Dental Prosthesis: know the types and which is the most indicated

In dentistry, there are different mechanisms to restore the aesthetics and functionality of a patient’s dental arch.

From orthodontic appliances to the repair of teeth with resin, current technologies allow a complete smile and functional chew to be returned to those who need it.

Among the methods used is the dental prosthesis, popularly called denture.

It consists of a structure produced from the mold of a person’s dental arch and is used to replace missing or badly damaged teeth.

Despite having become known as a structure that offers an artificial aspect, current techniques allow the prosthesis to offer solutions for those who need a new smile, in a natural way.

Keep reading and learn more about it!

What is a dental prosthesis?

Dental prostheses are structures that imitate the dental arch, used to replace a person’s missing teeth, either due to accidents or health problems such as caries and periodontitis – gum infection.

They serve to recover the aesthetics and functionality of the oral region and are made from the mold of the patient’s own mouth, that is, made to measure.

They can be made of different materials, such as acrylic or thermoplastic, and can be fixed or mobile.

The fixed version is attached to the mouth, usually with screws or dental cement, and only a professional can remove them after being placed.

The furniture are those in which the patient can remove and replace the structure in the mouth at any time.

What are the types of dental prosthesis?

There are different types of dental prosthesis available today. They can be divided according to their characteristics, such as removable ones – they can be removed at any time – and the fixed ones – are attached to the dental arch. There are also subdivisions such as partial, total, flexible and silicone.

Specifically, the main types that can be found in the market are:

Removable

The removable prosthesis, as the name implies, is one that is not attached to the mouth, that is, it can be removed and placed at any time.

Also known as dentures, it is used to replace one or more teeth and can be partial or total.

Total

The total version is one that replaces all teeth in the mouth, indicated for people who have none or only fragments of teeth. If the person still has fragments, extraction is done so that the prosthesis can be used.

Its structure is made by a base, usually of acrylic, that imitates the mucosa and is ded in the gum.

If the use is in the upper part of the dental arch, the fitting is also made in the palate – roof of the mouth. If it is at the bottom, the prosthesis has the shape of the letter U, to accommodate the tongue.

Partial

A partial denture is one in which it is not necessary to replace the entire dental arch, but only a few teeth.

Generally, this type of structure has metal clips (like hooks) on the tips of the base, which mimics the gums. These clamps are attached to the remaining teeth in the mouth and, thus, serve as support for the prosthesis.

Flexible

One of the existing dental prosthesis options is the flexible one. It is removable and made of a thermoplastic material – type of plastic that, when reaching a certain temperature, can be molded.

It receives this name, because its base is malleable and soft, different from the conventional ones usually made of acrylic.

It is a good option for partial removable, since, in addition to providing greater comfort, it also provides a better appearance. This is because the clamp that holds the structure is the same color as the gum or teeth.

In this way, the metal structure that holds the prosthesis in the conventional version is eliminated, and there is no risk of appearing when smiling.

It is worth mentioning that this type of prosthesis is made of a delicate material and, if there is any damage to the part, unlike the others, there is no way to repair it, requiring the replacement of the structure.

In addition, the patient’s adaptation may take longer than usual, since, because the prosthesis is malleable, there may be less stabilization in the mouth.

It is important to note that not necessarily all people will be able to use this type of prosthesis.

One of the requirements is that the patient still has several teeth in his mouth, otherwise, there will be difficulty in chewing during use.

Only a trained professional will be able to assess the clinical condition of each patient and indicate the possibility or not of using a flexible prosthesis.

Silicone

Silicone is one of the materials used for making removable dental prostheses. This type of structure aims to have a softer base than conventional ones.

In the same way as in the flexible version, metal staples are eliminated, being replaced by the colors of the material itself, which, in this case, can be transparent or of another color.

Thus, the silicone prosthesis is a good ally in terms of aesthetics. However, it is worth mentioning that this type of material can, over time, absorb liquid pigments and ingested foods.

Thus, the color presented during the first days of use can be affected, changing the initial color of the material.

In addition, the patient’s adaptation may be slower because of the more flexible structure, which may cause difficulties in chewing and phonation.

Because of these impasses, it is important to consult and follow the guidelines of the professional dentist when choosing this version.

Fix

A fixed dental prosthesis is one that is attached to the patient’s dental arch. It is usually supported by preexisting teeth in the mouth.

There are, in general, two situations for the placement of fixed dentures: the replacement of a few teeth and the entire dental arch.

If the goal is to supply only a few missing teeth, the procedure known as a bridge or crown is performed.

For cases of replacement of the entire dental arch, a prosthesis can be performed under implants, also known as a protocol.

Crown

The crown is indicated in cases where the patient has lost part or all of a tooth, either due to fractures or problems such as cavities. It is used to partially or completely cover a damaged tooth.

