Prosthodontics

What is Prosthodontics?

Treatment options

Crowns

A crown, or cap, can be required for a variety of reasons. Often a tooth that is heavily filled or has fractured will need to be crowned. In these instances, a crown is required to maintain the structural and functional integrity of the tooth. Teeth that have been root filled require a crown for the same reasons. Crowns are also provided to help improve the aesthetics of the teeth.

There are broadly 3 types of crowns:

1 Gold

The first type of crown is made entirely of gold. For cosmetic reasons, this is usually placed on back teeth. The wear characteristics as well as the fit of gold is excellent and it is generally accepted that gold restorations have the longest lifespan compared to other materials.

2 Porcelain bonded to metal

These crowns have a metal core with porcelain bonded on to this rigid foundation, and thus have advantages of strength and good aesthetics. These can be provided on front or back teeth. Despite the underlying metal, excellent aesthetics can be achieved with metal bonded crowns and these are often the most appropriate option.

3 All Ceramic

Finally it is also possible to have a crown made entirely of porcelain. Cosmetically, these are the most appealing but they may be more really suitable for front teeth and their use should be carefully planned.

The provision of a crown is usually carried out over 2 visits. During the first visit, the tooth is carefully prepared to allow room for the thickness of the crown. A temporary crown is made and fitted while the new one is being made. After the impression is taken of the tooth, the crown is custom-made by a lab technician according to the dentist's instructions. This is a very precise process, which ensures an exact fit. At the second appointment, the temporary crown is removed and the new crown fitted.

A crown is often the most reliable and predictable way of restoring strength to a weak tooth. The new crown should look, feel and function just like any of your natural teeth.

Bridges

Bridges are provided to replace missing teeth.

These can be a wide variety of design, but basically they can either involve the preparation of the supporting teeth (‘Conventional’ bridgework) or be of an adhesive design which is basically just bonded to the supporting tooth or teeth. Adhesive bridges (commonly of a design called ‘Maryland’ bridges) do often involve a little preparation of the supporting teeth, but this is minimal and usually does not even involve the need for anaesthetic.

Bridges are also usually provided over 2 appointments, the first being for preparation of the teeth, impressions and fitting of a provisional bridge. The second appointment is to try the new bridge in and if all is well to fit it. Depending on the complexity of the situation, there may be additional stages such as a ‘biscuit bake stage’ a technique where the bridge is tried in an unglazed form to allow adjustments to be made before the bridge is finished and fitted. In addition having a provisional bridge in place for a period of observation is often recommended to allow for review and adjustments to be made.

Bridges of course can be used in combination with other techniques such as the provision of crowns.

Partial/Full Dentures

Dentures are removable restorations to replace missing teeth. This can either be used to replace some or all of the teeth and can be used in conjunction with other restorations such as crowns and can also be supported by dental implants.

Removable prosthesis obviously have the disadvantage that they are not fixed, but can work very well and sometimes are the most suitable, or only option. They can be particularly appropriate in situations where many teeth are missing or where there has been very heavy loading applied to the teeth such as in the case below.

FAQs