dentures

Which possibilities of dentures are there?

The loss of one or more teeth is not only an aesthetic problem, it affects especially the chewing and speaking functions. Remedy can only bring the replacement of lost teeth by prosthetic measures .

Dentures is a generic term that describes ways in which teeth defects or complete teeth or groups of teeth can be replaced. It is primarily distinguished whether the dentures is stuck or removable.

Toothed dentures include, for example, crowns or bridges that can replace toothed parts or gaps. Alternatively, there are removable dentures, which usually replace a group of teeth or a large part of the teeth. The removable dentures include, for example, the total denture or partial dentures such as the telescopic or the model cast prosthesis . Combinations, ie fixed-removable dentures, are possible.

In dentures, anchoring is also different: Is a dental prosthesis like the full denture only anchored by soft tissue or is a denture fixed by teeth or implants? Implants have created a new dimension of fixed dental restorations even for patients without their own teeth, something that was inconceivable just a few years ago.

Which dental prosthesis fits individually is dependent on the affected person's jaw, teeth and general health. This is the careful planning and pre-treatment, as well as the own oral hygiene crucial for the durability of a denture.

The crown

A crown represents fixed dentures for the construction of individual teeth whose portion above the gums have been partially destroyed by caries, trauma or the like. For this, the tooth is prepared in a specific shape so that the crown optimally fits. The grinding of the tooth is relatively steep, so that the crown sufficient retention, so Halthat.

After grinding, an impression is made and the crown is made by a dental technician in the lab so that it is usually completed after one week. The crown as a fixed denture is divided into their materials and styles. Solid cast crowns are made entirely of metal, but can also be included as a veneer crown only as the lowest layer of metal and be veneered on the outside with ceramic or plastic. Furthermore, there are mantle crowns, which consist entirely of ceramic or are referred to as jacket crowns.

A crown can also compensate for a malformation or malposition and thus restore the aesthetics. Depending on the model, the cost of a crown is between 250 and 800 euros in a price range.

The bridge

A dental bridge is a fixed denture for the treatment of gaps, which is anchored on the natural teeth or implants with the help of crowns. The teeth or implants are referred to as bridge abutment, the crowns as a bridge anchor and the replaced teeth as an intermediate link . Yes, by construction, one distinguishes these types of bridges:

  • one-span bridges supply a single gap
  • multi-span bridges close several gaps
  • End pillar bridges indicate that the bridge element lies between two abutment teeth
  • Free-end bridges only hang on a pillar, the other end is exposed
  • Hybrid bridges are supported by an implant on one side and a tooth on the other side
  • Maryland Bridge / Adhesive Bridge: This bridge is specifically for a range of teeth that experiences little strain and therefore lies in the front. The bridge member is attached to the adjacent teeth only by means of two wings and is an aesthetically high-quality supply. The dental bridge is the alternative of providing a gap to the implant that is needed in patients when an implant is not possible due to insufficient bone, for example.

The cost of a bridge varies according to the extent and desire of the materials. A tripartite bridge that fills the gap of a lost tooth is roughly within a price range of 800 to 1500 euros.

The prosthesis

The term denture is a generic term that describes a variety of removable dentures. For the layman, the classic denture is a full denture, often referred to as a " third tooth ". The total denture is intended to replace the entire teeth and consists of a plastic base with integrated plastic teeth or ceramic teeth. The cost of a total prosthesis in the upper and lower jaw is between 800 and 1000 euros. Ceramic teeth are a bit more expensive than plastic teeth, but do not wear out so quickly.

You might also be interested in: costs of a denture

Furthermore, there are partial dentures in addition to the full dentures, which replace a part of the teeth and fill gaps. Here, a distinction is made between model cast prostheses and telescopic prostheses. Cast partial dentures are anchored by cast metal clamps on the remaining teeth, the teeth to be replaced are either plastic or ceramic. Telescopic prostheses work via a double-crown system. The remaining teeth are covered by a primary telescope, a cemented crown, which fits perfectly into the prosthesis as a secondary telescope can be fitted. The telescopic prosthesis offers good grip and high aesthetics. Price wise, it is therefore usually more expensive than a model casting prosthesis and depending on how many teeth are still available.

The palate plate

The palate plate in the upper jaw is necessary in some pines to get the hold of a denture by sufficient suction effect. By gravity, a prosthesis without palatal plate would simply fall down.

However, some patients have problems with it due to severe gagging and can not tolerate a palate plate. In the upper jaw, a complete palate-free prosthesis can only exist from a number of six teeth or implants. If fewer teeth or implants are present, the prosthesis must have a certain amount of palate to ensure the grip. Thus, the palate plate is, for example, always present in full dentures.

