Protetik Diş Tedavileri (Prostodonti)

Protetik Diş Tedavileri (Prostodonti)


Removable Prosthesis

Removable ProsthesisRemovable prosthesis are types of prosthesis that are applied on patients that have lost chewing and speech functionality as a result of losing all of their teeth.  

These types of  prosthesis are held in place on the upper jaw by the force of vacuum. However, as patients chew, they move around as a result of the compression of the mucous membrane and due to the fact that they rest on soft tissue (gums). Thus, the amount of chewing force is approximately 8-10 times less than that of individuals who possess their full set of natural teeth.  

Nowadays, it is possible to produce prosthesis that bond extremely well with or are fixed to patients' jaw bones through the use of implant technologies. However, in the event that implants cannot be embedded in patients that have experienced a prolonged amount of time without their teeth causing excessive amounts of bone loss; total prosthesis are left as the only treatment alternative.  

Artificial sets of teeth are bonded together with plastics (pink acrylic-PMMA) to obtain total prosthesis. Artificial teeth made of plastic or ceramics are chosen according to factors such as the patients' gender, facial and jaw bone structure and are produced after a model of the prosthetic teeth are presented to the patients for approval.  

Preferably, the lower and upper total dental prosthesis should be replaced at the same time. In many cases, preparing an opposing prosthesis to an existing, old lower/upper prosthesis may not be the correct course of action to be taken. In time, the physiological changes that occur in the body (jaw bones) may result in the degradation of the compatibility of the prosthesis. The time it takes for such degradation to occur is approximately 5 (five) years.  

Bone loss may occur in the jaw bones and mucous keratinization may change in conjunction with old age. As a result of these factors new wounds may develop due to mechanical traumas. In addition, abrasion may also occur in the artificial plastic teeth. Each of these factors are sufficient reasons for the renewal of the prosthesis.  

Two types of teeth are used as artificial teeth, namely plastic and ceramic teeth. Porcelain teeth are of course more aesthetic and abrasion resistant compared to plastic teeth. However, they have a disadvantage of making excessive noise when they collide with other teeth.  The choice of materials to be used for artificial teeth should be left to dentists.    

Total prosthesis are types of prosthesis produced from tissue friendly plastics that are applied on patients that have lost all of their teeth in order to restore their chewing and speech functionality.  

In addition to restoring the patients' loss of functionality, prosthesis also aim to repair speech impediments and improve aesthetic appearance. As a result, while the degradation in patients' oral health is greatly restored, most individuals who are forced to live in public with missing or damaged teeth also reap psychological benefits from such treatments because individuals who are forced to lead their lives with poor oral health (even if for a short while), usually first forget how it feels to smile.  

This results in the deterioration of individuals' self confidence in addition to causing functional defects. Prosthesis applied to such patients aim to increase their quality of life.  

In many cases, bone loss may occur in due time as a result of losing all teeth. Bone loss occurs at a rapid pace immediately after teeth are pulled out, but the loss slows down in time (in relation to the amount of bone that is lost). The compatibility of the existing prosthesis are also adversely effected and result in them to function unsatisfactorily. In this case, the prosthesis must be refitted (rebased) or renewed.

The most important factor associated with patients' satisfaction related to total prosthesis (dentures) is how stable the prosthesis are in their place. Acceptable total prosthesis fitted in the upper jaw can stay attached comfortably with the vacuum force created between the prosthesis and the upper jaw. However, due to the fact that the total prosthesis fitted in the lower jaw do not cover a sufficient area and are subjected to the movements of the tongue and cheeks, it is very hard for sufficient vacuum force to develop to hold the prosthesis securely in place. 

Chewing forces attained with total prosthesis are approximately 20% of the chewing forces attained by individuals with natural teeth. The main reason for the reduction in chewing forces is that the prosthesis is supported underneath by soft tissue. With the developments in implant surgery in recent years, the success of implant treatments over the long-term and high levels of patient satisfaction, removable implant prosthesis or fixed total prosthesis are recommended as primary treatments for patients that have lost all of their teeth. As a result, apart from eliminating the problems related with the attachment of the prosthesis, chewing forces obtained with the prosthesis are substantially increased.