Dental prosthetics deals with the replacement of lost teeth and soft parts of the oral cavity with the use of total or partial prostheses, crowns, and bridges. What was important in dental prosthetics was to find a material that is both aesthetically acceptable and resistant enough to stand all the forces that develop during the chewing.
The last few years have brought a true revolution to dentistry with new materials. The main features are light refraction and transparency that is very similar to a natural tooth. Moreover, these materials have an exceptional mechanical resistance that is as high as the previously used metal.
Crowns, metal-ceramic bridges, CAD/CAM, metal-free ceramics. Crowns are made in case of bigger damages of the natural tooth (due to caries, fracture, i.e. when a filling for that tooth cannot be made) or for aesthetic reasons (unsatisfactory colour, shape, or slight deviations of tooth positions). The tooth that is being restored has to be prepared first so that a crown can be placed there. If a large part of the tooth is missing or strengthening is necessary, a cast upgrade or fibreglass peg are usually done.
Having been prepared, the remaining part of the tooth is imprinted and a crown is made in a lab accordingly. During the final stage, the crown is cemented to the prepared tooth, and when they are bound, the tooth gets a completely natural appearance. When it comes to metal-ceramic bridges, a layer of ceramics is applied to the metal substructure and completely covers it so that the metal cannot be seen in the mouth. That way, resistance is ensured by the metal, while at the same time, ceramic on the surface contributes to a great aesthetic effect. Except for the high resistance and excellent aesthetics, these upgrades are not so expensive, so patients opt for them very often. It was not easy to find a material that is both aesthetically acceptable and resistant enough to stand all the forces that develop during the chewing.
Zirconium dioxide and lithium disilicate are materials that have made a true revolution in dentistry in the last few years. The main features are light refraction and transparency that is very similar to a natural tooth. Moreover, these materials have an exceptional mechanical resistance that is as high as the previously used metal.
Prostheses can be total and partial. Total prostheses are created when all teeth are missing, whereas the solution for patients with a small number of preserved teeth is partial prostheses. A partial prosthesis is attached to the remaining teeth with small hooks and attachments (buckles or fasteners) and they can be acrylic or skeletal (also called wisil dentures). A partial acrylic prosthesis is completely made from acrylate and attached to the remaining teeth with wire hooks, so it is less resistant than a skeletal prosthesis. For that reason, it is less used, but its advantage is the cheaper price. A partial skeletal (wisil) prosthesis is a better solution because of the metal skeleton that provides more resistance and greater comfort ensured by the smaller part of the prosthesis leaning on soft tissues (the palate, sublingual region). Thus, the feeling of a foreign body is masked. Its advantage is also the attachment to the remaining natural teeth with the use of more precisely made cast hooks, which ensures considerably better stability in the mouth. Instead of hooks, attachments can be used to form a much better connection to the surrounding teeth.
Attachments hold the prosthesis firmly and stably in the mouth, and they are hidden in the part of the prosthesis that cannot be seen from the outside. In those cases, the bearing teeth have to be upgraded with special crowns attached to the prosthesis based on the principle of keys and locks. The word “veneer” stems from German “Furnier” and French “fournir”, i.e. “furnish or cover something made of a cheap material and improve it”.
In dentistry, it has a similar meaning, however, veneers are used for teeth and lead to better aesthetic results in patients.
No matter if the veneers are composite or ceramic, the preparation of the front surface of the tooth is necessary, usually of the anterior teeth - incisors. That way, a thin layer of enamel is removed for composite veneers or a somewhat thicker layer for ceramic veneers. Dental veneers are the least invasive method for the change of colour, shape, and position of the teeth. They enable the maximum preservation of the tooth substance and beautify the smile with minimal preparation.