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PROSTHODONTICS

Mohammed Tamimi

Introduction
To
Prosthodontics
By: Mohammad Al-Tamimi
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Prosthetics is primarily the art and science of supplying artificial replacements for missing
parts of the human body (ex. Missing hand, eye, ear ...Etc.).
Prosthesis is just another term for the actual replacement. It is an artificial replacement for an
absent part of the human body.
We as dentists, are primarily concerned with prosthodontics, which is the branch of dental
science that pertains to the replacement of missing teeth, oral tissues and craniofacial
Dontics stands for: the replacement, and Prostho From the roots of the word, s. structure
represent teeth. This means it aims on replacing parts of the oral and maxillofacial structure.

agnosis, "the dental specialty pertaining to the di as (Not included) The ADA defines it
treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance
and health of patients with clinical conditions associated with missing or deficient teeth and/or
oral and maxillofacial tissues using biocompatible substitutes."

Prosthodontics are:
1- Fixed prosthesis: stays inside the patients mouth, the patient
cannot take it off, (such as fixed crowns or bridges) only the
dentist can undergo the required procedures.

2- Removable prosthesis: it can be taken off and placed back
inside such as Removable complete prosthodontics and
Removable partial prosthodontics.

3- Implant prosthodontics: A dental implant is a
manufactured post that is designed to create a stable
foundation for a natural looking tooth restoration. Placed
directly into the jawbone, a dental implant is the closest
thing to a person's natural tooth.

4- Maxillofacial Prosthetics: is a subspecialty of
Prosthodontics that involves rehabilitation of patients with defects or disabilities that
were present when born or developed due to disease or trauma. Prostheses are often
needed to replace missing areas of bone or tissue and restore oral functions such as
swallowing, speech, and chewing.
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The two other subdivisions (maxillofacial and Implant
prosthodontics) are overlapped with fixed and
removable, for example: we can have a
fixed/removable crown over a natural tooth or on an
implant tooth. This way we have: removable /fixed
maxillofacial (which is on the natural tooth) or
removable/fixed on an implant.


Quick review :

Fixed prosthesis: is something which is cemented in the patients mouth (crowns and
bridges).

Golden crowns were commonly used in the past, but currently patients dont like the
appearance it gives on their anterior teeth. Therefore, it is not so common anymore .

We also have Porcelain-fused-to metal (PMF), is a metal core tooth cover with porcelain
crown (Porcelain is the closest to the natural fibers of the teeth) .

Crowns as we know are a one-tooth

Some useful information from www.colgate.com
A CROWN IS USED TO ENTIRELY COVER OR "CAP" A DAMAGED TOOTH.
BESIDES STRENGTHENING A DAMAGED TOOTH, A CROWN CAN BE
USED TO IMPROVE ITS APPEARANCE, SHAPE OR ALIGNMENT. A CROWN
CAN ALSO BE PLACED ON TOP OF AN IMPLANT TO PROVIDE A TOOTH-
LIKE SHAPE AND STRUCTURE FOR FUNCTION.
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Procedure .


Bridges are also a common procedure for a
patient who is missing one or two teeth. The
two teeth in contact with the gap are crowned
after being trimmed and the gap is bridged
with and artificial tooth .

Not all teeth require us to trim them; what we
do is that we trim slightly from the inside
toward the palate, we dont trim the outside,
and we make a special bridge that will stick
towards the inside of the teeth via an
adhesive bridge.

We also have implant prosthodontics
(restorations placed on implants) these types
of implants are cemented in the jaw bone by a
titanium nail and covered with a crown, so we can either have fixed or removable
prosthetics on implanted teeth as much as on natural teeth.

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Differences between natural teeth and artificial teeth (from the slides):




The reasons why maxillofacial prosthetics are used are usually: different oral
diseases, trauma, and malignancy.

Sometimes prosthesis reaches all the way in the back of
the patients mouth where the palate is. In this case, the
nose is opened with the palate and as we know the palate
has many advantages in separating the food and drinks
from the nasal cavity, in speaking and in swallowing. Here
an artificial stopper is placed in the maxilla. Therefore, it
is given the term maxillary obturator and it totally
occludes the oral-nasal opening .





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VIP Note:
Dentulous is a condition in which the complete
set of natural teeth are present in the mouth
(dentate), and edentulous is the condition in
which the mouth is deficient of teeth
(toothless) or partially edentulous patients
who have some of their teeth. And in the
second condition (toothless) we apply
complete dentures, and as we noticed it has a
natural looking gum with something like blood
vessels .




Removable prosthodontics

It has two major divisions:

1. Complete removable prosthodontics: some patients are completely
edentulous as we mentioned; due to different oral diseases, severe oral cavities,
gingivitis that leads to tooth loss, trauma or rarely born with no teeth buds
therefore no teeth growth. In this case we do a complete prosthesis .

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2. Partial prosthodontics: If a patient is partially edentulous, we can make him
prosthesis, in this case it is partial prosthesis .


Types of dentures:

1- Over denture: a denture applied over a tooth by
removing the crown and leaving the root, removing a part
of the tooth or on an implant. It has its advantage.

2- Immediate denture: it is actually very useful for the
patient. Now suppose I extracted his tooth/teeth, it might
take weeks and sometimes a month to get his denture ready
to be worn , how would the patient go on with his practical
life with no teeth ? For that we have immediate denture (a
removable prosthesis), as a temporary solution.
.
3- Single dentures: which are a type of artificial dentures.











Definitions:
Prosthodontics: From the roots of the word, Prostho stands for: the replacement, and
Dontics represent teeth. This means it aims on replacing parts of the oral and
maxillofacial structure.

Dentulous: is a condition in which the complete set of natural teeth are present in the
mouth.


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Edentulous: is the condition in which the mouth is deficient of teeth (toothless) or
partially edentulous patients who have some of their teeth.

Denture: A partial or complete set of artificial teeth for either the upper or lower jaw. A
lso called dental plate.


Test:

1- What are the subdivisions of prosthodontics?

2- What are the differences between bridges and crowns?

3- What is the difference between dentulous and edentulous patients?

4- What are the types of dentures?