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Restorative Dentistry

Fixed Dental Prostheses: Crowns and Bridges

Fixed dental prostheses, including crowns and bridges, provide durable solutions to restore both the function and aesthetics of teeth. These prostheses are not removable, instead they are securely attached to existing teeth or implants, ensuring long-term comfort and stability.

A crown is a cap that completely covers a damaged or weakened tooth, restoring its original shape, size, and strength.

A bridge is a dental prosthesis designed to replace one or more missing teeth. It is fixed to adjacent teeth, which are fitted with crowns to support the bridge.

Fixed prosthetics are used when:

  • The tooth is so damaged that a filling or inlay is insufficient for restoration.
  • To replace one or more missing teeth.
  • To correct bite issues or improve aesthetic appearance due to the condition or placement of teeth.
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Removable Dentures: Partial and Full Dentures

Removable dentures restore the function and aesthetics of missing teeth, in case of both partial or complete tooth loss. These dentures are easy to remove and clean, providing comfortable daily use.

1. Partial Dentures

Partial dentures are used when some teeth of the patient are missing but the remaining ones are sufficient to hold the prosthetic stable. They restore missing teeth, improve chewing function, and prevent the remaining teeth from being displaced.

2. Full Dentures

Full dentures are designed for patients who have lost all their teeth in a given arch. These dentures completely replace the missing teeth, restore the patient’s smile, and support chewing and speech functions.

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All-On-X Dentures: Implant-Supported Full Dentures

All-on-4 and All-on-6 dentures provide innovative, effective solutions for patients who have lost all their teeth or have very few remaining teeth, restoring smiles, confidence, and quality of life. These systems use implant-supported dentures that are stable, durable, and aesthetically pleasing.

  • All-on-4: Four implants are placed in the jawbone—two at the front and two angled at the back for greater stability and optimal load distribution. It is commonly used for lower jaw rehabilitation.
  • All-on-6: Similar to All-on-4 but with six implants, offering increased stability, particularly for the upper jaw where bone quality may be weaker.

When is it used?

All-on-4 or All-on-6 dentures are ideal for patients with complete tooth loss in an arch (upper or lower) who are looking for a fixed, long-term solution. They are especially suited for patients with limited bone density, as these systems ensure stability with fewer implants.

Attachment Process

The dentures are secured to implants using small screws. 

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Temporary Dental Prostheses (PMMA)

Temporary crowns or bridges are often needed during the preprostatic phase while necessary treatments are made, so that the permanent replacements are fitted on healthy gum and teeth. These temporary solutions protect prepared teeth while awaiting final restorations.

Temporary replacements are made of PMMA (polymethyl methacrylate), an interim solution for used during long-term restoration procedures until the permanent replacements are fitted. They provide aesthetic, functional, and protective benefits during longer treatment processes.

Purposes of Temporary Prostheses

  • Aesthetics: Restores the patient’s smile and appearance during treatment, therefore negating the need to live with a lack of teeth. This is especially important in the case of frontal teeth, where aesthetic considerations are key.
  • Functionality: Enables normal chewing and speech until the permanent solution is fitted. This prevents bite changes and the risk of developing speech issues.
  • Gum Shaping and Healing: Temporary prostheses help shape and heal the gums, especially after implant placement. This is critical to ensure the perfect fitting of permanent replacements.
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Digital Impression Taking (Intraoral Scanner)

Digital impression taking is a modern dental procedure that uses an intraoral scanner to create a three-dimensional (3D) digital model of the patient’s teeth and oral cavity, replacing traditional impression materials. This technology is a major progress in dentistry, since it is faster and more comfortable than traditional techniques.

The intraoral scanner is a special, handheld device that procedures high-resolution images of the patients’ teeth, gums and other parts of the oral cavity. The images are immediately processed by the scanner’s software, generating a three-dimensional (3D) digital model on the screen of a computer. We then use this digital data for planning dental replacements, orthodontal devices or other dental treatments.

Advantages of Intraoral Scanners

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Jaw Relation Registration (Bite Adjustment)

Jaw relation registration, also known as bite adjustment, is an important diagnostic and therapeutic procedure in dentistry. It involves recording the relative positions of the upper and lower jaws and their occlusion (contact between teeth). This process is vital for designing crowns, bridges, dentures, and other prostheses.

Importance

  • Functional Occlusion: The correct registration of jaw relation is key in ensuring proper tooth contact, preventing joint issues, chewing difficulties, and tooth wear.
  • Aesthetic and Functional Restorations: The correct adjustment of dental replacements (crowns, bridges, full or partial protheses) is only possible if the correct relation between the upper and lower jaws is determined. This ensures comfortable and effective use of replacements.
  • Prevention and treatment of Jaw Joint Issues: Incorrect bite alignment risks temporomandibular joint (TMJ) disorders. Jaw relation registration has an important role in the treatment of such issues.

Facebow

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Selective Grinding

Selective grinding is a precise dental procedure to fine-tune the biting surfaces of teeth. This procedure is applied to cases where the patient’s bite is not aligned correctly, causing discomfort or pain. This technique helps optimal contact between teeth, improving the load distribution.

The use of Selective Grinding

  • Balancing the bite: Selective grinding ensures that the contact between teeth is adequate when the patient closes their jaw. This prevents unequal load distribution which would damage teeth and the jaw joint.
  • Relieving pain and discomfort: Teeth not matching together correctly can cause headaches, pain in the jaw, sensitivity in the teeth or tooth wear. Selective grinding aids these symptoms.
  • Protection of dental restorations: If the patient is fitted with new fillings, crowns or bridges, selective grinding ensures that these correspond harmoniously with the rest of the denture, avoiding needless load bearing.
  • Preventing excessive tooth wear: Uneven bites expose some teeth to disproportionate stress, leading to faster wear, cracks or enamel fractures. Selective grinding prevents these issues, ensuring an even load bearing.
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Wax-Up / Mock-Up

Wax-ups and mock-ups are techniques used in the planning procedure. They are generally used before aesthetic or functional restorations, so that both the dentist and the patient understand how the final result will look like. Both methods play an important role in the preparation of dental treatments.

Wax-ups are models made digitally or from wax during the planning phase of a treatment, simulating the final restoration or dental correction.

Mock-ups are models made on the basis of wax-ups that can be tested in the patient’s mouth, directly showing the possible outcome of the treatment.

Importance of the techniques

  • Accurate planning: Enables the dentist and dental technician to plan the restoration size, shape, and function.
  • Patient satisfaction: Allows the patient to get a preview of the final results of the treatment.
  • Cost-efficiency: Reduces errors and saves costs by preventing the need for potential remakes.

Jaw Joint Therapy

In the treatment of jaw joint (temporomandibular joint (TMJ)) dysfunctions, various types of therapeutic splints, such as Michigan splints, relaxation splints, or others are used. These appliances alleviate joint pain, reduce muscle tension, help occlusal balance and restore normal jaw function.

Causes of TMJ Dysfunction

  • Stress or teeth grinding (bruxism).
  • Improper bite alignment (occlusal dysfunction).
  • Missing teeth or poorly fitted restorations.
  • Trauma to the jaw or skull.
  • Myofunctional dysfunctions (overuse of jaw muscles)
  • Persistent stress and psychological factors

Michigan Splints

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