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Dentures

What can we imagine under the term denture? As the name suggests, dentures are used to replace missing teeth or to restore their original shape (function). Dentures are those that have been created outside the patient's mouth based on dental impression.
Dentures can be divided into two groups depending on whether the denture is removable or if the patient has it fixed permanently in the mouth.

Fixed dentures

These include all dentures that are firmly fixed to teeth or implants. These are mainly cosmetic veneers, onlays, crowns and bridges. Fixed dentures represent the best solution in terms of functional, aesthetic but also psychological properties.

Veneer

These replace the front tooth surfaces and are most often made of highly aesthetic ceramic material. With veneers we are able to improve any undesirable shape or color of the teeth, so these dentures are very popular in the aesthetic area of the teeth. These are thin and brittle ceramic dentures that will only get the required strength after they are attached to the tooth. Veneers can also be placed on teeth without previous grinding, but in most cases, it is necessary to remove a portion of hard tooth tissue to ensure optimum conditions for applying the veneer. Because it is an irreversible process, careful planning is needed so that the patient has a good idea about the result before grinding.
Before making dental veneers, we create models where wax veneers are designed. This work is consulted with the patient. We are particularly interested in whether the patient is happy with the shape of the teeth, or whether they wish to make some adjustments. Then we pass the situation into the patient’s mouth using temporary resinous material to get a better idea of what the end result will look like. It should be noted that we have not yet made any irreversible procedures at this stage. We have good experience with having the patient go home with a temporary denture to get feedback from family and friends. Only after everyone is satisfied can we get to work. The teeth are gently prepared, a dental impression is made, and the dental technician makes the aesthetic tooth veneers based on the information obtained. These veneers are carefully fixed one at a time to the teeth and the result is fantastic.

Onlay

This is a modern denture for the lateral part of the teeth. Its task is to add to the damaged tooth to restore its original shape and protect it from further damage. We can imagine the onlay as a large white filling that sticks to the tooth in one piece. It is made of ceramic or composite material. An onlay covers the whole chewing surface of the tooth, which allows a uniform distribution of chewing forces and reduces the risk of rupture. Onlay is a suitable type of denture especially for teeth where the root canals have been treated. Teeth are no longer nourished by the pulp and become brittle. Such a tooth, in combination with a large chewing pressure, is in danger of formation of a deep crack, which often leaves the physician with no choice but to extract the tooth. This needs to be taken into consideration every time the tooth is significantly weakened by an inappropriate filling or a root canal filling.

Dental crowns

These take form of a thin protective coating that covers the whole crown part of the tooth and prevents its damage. Dental crowns therefore have a protective function. Like onlays, they are indicated after treatment of root canals and to protect damaged teeth. Using dental crowns, we are able to make a more significant correction of color and shape in the aesthetic area of the teeth. Dental crowns can be divided according to the material used: metal, resin, ceramic and metal-ceramic crowns.

Metal crowns

These can be put on the back teeth, where large chewing forces are at work. Such crowns are not very aesthetic, so we do not recommend this treatment for teeth visible while smiling or having a conversation. They could unnecessarily attract unwanted attention. But there is nothing wrong with them as far as function is concerned.

Resin crowns

They have the exact opposite properties than metal crowns. The aesthetic aspect is satisfactory, but the resin crowns do not have sufficient resistance to withstand large chewing forces long-term. They are also more prone to color changes and for this reason they are only suitable as a long-term provisional solution.

Ceramic crowns

These have the best optical properties out of all dentures, so the resulting aesthetic impression is very good. Ceramic crowns look natural and are often indistinguishable from your own teeth. In addition, they are not as prone to changing color or losing gloss as other types of substitutes. They are therefore the ideal solution whenever we make crowns on the front teeth.

Metal-ceramic crowns

As the name suggests, it is a combination of two materials: metal and ceramics. The thin metallic layer is put on the tooth and provides mechanical resistance of the denture and thereby reinforces it. The ceramic layer then covers the entire crown surface and takes care of the aesthetic aspect of the denture. Metal-ceramic crowns have a very good resistance to chewing pressure and the resulting aesthetic impression is also very good, so they are suitable for back teeth. Because the dark thin metal hem can be seen in the margins of the tooth, a full-ceramic crown is best suited to the front teeth.

Dental bridges

These allow us to replace the missing tooth to fill the gap that appeared after its loss. The construction of the dental bridge resembles a classic bridge. It consists of pillars and segments between them. Under the pillar constructions, we can imagine classic dental crowns that are fixed on ground teeth. The segments then connect these crowns. They have the shape of a natural tooth, and they fill up the space after it's lost. Dental bridges, like crowns, are made of metal, resin, ceramics or metal ceramics.

Removable dentures

These allow us to replace missing teeth if it is not possible to make a fixed denture. A typical example is the loss of back molars. It is not possible to create a classic dental bridge here because the last tooth on which the bridge would be anchored is missing. So, we have two choices. Replace the missing back teeth with implants or make partial removable dentures. Removable dentures are usually the cheaper solution, so they are mostly chosen for financial reasons.
Even with a perfectly made removable denture, it is necessary to remember that its function is significantly reduced compared to natural teeth. In other words, you have to learn to eat and talk properly with them.
As the name suggests, these dentures are not "fixed" in the mouth. Each evening, the denture needs to be carefully cleansed of food residue and the coating that was created during the day. Soap and a regular brush or toothbrush are all that it takes. Then rinse with water and store the denture it in a dry place.
Even with complete dentures, it is necessary to take regular preventive examinations. Although the teeth cannot deteriorate, regular check-up of the prosthetic bed and adjustment of the denture are necessary for the proper functioning of the denture.

Medical team

Doc. MUDr. Eva Gojišová / Chief physician - dentistry
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