crowns is much better than that of a tooth-supported bridge.