It is our aspiration to preserve the natural tooth substance and to preserve teeth for a lifetime. Unfortunately, this is not always possible. In the worst case teeth are lost. Then the missing teeth should be replaced quickly. Apart from cosmetic reasons and possible problems with food intake, the remaining teeth migrate into the gaps over time. This can lead to Malocclusion and inappropriate stress on the joint, which can lead to problems.
There are different ways to replace teeth. Crowns and bridges can replace single teeth, partial or full dentures replace more teeth. A distinction is made between fixed and removable dentures. The aim should be to regain a functional and aesthetical dental arch. Alternatively, in the event of tooth loss, it is of course always possible to use dental implants.
Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.
Different materials are used, depending on the aesthetic requirements. All-ceramic crowns and bridges are the most aesthetically pleasing option.
A crown is used to entirely cover or “cap” a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment.
Crowns can be distinguished from partial crowns or onlays, which do not completely cover the tooth. An onlay is always to be preferred if intact parts of the natural tooth can still be preserved. This protects the pulp, i.e. the tooth nerve.
Gaps between teeth can be fixed by bridges if the adjacent teeth are firmly anchored in the bone. These teeth are prepared to be covered by crowns. The bridge is then fabricated in the laboratory and the missing tooth is shaped with a convex pontic at the base. After cementing the bridge in the mouth, it is not recognizable that a tooth was missing in that position.
Two types of removable dentures are available — complete and partial dentures. Complete dentures are used when all teeth are missing, while partial dentures are used when some natural teeth remain.
The most important anchorage types for dentures are telescopes (double crowns), attachments and clasps. Compared to telescopes and attachments, clasps have the disadvantage of being visible and putting unphysiological strain on the teeth. Telescopes, on the other hand, are the type of anchorage that exerts the most physiological load on the abutment teeth.
Full dentures are indicated when natural teeth are no longer present. A full denture is held in place by the suction power and muscles of the mouth. To ensure an optimal hold, high-precision impressions of the oral cavity and soft tissues must be taken. The expansion of the denture base plays a decisive role for the hold.
Especially in the lower jaw, a massive reduction of the jaw bone (atrophy) can occur after a few years of edentulism. To prevent this and to optimize the dentures precise fit, full dentures can be anchored via implants.