Prosthesis

Nowadays, tooth deficiencies negatively affect many factors such as aesthetics, speech, chewing, biting and tearing. In the light of current treatments, it is possible to eliminate tooth deficiencies with different prosthetic alternatives.

What are the treatment options for several missing teeth?

There are implant, fixed prosthesis and removable prosthesis treatment alternatives for one or more missing teeth.

Fixed Bridge: It is applied to cover the missing teeth by taking support from neighboring abutment teeth in order to meet the loss of aesthetics, pronunciation and function in the absence of one or more teeth. Depending on the case, a choice is made between materials and bridge types.

Implant-mounted Crowns and Bridges: These are fixed (bonded) prostheses applied by surgeons to the jawbone after the titanium screws in the form of roots are integrated with the bone (approximately 2-6 months) in the absence of one, several or all teeth.

What are the Stages of Making Fixed Prostheses?

The finalization of fixed prostheses involves at least 4 sessions of treatment.

• Preparation and Measurement: The tooth or teeth to be restored are reduced in size by the amount of restoration to be applied and precise measurements of the whole mouth are taken for laboratory modeling and procedures. Color determination is determined by the joint decision of the patient and the physician.
• Substructure Rehearsal: The zirconium or metal substructure prepared on the model is rehearsed in the oral environment.
• Porcelain Proofing: This is the stage before the restoration is finished. The relationship of the porcelain prepared in the laboratory with neighboring, opposite teeth and surrounding tissues is checked. Aesthetic and color harmony is checked. The patient's final approval is obtained. It is sent to the laboratory for polishing.
• Polishing and Cementation: The restoration polished in the laboratory is tried in the mouth for the last time, if there is no problem, the restoration is fixed on the tooth after the patient's approval is obtained, and the residues are cleaned after the adhesives harden.
• Patient Information: All oral hygiene and care has a direct impact on the lifespan of the restoration. The patient is informed if there are special methods required for restorations (bridges). An appointment is made for routine checks.

What is a Removable Prosthesis?

Removable dentures are appliances that can be worn and removed by the patient and replace missing teeth. There are various types including total dentures, partial dentures, immediate dentures and overdentures.

• Total Dentures: In cases where there are no natural teeth left in your mouth, these are prostheses made of acrylic, which are supported by the bone tissue remaining in the upper and lower jaw, and are also called 'dentures' among the people. It finds application in special cases where implants cannot be made. Using porcelain teeth in total dentures is generally not a healthy approach. For this reason, plastic teeth are used in these prostheses; however, these teeth may become discolored over time.
• Partial Dentures: In cases where some of the natural teeth are present and some of them have been extracted, removable dentures are called 'partial dentures'. Partial dentures are either made of acrylic or one-piece cast. These types of dentures provide retention with crochet wires attached to the main teeth. For patients who think that this wire appearance is not aesthetic, aesthetic prostheses with sensitive connection can also be made.
• Immediatric Dentures: In cases where all the main teeth need to be extracted, if the patient does not want to be toothless, prostheses called 'immediate dentures' can be made, which are inserted immediately as soon as the natural teeth are extracted. When the healing is complete and the tissues become incompatible with these prostheses, the patient's permanent prostheses are started to be made.
• Overdentures: The prostheses that the dentist will make following some special preparations on a few natural teeth or roots in the mouth are called 'overdentures'. The natural teeth or roots on which the prosthesis sits provide retention and stability to the prosthesis.

Will I get used to my dentures?

Dentures take some time to get used to and this varies from person to person, even with very well-made dentures. The new denture will feel foreign and large in the mouth. There will be a feeling of fullness in the lips and cheeks. It is more difficult to get used to the lower denture than the upper denture, as the lower denture can move and dislodge more. In the first days, the amount of saliva increases as a result of stimulation of the glands. This will pass over time.

Why do dentures hurt?