In general, it aims to restore both functionality and aesthetics of the place and, therefore, it can also be applied to correct deformations or protect sensitized teeth.

This type of prosthesis consists of an artificial tooth, molded from the patient’s mouth, made of porcelain or other metallic materials.

For cases in which there was total loss of the tooth, it is necessary to place an implant, which will fix the structure.

When the coverage is partial, the crown can be cemented above the pre-existing tooth, and there may be a need for wear, that is, a decrease in its size for the perfect fit of the prosthesis.

Ponte

The bridge is a type of fixed prosthesis, used in cases of loss of few teeth.

Thus, despite the lack of a tooth, there are still other neighbors, who will serve as pillars for the bridge to be placed.

In the version that recovers only one tooth, for example, the bridge consists of three porcelain units grouped: an artificial tooth in the middle, which will fill the empty space, and partial crowns on both sides, which will be coupled over the natural teeth.

It is worth mentioning that not necessarily all dental bridges will be in this format. It may be that there are adaptations according to the number of teeth to be replaced, changing the position of the abutments, for example.

As part of the bridge is placed above the existing teeth (the abutments), it is necessary that they undergo wear, that is, reduce the size, before receiving the prosthesis.

This, so that there is an ideal fit and the dental arch is not elevated or bulky. Spending is usually done on the entire circumference of the tooth and also on the top.

After wear, the prosthesis is cemented, that is, fixed, on the existing teeth.

Under implant or protocol

The fixed type under implant, also called a protocol, is the prosthesis used to replace the entire dental arch of a person.

It is a unique structure that fills all teeth and is completely screwed into the mouth.

In this case, before attaching the prosthesis, surgery is performed to place some implants – metal pins, in general, inside the jawbone.

These implants will serve as a basis for fixing the prosthesis, which will be threaded on these pins. In general, 4 to 6 metal pins are placed, which will hold about 12 teeth.

Overdenture

The overdenture prosthesis is a version of prosthesis on implants, however, removable.

It consists of the application of 2 or 4 teeth from the patient’s mouth, however, instead of placing the prosthesis directly on the pins, a metal plate is placed.

The plate is fixed, that is, there is no way to remove it, and on its surface there are small clips, which will serve to fix the structure of the prosthesis (which also has clips).

Thus, the prosthesis is fitted to the plate and remains firm, however, there is a way to remove it for hygiene.

What is the best dental prosthesis?

Each patient has his particularities and needs. Thus, it is not possible to state which is the best dental prosthesis, since the response may vary according to the person’s clinical condition. Thus, it is important to consult a professional who will indicate the best option for each dental arch.

Despite this, in general, some of the prostheses are indicated for specific cases.

For example, if the person has lost all teeth, but is in good general oral health , a full fixed prosthesis may be recommended. If the patient has lost only one tooth, the crown may be a good option.

In general, there is no better or worse prosthesis, but one that meets the needs of a patient more or less effectively.

Who needs to put?

The dental prosthesis, regardless of the version, is indicated for patients who have missing or damaged teeth, which compromise the functionality and aesthetics of the dental arch.

It can be used by people looking for a solution to correct chewing and phonation or even for those who just want to improve their appearance.

It is important to emphasize that the decision to place a prosthesis must be made with a trusted dentist, who will analyze the clinical picture and indicate which is the best option for each patient.

What is the price of a dental prosthesis?

The price of a dental prosthesis depends on some variables such as the geographic region, the professional chosen for the placement, type of prosthesis and also the material used in the manufacture.

There is no way to indicate specific values, however, some of the prices * can be approximately:

* Prices consulted in June 2020. Prices may change.

How long does a dental prosthesis last?

It depends . The duration of a dental prosthesis may vary according to the type of structure, material used in the manufacture, the professional chosen for the placement and hygiene care of the patient.

In general, a prosthesis can last between 6 to 8 years, and its replacement may be indicated after this period.

How to care for a dental prosthesis?

Care with the dental prosthesis is essential to maintain the integrity of the structure and ensure a good longevity of the product.

Despite completely replacing the aesthetics and chewing of natural teeth, there are some actions that must be done differently than usual, such as tooth brushing, for example.

For those who use prostheses, simple actions like this may require even more attention on a daily basis.

Among the different necessary care with the piece, the main ones are:

Maintain proper hygiene

Proper hygiene is essential for a good result of using the prosthesis. Ensuring that food scraps do not accumulate in the mouth is important so that bacterial plaque does not form, for example, which can harm the material of the prosthesis.

In general, cleaning is a little different for the removable and fixed version.

Removable

In the case of a removable prosthesis, it is recommended to clean the structure after each meal. It is worth mentioning that the cleaning should not be done directly in the mouth – it should be removed and the cleaning done by hand.

It is recommended that running water and mild soap or paste suitable for prosthesis be used.