The implant

Implants are artificial tooth roots that are used to anchor a crown, bridge or denture into the jawbone. Furthermore, implants can also be used for anchoring orthodontic appliances and for holding epitheses (= custom-made face prostheses) in the case of defects in the facial area.

Implants are now surgically inserted into the bone under local anesthesia and are made of titanium or ceramic. Titanium is a particularly biocompatible metal that rarely generates repulsive reactions. As an implant form, screws or cylinders are preferred because studies indicate that the prognosis of healing is greatest in these forms.

Implantation is not possible with every patient. Insufficient bone supply and medications that prevent healing of the implant are the most common exclusion criteria for implantation. Furthermore, an implant insertion is only possible in adult patients, as in children, the skull and jaw growth still stops and the implant does not grow, so in this case, the growth of a jaw section would be inhibited.

An implant restoration is often associated with patience. If bone has to be augmented in advance, if the bone supply is insufficient, the time to implant is increased by 6 to 9 months until the artificial bone or bone graft heals. Most practitioners prefer no immediate loading during implantation but a long-term healing phase. Depending on the implant, it is then waited 3 months (in the lower jaw) to 6 months (in the upper jaw) until the implant has fully grown in the bone and can be loaded with dentures.

The cost of an implant is a pure contribution, which are measured with a price of 1000 euros upwards without dental prosthesis. Since dentists make the prices for implants completely private, there are particularly large variations in the price. See: Cost of a dental implant

The veneer

A veneer is a veneer that is attached to the outer surface of the tooth with a special tooth adhesive. The veneer is very thin and made of ceramic, which is why it can achieve highly aesthetic results. Therefore, a veneer is especially suitable for anterior tooth replacement and can thus reconstruct small defects. Due to the advanced manufacturing technique and the color brilliance, a difference to the "real" neighboring teeth is almost invisible to the layman. The cost of a veneer are higher than for a crown and can be priced up from 800 euros upwards.

denture material

The materials for dentures vary and determine the price depending on the design. Fixed dentures such as crowns and bridges are either made of metal, veneered with ceramic or unbleached, or completely made of ceramic.

Metals may be precious metals such as gold, but non-precious metals are chromium-cobalt-molybdenum alloys .

Implants are made of either titanium or ceramic, the structure attached to it as well. The crown lying on top can consist of a ceramic-veneered metal framework or be made entirely of ceramic.

Removable dentures such as a full denture is either completely made of plastic or a plastic base with ceramic teeth.

Partial dentures consist of metal parts with metal brackets or cast iron clamps and plastic or ceramic teeth. Telescopic prostheses are also combined work made of metal and plastic or ceramic.

Without metal - is that possible?

With fixed dentures, it is possible to use no metal and to manufacture crowns, inlays, onlays, partial crowns, veneers and bridges entirely from ceramic. For implants, there are recently zirconia implants, a type of ceramic in which the structure and the crown sitting thereon are also made of ceramic and therefore completely metal-free. With removable dentures, the total denture is made of plastic or combined with plastic teeth with ceramic teeth, which is therefore also metal-free.

For model casting prostheses, telescopic prostheses and similar removable variants, braces and prosthetic brackets as well as the base are always made of metal. Metal-free variants are being researched but are not on the market.

Cleaning the dentures

The cleaning of dentures differs in terms of whether the dentures is stuck or removable. Fixed dentures such as crowns or bridges are cleaned just like your own teeth. He is cleaned with a toothbrush and toothpaste at least twice a day. In the interdental spaces, crowns are treated with floss or interdental brushes, while pontics have special dental floss with a reinforced end and a fluffy center piece. This piece is threaded under the bridge member to be able to clean underneath.

With removable dentures toothpaste is not necessary. With a toothbrush and conventional detergent, the dentures should be removed from food debris, again at least twice a day, preferably directly after eating. For harder deposits and tartar, ultrasonic cleaning is recommended, in which the dentures are placed in an ultrasonic bath and the ultrasonic waves break off the deposits without stressing the materials. This process can be done once or twice a day. Denture cleaners in tablet form are also used as supportive.

Home remedies such as dilute citric acid solution or acetic acid solution can also remove hard deposits, but are not as gentle as the ultrasonic bath due to the acid and can damage the materials of the denture over a longer period of time.

Can you stick a denture?

A broken or broken dentures, eg broken plastic teeth, can not be glued independently. The fragments can not be inserted properly and without gaps by hand, furthermore, the use of household adhesives in the oral cavity is absolutely counterproductive. The substances are not suitable for the oral mucosa, partly carcinogenic and may damage the oral flora.

