Prosthesis refers to an artificial appliance used for the replacement of teeth. It is considered vital to replace any missing teeth due to the way existing teeth will shift to compensate for the empty space remaining from a missing tooth. Crooked teeth can lead to further tooth decay and periodontal (gum) disease which can further lead into the loss of other teeth.
The three main types of prosthesis are removable dentures tooth supported fixed bridge and dental implant supported bridge. Removable dentures are the least expensive of the three options and initially are esthetically pleasing. Due to physical health and/or economic conditions removable dentures are the only options available for patients. However in most cases they are simply a good interim solution for patients undergoing osseointegration (dental implant treatment.) This is due to its numerous disadvantages. These include health reasons: it continually causes bone loss; its movement can irritate or ulcerate the underlying gum tissue; denture movement can cause chronic irritation which can lead into soft tissue hyperplasia (excess tissue growth); and the bone under the denture deteriorates due to the loss of tooth roots. Additionally removable dentures although initially esthetically pleasing can lead to long term esthetic problems caused by its health disadvantages. These include: bite collapse (changes to the face and appearance of the mouth jaw and chin) caused by bone loss; acceleration of the aging process caused by bite collapse increases the number of pronounced wrinkles around the mouth; and the possibility that the metal may damage the surrounding healthy teeth.
Of the other main types of prosthesis tooth supported fixed bridges are a better option than removable dentures. The main benefit is that they are removable only by a dental specialist and not by the patient. They are also generally more esthetically pleasing than removable dentures and also offer better chewing ability. Additionally they require less maintenance time but still have a variety of disadvantages. These include health reasons: due to the loss of its roots bone continues to deteriorate behind the false teeth; for those teeth that are adjacent to the affected tooth their health are compromised as they must be cut down in order for the bridge to be attached; the possibility of periodontal (gum) disease increases; and the possibility of root and tooth decay for those teeth under the bridge. In terms of long term oral esthetics the main disadvantage is gum recession.
The best option for prosthesis is the dental implant support bridge. Dental implants provide a solid anchor for teeth and actually stimulate bone growth. Additionally adjacent teeth are not impacted. They are also the most esthetically pleasing. However dental implants are the most initially expensive of the three main options of prosthesis. They also require the presence of adequate bone in order for it to be placed. If adequate bone is absent a bone graft procedure may be required.
Prosthesis can only be used to replace a missing tooth two months at the earliest after the affected tooth is extracted. There are two main materials that prosthesis is made from. The best option is cermets which consist of a metal frame that is covered with china. They are more esthetically pleasing than prosthesis made from plastic which also have the following disadvantages of toxicity and changing color with time.
