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perfect smile Tooth replacement

Modern dental prcedures provide a host of options for replacing missing tooth-from traditional dentures to crowns & bridges (metal ceramic and metal free ceramics) to the latest dental implants.

Why replace a missing tooth?

In a normal, healthy mouth, chewing function is well balanced since each upper tooth has proper contact and function with corresponding lower teeth. Because of this natural proper balance, undue strain or irritation on the gum tissue and bone is non-existent. Drifting or spreading of teeth does not occur and oral hygiene is easily maintained. But, this natural proper balance is quickly destroyed when a tooth is lost.

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This is what can happen:
  • The opposing molar may super-erupt.
  • The unprotected ridge is subject to trauma.
  • The neighbor teeth tilt and proper functional balance is destroyed.
  • The drifting teeth create food impact areas where decay starts – or where Periodontal Disease can start.
  • Destruction to the bone will result as teeth drift and tip.

The loss of teeth is associated with diminished self-confidence and of course chewing difficulties. So, it is necessary to replace the missing teeth as early as possible with something that resembles your natural teeth to the maximum. With recent developments in dentistry, a number of options are now available to the patients to choose from.

FIXED TEETH Patients willing to get replacements via fixed teeth may opt for crowns and bridges or for dental implants.

DENTAL CROWNS AND BRIDGES

Simply stated, a dental crown is a tooth cap placed to cover the tooth to restore its shape, its size and its strength. A bridge is a combination of crowns.

A dental crown may be advised to: Protect a weak tooth (for instance, from decay) from breaking especially after an RCT

  • Restore an already broken tooth or a tooth that has been severely worn down
  • Cover and support a tooth with a large filling when there isn’t a lot of tooth left
  • Hold a dental bridge in place
  • Cover misshaped or severely discolored teeth over a dental implant
  • Dental bridges are meant to replace missing teeth by "bridging" the gap between two remaining teeth. This involves creation of a pontic, or false tooths with a dental crown on either side. The crowns are fitted over the remaining teeth to hold the false tooth in place.

When there are only teeth on one side of the gap, cantilever bridges may be given. cantilever bridges consist of two side-by-side crowns and only one is connected to the pontic.

A fixed bridge helps to
  • Replace missing tooth/teeth.
  • Helps balance a normal bite.
  • Helps prevent undesirable stress on the dental ridge.
  • Prevents over-eruption of the opposing teeth.
  • Prevents drift and tilt of adjacent teeth.
  • Prevents tooth decay in adjacent drifted teeth
  • Retards onset of gum diseases

To design a bridge, the dentist must reshape the teeth to make room for the crowns. The dentist then makes a mold of the teeth. This mold is then sent off to a laboratory, where the actual crowns and bridge are made.

These crowns and bridges require a bit of extra care in terms of oral hygiene. With such care, bridges can last up to several years.

MATERIALS FOR DENTAL CROWNS AND BRIDGES

Metals – These could include NI-CR and other base metal alloys. Metal crowns are subjected to corrosion. Fitting will not be very great and will create decay in the underlying crown. May generate electrochemical reactions in the mouth .

Indications:

Worn out teeth and cases of deep bite where creating additional space for porcelain is not possible. Posterior teeth where esthetics are not the prime concern

The only real drawback is that they look like metal and not a naturally white tooth.

Metal-Porcelain

They combine the strength of the metal along with the esthetics of porcelain.. Of course the porcelain is slightly more prone to chipping. precision is not very high. Fitting will not be very great .may cause decay in the underlying crown. May generate electrochemical reactions in the mouth.

Will cause gum problems like receding of gums and inflammation of gums in the long run.

ALL CERAMIC CROWNS AND BRIDGES:

These are the best looking crowns, and probably the best value for your money as far as esthetics are concerned. Contrary to what might appear, these materials are extremely strong and fracture tough. The material can well sustain the masticatory forces, providing durable crowns and bridges with beautiful esthetic results. They can be conveniently and reliably used in any part of the mouth. These are also the preferred material of choice in patients with metal allergies. Metal free restorations are produced with the latest CAD/CAM technology ensuring precision of fit.

Biocompatible:

Zirconia reduces the accumulation of harmful bacteria at the gum line by 90% compared to natural tooth structure. Superior fit: Zirconia fit is superior to all other restorations, This is due to the fact that there is virtually no expansion or contraction, as there is no casting of the metal.

Esthetics:

Zirconia offers patients the beauty, health and longevity of mETAL free ceramics and bridgework Because it is made of high quality zirconia. zirconia can impart a natural hue to All Ceramic crowns and bridges. The light-dispersion effects of Zirconia are designed to mimic those of healthy natural tooth structure. There is no oxidation, so it will not lead to black lines at the gum margins.

All Ceramic Crowns and Bridges (Metal Free ceramic crowns)

These are the best looking crowns, and probably the best value for your money as far as esthetics are concerned. Contrary to what might appear, these materials are extremely strong and fracture tough. The material can well sustain the masticatory forces, providing durable crowns and bridges with beautiful esthetic results. They can be conveniently and reliably used in any part of the mouth. These are also the preferred material of choice in patients with metal allergies. Metal free restorations are produced with the latest CAD/CAM technology ensuring precision of fit.

No PFM ‘gray lines’ ever

With metal ceramic, soft tissue around the tooth can recede, over time, revealing the metal underneath as ugly gray lines. This simply can’t happen with Zirconia because they are metal-free.

Bio-compatible

Zirconia all-ceramic solutions are completely tissue-friendly. Your crown, bridge or veneer (laminate) integrates beautifully with its surroundings, encouraging gum to grow back up to the tooth, as it would naturally. And because they are bio-compatible, there are no allergic reactions, no sensitivity to temperature and no impact on taste.

Perfect fit Zirconia solutions are precision-engineered in state of the art production facilities. And they fit so well you will forget they are there.

Perfect match

Zirconia uses a unique system to subtly match your real tooth’s color and translucency so they’re almost impossible to tell apart from real teeth.

Zirconium is a high-tech ceramic, Zirconium Oxide, which has already been proven in many extreme situations such as heat shields in the Space Shuttle, brake disks for sports cars and the spherical heads of artificial hip joints. Using Zirconium has many advantages.

Improved Aesthetics

  1. Due to the white zirconium oxide milled substructure
  2. Optimal shade match to the existing natural teeth
Compatibility
  1. Verified by the medical application of zirconium oxide for about 20 years
  2. No allergic reactions reported in the published literature
  3. Good insulating behavior of the ceramic against cold/warm influences
  4. Thanks to a smooth ceramic surface that supports good oral hygiene
  5. No interaction with other dental materials
Durability
  1. Thanks to the exceptional strength of zirconium oxide
  2. High stability requiring minimum framework dimensions

Zirconium delivers the strength you’ve been looking for in an esthetic all-ceramic restoration. The Zirconium system combines CAD/CAM technology with a translucent zirconia framework that can be custom colored creating a restoration strong enough for long span bridges, with precise fit and esthetics your patients expect.

 

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Authored By Dr.P.S. Lakshmi

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