This is because the toothpaste generally used on natural teeth is very abrasive and can cause damage to the structure. The brush must also be special, so that the bristles do not cause problems.

In general, simply brushing both inside and outside the structure, ensuring that there is no food residue on the prosthesis.

Fix

For fixed dentures, hygiene is similar to that of natural teeth, being carried out directly in the mouth.

It is recommended to brush in the usual way, with brushes and specific pastes for prosthesis and, when flossing, be careful not to damage the structure.

Take out to sleep

For cases in which the prosthesis is mobile, it is recommended that, before sleeping, the patient removes the structure.

This allows the oral tissues to rest from the pressure made by the prosthesis during the day and to remain healthy.

In addition, during the night, the body produces less saliva, which generally results in a greater proliferation of bacteria in the oral environment.

If the patient is using the structure, there may be an accumulation of these microorganisms in the prosthesis, causing problems of fungal infections, such as oral candidiasis .

Keeping the prosthesis in the water

In periods when the person is not using the prosthesis, such as at night, it is recommended to leave the structure in a container filled with water or a solution suitable for prostheses.

This allows the structure, usually made of acrylic, to not dry out and be stained, in addition to promoting a greater cleaning of it.

It is noteworthy that hot water should not be used or boiling in the piece, only lukewarm water.

Make regular visits to the dentist

Making frequent visits to the dentist, usually every 6 months, is also part of the care with the dental prosthesis, so that the professional can check the condition of the piece.

In addition, whenever there is any discomfort or problem, it is very important to seek professional help, which will indicate the best way to resolve the situation.

Using a damaged structure, such as dentures that are too loose or even that are abnormally hurting the gums, can be harmful to oral health.

Thus, it is always worth turning to a professional when problems occur, in addition to following the guidelines of the dental surgeon.

What is the difference between implant and fixed dental prosthesis?

Both the implant and the prosthesis are techniques used to replace lost teeth. Despite this, the way of carrying out the procedures is different, in addition to presenting cost, durability, stability and other characteristics, which are also different. In general, advantages and disadvantages can be seen in both cases:

Specifically, among the differences in the procedure are:

Dental wear

The main distinction between the two techniques is that for the placement of the fixed prosthesis, it is necessary to wear the remaining teeth, while in the implant this is not necessary.

This is because, in the fixed prosthesis, it is necessary that the structure is supported to keep it in place. In this way, the teeth adjacent to the empty space serve as pillars for the prosthesis.

In order for the result to be aesthetically pleasing and the structure to be satisfactorily attached, it is necessary to reduce the size of the abutment teeth, so that the crowns fit perfectly, without leaving the dental arch with an abnormal volume.

In the case of the implant, this wear is not done, since the artificial tooth is attached to a metallic pin, implanted next to the person’s jaw bone.

Thus, in general, interference with another tooth is not necessary for placement.

Bone loss

A characteristic that differentiates the fixed prosthesis and the implant is bone loss.

When a tooth is lost, the bone in the affected region gradually disintegrates, leaving an empty space. The implant fills this space with the implanted metallic pin.

In the case of the prosthesis, this occupation does not occur, leaving a gap in the place, previously occupied by the root of the tooth.

This can increase the chances of infiltrations – the entry of residues and bacteria into the tooth – and cavities, damaging the prosthesis.

Cost

The cost is a point that differentiates the treatments. The prosthesis, in general, has a more accessible value than the dental implant, since it does not involve surgery, for example.

The value of the procedure may vary according to the specificity of the condition of each patient, however, the average prices are *:

Fixed dental prosthesis : R $ 1400 to R $ 1600;

Dental implant : R $ 1500 to R $ 2500 (per tooth).

* Prices consulted in May 2020. Prices may change.

Durability

The durability of both the prosthesis and the implant can vary according to the quality of the material used in the structure, the patient’s care with oral hygiene and if the person has habits such as bruxism – grinding or clenching teeth during sleep – , for example.

In general, a fixed dental prosthesis lasts between 6 to 8 years, and it is recommended to change it after that time.

The dental implant can last for approximately 15 years.

Comfort and stability

When placing a dental prosthesis, the artificial teeth are grouped together, with no space between the teeth. This harms some points of hygiene, since there is no way to floss, for example.

In the implant, the artificial crowns are individualized, with spaces between the units, as in the natural dental arch.

In addition, the dental implant tends to have greater stability in the mouth, since it is attached to a pin attached to the bone, that is, it is fixed more firmly.

The smile can directly affect a person’s self – esteem . Damage to teeth or even the lack of them can cause, in addition to chewing problems, social inhibition and fear of smiling.

Therefore, tooth replacement mechanisms and treatments are important to return a complete dental arch to those in need.

Among the options available are dental prostheses, very useful both for those who have lost all their teeth and for patients who lack one or two teeth.

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