Options for replacing teeth/restoring teeth

• options for restoring teeth:

  • intra coronal restorations
  • extra coronal restorations
  • cast restorations
  • fixed prosthesis
  • removable prosthesis
  • dental implants
  • no treatment
• intra coronal/direct restorations

  • permanent: amalgam, composte, glass ionomer
  • dressing: kalzinol, GI, Poly F
• composite filling

  
• intra coronal restorations/indirect

  • cast restorations: made outside mouth by dental technician from imps/scan taken by dentist
  • gold, porcelain inlays, pressed composite
• porcelain onlay

  
• gold inlay

  
• extra coronal restorations:

  • crown - full veneer, 3/4 crown, post crown, temp crown
  • material - gold, non precious metal alloy, porcelain bonded to metal, ceramics, acrylic resin
• porcelain crowns

  
• gold crown

  
• non-precious metal crown

  
• post crown

  
• why might we place an extra coronal restorations?

  • tooth heavily restored
  • root filled
  • restore occlusion
  • prevent repeat fracture of particular filling
  • aesthetics
  • 3/4 crowns - restore, protect cusps
  • temp crown - protects, stablises
• fixed prosthesis - Bridges

  • fixed-fixed: 2 retainers, 1 pontic, consider viable roots, no associated dental diseases, enough tooth tissues for support, rads required.
  • cantilever: pontic supported by 1/2 retainers, on one side of gap.
  • maryland bridge: pontic supported by 1/2 wings cemented with adhesive.
• fixed - fixed bridge

  
• cantilever bridge

  
• maryland bridge

  
• what would we consider with bridges as a DHT

  • excellent OH to maintain gingivae and bridge work
  • expensive
  • advanced conservative tx by dentist
• acrylic partial denture

  
• partial colbalt chrome

  
• pros of acrylic denture

  • less lab time
  • easy to add teeth
  • easy to repair
  • good aesthetics
  • cheaper
• cons of acrylic dentures:

  • allergy to acrylic
  • more palatal and soft tissue coverage
  • incorrect design = strip gingivae
  • good oh of denture and remaining teeth
• pros of cobalt chrome denture:

  • kinder to oral tissues
  • tooth and tissue support
  • more precise and stable
  • less allergies to metal
  • stonger and thinner so better tolerated
• Two types of acrylic denture?

  • acrylic (plastic)
  • thermoplastic nylon (valplast)
• cons of cobalt chrome denture:

  • expensive
  • more lab time
  • more skill - technician and clinician
  • affect supporting tissue if poor oh
  • clasps visible
  • difficult to add teeth
• immediate replacement acrylic denture

  
• Flexident? valplast, more expensive, tooth coloured clasps?
• pros of removable prosthesis:

  • non invasive
  • versitles
  • cheaper
  • shorter appointment times
  • adapted/addition
  • technique less precise for clinician
• cons of removable prosthesis:

  • less retentive and stable
  • better OH needed
  • clasps? unaesthetic
  • less acceptable by pt
• dental implant:

  • pre op assessment
  • expensive
  • not suitable for smokers, bleeding disorders, perio
  • stages process
  • no support required from other teeth
• dental implants

  
• process of placing implants