Prosthodontics, also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses. Prosthodontic procedures include crowns, bridges, veneers, inlays, onlays, complete and partial dentures. Dental implants have become the preferred method for replacing missing teeth; so many prosthodontic procedures today are done with implants as the support instead of the natural teeth or gums.
A dental crown is a tooth-shaped “cap” that is placed over a tooth — to cover the tooth to restore its shape and size, strength, and improve its appearance. The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.Your dentist may recommend a crown to:
- Replace a large filling when there isn’t enough tooth remaining
- Protect a weak tooth from fracturing
- Restore a fractured tooth
- Attach a bridge
- Cover a dental implant
- Cover a discolored or poorly shaped tooth
- Cover a tooth that has had root canal treatment
Types of Crown
Permanent crowns can be made from stainless steel, all metal (such as gold or another alloy), porcelain-fused-to-metal, all resin, or all ceramic(Emax. Lava, Zirconia)
How do Bridges Work?
Dental bridges literally bridge the gap created by one or more missing teeth. A bridge is made up of two or more crowns for the teeth on either side of the gap — these two or more anchoring teeth are called abutment teeth — and false tooth/teeth in between.
A bridge may be recommended if you’re missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.
Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost.
Porcelain or ceramic bridges can be matched to the color of your natural teeth.
Types of Bridges
- Traditional bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics.
- Cantilever bridges are used when there are adjacent teeth on only one side of the missing tooth or teeth. Cantilever bridges are usually used to replace only one tooth.
- Maryland bonded bridges (also called a resin-bonded bridge or a Maryland bridge) are made of plastic teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth.
Porcelain Inlays versus Metal Fillings
- When you receive a porcelain inlay instead of a metal filling, our dentists can preserve more of your natural tooth.
- Porcelain inlays look natural.
- Your teeth become stronger with porcelain inlays as opposed to weakening when metal fillings are used.
- Your porcelain inlays will not contract and expand with hot or cold foods, which mean they will not crack your teeth.
- Porcelain inlays are more durable than the metal fillings are.
- An inlay resists the forces created when you bite down.
- Inlays offer perfect contours for healthy gums.
When decay or fracture incorporate areas of a tooth that make amalgam or composite restorations inadequate, such as cuspal fracture or remaining tooth structure that undermines perimeter walls of a tooth, an onlay might be indicated. Similar to an inlay, an onlay is an indirect restoration which incorporates a cusp or cusps by covering or onlaying the missing cusps. All of the benefits of an inlay are present in the onlay restoration. The onlay allows for conservation of tooth structure when the only alternative is to totally eliminate cusps and perimeter walls for restoration with a crown. Just as inlays, onlays are fabricated outside of the mouth and are typically made out of gold or porcelain.
Gold restorations have been around for many years and have an excellent track record. In recent years, newer types of porcelains have been developed that seem to rival the longevity of gold. If the onlay or inlay is made in a dental laboratory, a temporary is fabricated while the restoration is custom-made for the patient. A return visit is then required to fit the final prosthesis. Inlays and onlays may also be fabricated out of porcelain and delivered the same day utilizing techniques and technologies relating to CAD/CAM dentistry
Many consider dental onlays indirect fillings. These onlays offer patients a stronger, well-fitting and longer lasting repair for tooth decay or other structural damage.
While a dental filling is molded during your dental visit, an onlay is created in a dental laboratory before it is fitted and then bonded to a damaged tooth. A dental restoration that requires material to be bonded within the tooth’s center is considered an inlay whereas, restorations involving the entire biting surface or one or more points (cusps) of a tooth are onlays.
Benefits of Onlays
- Easy Cleaning: Dental onlays are tailored to fit perfectly with minimal preparation. This makes cleaning a dental onlay easier than cleaning a crown.
- Color: A dental onlay is less likely to discolor than a tooth-colored resin filling.
- True Size: A composite filling may shrink while it cures, prefabricated gold or porcelain onlays will not.
- Natural Tooth Preservation: Dental onlays allow our dentists to preserve the healthy tooth structure while restoring the damaged or decayed areas, this allows for functional longevity.
- Stability: Dental onlays are strong and stable. Their superior fit and resilient material make onlays a great choice, sometimes even strengthening a damaged tooth. This strength occurs because a dental onlay does not require our dentists to totally reshape the tooth that is being restored.
Some Recent Cases
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