As a result of the prostheses sitting on soft tissues and moving, no matter how much care is taken in their construction, there may be dents in some places. The patient should not neglect the controls and the prosthesis should be corrected. It is very wrong for the patient to pick up the dents. The patient should have worn the prosthesis for at least 9 hours before coming to the dentist for correction. Only this time allows the problematic areas to be seen.

Will I be able to eat normally with my dentures?

During this process, it is recommended that patients chew slowly on the right or left side, whichever side is more comfortable, without opening their lips and taking small bites. In the first days of wearing dentures, soft foods should be eaten and should never be bitten with the front teeth. This causes the back parts of the dentures to move away from the tissues. The tongue, lips and cheeks have a great influence on the control of the prosthesis. A patient who has used dentures in the past is easier to get used to than a new patient. If the patient has been toothless for a very long time, he/she can eat more easily without teeth than with dentures. However, this is not healthy. Once he/she gets used to his/her dentures, he/she will be able to eat much more comfortably with dentures. It takes at least 4-6 weeks to eat normally with total dentures. Patients should spend this period taking into account the recommendations of their physicians and most importantly, they should be 'determined' to use their prosthesis. They should not give up and remove the prosthesis immediately. This is especially true for patients with old prostheses. Because if they take off their old prostheses and put on their new ones at the slightest knock, it may take a long time for them to get used to their new prostheses.

Will I be able to speak normally with my dentures?

Dentures can cause changes in the oral environment, such as difficulties in the pronunciation of some sounds, even if only slightly. In this case, you should practice reading aloud and in front of a mirror and try to normalize the pronunciation by repeating words that cannot be said correctly.

Will I wear my prosthesis for 24 hours?

Patients should wear their dentures continuously in the first few days to get used to them as soon as possible. However, after getting used to them, the prostheses should not be worn at night, the tissues should be rested; they should be left in water when removed to prevent drying and possible dimensional changes. This is very important for the health of the tissues. The cheek resting on the pillow and the weakening of the neuromuscular control mechanism at night may cause the dentures to come out of the mouth.

Should I use denture adhesives?

Continuous use of denture adhesives is not desirable. However, there is no harm in using them for short periods of time when necessary. Your doctor will explain to you how to use these adhesives when needed.

Will I be able to use my prostheses for life?

Prostheses cannot be used for life. Although it is said that some procedures should be performed every five years under normal conditions, this period varies according to the patient. The reason why prostheses cannot be used for life is the changes in living tissues. Over the years, the compatibility of prostheses with tissues deteriorates. The prostheses become loose, start to fall off, and it becomes difficult to eat. This has nothing to do with prostheses. It is entirely the result of changes in living tissues. In this case, the dentures need to be filled, the base material that is out of harmony needs to be completely replaced or a new denture needs to be made. The dentist will make this decision.

How long will it take to make my dentures?

The construction of removable prostheses normally takes five sessions from the time the impression is taken. However, the number of sessions may increase if necessary. After the prosthesis is fitted, patients may need to come for a few more sessions to get used to the mouth. In this case, it may generally take 1-1.5 months for a removable prosthesis to be completely finished and for the patient to be able to use the prosthesis. In this regard, our patients should be aware that a certain period of time is required for construction and acclimatization.

Do I need to visit my dentist after getting used to my dentures?

Patients with total dentures should be checked every six months, just like people with natural teeth. Depending on various factors, the tissues under the denture may change. Over time, the prosthesis loses its compatibility with the tissues and may cause damage to the tissues until the patient realizes this. Various lesions may occur in the mouth, related or unrelated to the prosthesis. For this reason, patients using total dentures should be carefully examined by a physician at least twice a year.

Are there alternatives to classical removable dentures?

The most modern alternative to conventional removable dentures is implant-supported dentures. This is especially true for lower total dentures. The implant procedure improves both the retention and stability of the prosthesis. In order for these more costly prostheses to be applied, all local and systemic conditions must be suitable. The prosthodontist will give you the necessary information after examining you.