Therefore, a defective dentures in practice and the laboratory must be restored. At the dentist, an impression is taken to restore the dentures perfectly and to ensure optimal fit. After a waiting period of half to a whole day, the repaired dentures can be reintegrated. Sometimes the repair is still under the warranty period. Otherwise, private costs may arise, which can be clarified with the dentist.

Is a denture tax deductible?

Dentures fall under the benefits of tax, which can be deducted as " extraordinary burdens " in principle. However, they have to exceed the reasonable tax burden and are therefore considered as unreasonable costs. The reasonable costs are dependent on the income and calculated as a percentage thereof. Therefore, the person concerned should be informed in advance, how high his reasonable limit is and whether he can deduct the cost of the dentures tax. In case of doubt, one of the personal tax advisors can help.

history

Dentures is not an invention of modern times. There have always been attempts to replace lost teeth. Among the earliest finds are bridges of gold plates, which were fastened with gold wire, for example, the Etruscans. The missing teeth were replaced by human or animal teeth . The Romans knew already dentures.

Not only bridges or prostheses have been improved over time, also trying to replace the natural teeth by artificially made. Teeth were carved from a variety of materials such as ivory, wood or animal teeth . In the 18th century, teeth were made of porcelain . It was not enough to just teeth, but to manufacture the whole denture of porcelain. In the 19th century, the rubber was discovered as a prosthetic material, so the prostheses were much cheaper, so that more people could afford a prosthesis. Today, the rubber has been replaced by plastic and the artificial teeth are also made of plastic.

Fixed dentures: advantages and disadvantages

Fixed dentures are often more likely to feel like your own teeth than removable dentures. He is used with special cements and then stays in the mouth. The cleaning is the same as for natural teeth, but must be cleaned very carefully with floss and interdental brushes. Also aesthetically, fixed dentures can be perceived as more beautiful - depending on the price range in which the corresponding removable pendant is located. The hold, which often leaves much to be desired with removable replacement, is given here in any case.

As a disadvantage, one can list the loss of healthy hard tooth substance, since the tooth must be ground for a crown or bridge. Most of this, however, is already heavily destroyed, which is then to cope. Furthermore, fixed dentures usually can not be extended if, for example, a bridge is lost. You would then have to make a new dentures.

Removable dentures

A cheaper alternative to fixed dentures is the removable replacement, the prosthesis. It is suitable for a gap denture, in which even your own teeth are present, even if it is a free end position. In the case of complete tooth loss, the so-called full denture is the method of choice when implants are dispensed with. The partial denture consists of a plastic base, which rests on the mucous membrane and covers the entire palate in the upper jaw. In the lower jaw of the tongue area is left out, so that the prosthesis body is much smaller. The prosthesis is secured by braces, which are attached to the remaining teeth. See also denture adhesive.

In addition to the plastic prosthesis, a casting prosthesis made of metal can be used. For this purpose, special clip elements must be used. These are support brackets, which not only encompass the staple teeth, but also rest on the occlusal surface. This prevents the prosthesis from sinking too much into the mucous membrane. Another type of attachment, which requires much more effort, is the use of telescopes. For this purpose, teeth must be ground and crowned. The counterpart is incorporated into the prosthesis. Such an attachment has the advantage that no clip elements can be seen. The removal of the prosthesis can cause difficulties, however, since the telescopes can sit very tightly. In a cast prosthesis, portions of the palate base may remain free of metal. This is called a skeletal prosthesis.

Another way of attaching the partial denture is the sedimentation technique. This is dispensed with brackets, but after overcrowning a few teeth, a groove is incorporated on the side or at the back of the crowns and inserted the appropriate counterpart in the prosthesis, which can then be latched into the groove. Due to the lack of brackets, the attachment is invisible.

When all teeth are missing, only a full denture comes into question. Since there are no longer any teeth, it is no longer possible to stop using staples, telescopes or attachments. Therefore, the full denture holds only by adhesion to the mucosa. Prerequisite is a functional impression, which takes into account the muscle movements and a valve edge in the cover fold. There is also a viscous saliva produced by the parotid gland. In the upper jaw, a firm grip of the prosthesis can generally be achieved under normal jaw conditions under these conditions. In the lower jaw it is more difficult, because here also the leverage of the tongue is added. If you can not get hold of a full denture, only the insertion of implants remains.

The removable denture has the advantage that it is easy to clean and can be expanded if necessary, see also denture cleaning. However, a partial or full denture gives the patient the feeling of having a foreign body in their mouth. Over time, however, habituation occurs. Also, in a new prosthesis, the language may initially be disturbed, but that also loses itself after a settling-in period. In the initial phase, the salivary secretion may be increased.

Dentures and Partials (December 2019).


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