​​It is a major discipline that carries a heavy mission by incorporating many fields such as removable and fixed prostheses, implantology, and maxillofacial prostheses. It is the science and art of restoring function, aesthetics, comfort, and health by repairing or replacing the missing parts of teeth, or one or more missing teeth and the related lost tissues using appropriate materials.

Occlusion (bite) principles are among the most important aspects we focus on, regardless of the type of prosthesis being made.

Removable Prostheses

They can be defined as artificial appliances that can be inserted and removed by the patient and replace missing teeth.

Removable prostheses are applied when the abutment teeth cannot withstand the load, when there are wide areas of missing teeth, when the edentulous area does not end with a tooth, or when there are no teeth present in the mouth.

Removable Partial Denture

These are prosthetic applications supported by both teeth and soft tissues. For tooth support, clasps are placed under the convex area near the gum line of the tooth to provide retention. Tissue support is provided by the surface of the prosthesis that rests on the soft tissues. Thus, the force is distributed between the teeth and the tissues.

Total (Complete) Denture

If there are no teeth remaining in the mouth to serve as abutment, force transmission, support, and retention are provided by the denture resting on the tissue surface. These completely tissue-supported prosthetic applications are called total dentures.

Clasps in removable partial dentures may cause aesthetic concerns, especially on front teeth. Additionally, applying force with clasps onto teeth with insufficient periodontal health may lead to the loss of those teeth. In such cases, the force applied to a single tooth may be distributed by connecting the teeth with crowns. Metal clasps may cause wear or damage to the healthy teeth they surround. Precision attachment dentures are a combined prosthetic approach in which the edentulous areas are supported by a removable prosthesis, while the shape, color, and positional irregularities of the existing teeth are corrected with fixed prostheses. The abutment teeth are prepared, and while making the crowns, special prefabricated components called precision attachments are placed on the surfaces adjacent to the edentulous area. Thus, instead of unaesthetic metal clasps, an invisible and aesthetic retention system is achieved.

When excessively tilted, crowded, or elongated teeth may cause incompatibility with the prosthetic area, instead of extracting them, their lengths can be reduced and telescopic crowns (double crowns) or precision attachments may be applied. Approaches where the abutment tooth remains inside the prosthesis and the removable prosthesis is placed over it are called “Overdenture” prostheses. Keeping the tooth root in the mouth prevents bone resorption and preserves oral sensory perception.

Fixed Prostheses

These are prosthetic structures produced on models obtained after tooth preparation, adapted in the mouth, and permanently cemented to remain fixed on the tooth. In fixed prostheses, the substructure generally consists of metal alloys, full-ceramic materials, or zirconium.

Crown

A crown is made for individual teeth with significant material loss or aesthetic problems. After taking impressions from the prepared tooth, the technician prepares the substructure for strength on the model and then applies porcelain (or less commonly today, acrylic) to provide aesthetics.

Bridge

In cases of multiple missing teeth, structures that fill the missing spaces using the nearest healthy teeth as abutments and remain permanently in the mouth are called bridges. However, the teeth selected as abutments must be healthy and strong enough to withstand the load placed on them.

Maryland Bridges (Adhesive Bridges)

For single anterior tooth loss, Maryland bridges can be an option. The adjacent teeth are not cut; instead, retention is provided by placing thin wings on the palatal or lingual surfaces.

Laminate Veneer

Discoloration, misalignment, structural and shape abnormalities, or existing gaps between the front teeth may create aesthetic concerns. Laminate veneer is a prosthetic approach in which very minimal preparation is performed only on the front surface of the tooth within the enamel limits. Thanks to advances in filling technology and bonding systems, laminate applications can also be performed using composite materials.

Telescopic Crown

When excessively inclined, crowded, or elongated teeth interfere with the area planned for prosthesis, instead of extracting these teeth, their lengths may be reduced and telescopic crowns—interlocking double crowns—may be applied.

Inlay – Onlay Restorations

Inlay and onlay restorations are laboratory-fabricated large restorations used when tooth structure loss is excessive. If the loss is limited and the cusps are intact, an inlay is applied; if the loss is extensive and involves one or more cusps, an onlay is preferred.

Implant Prostheses

They restore the function, aesthetics, and phonetics of teeth lost due to various reasons using implant-supported prostheses. Dental implants are biocompatible titanium artificial roots placed into the jawbone to restore missing tooth function and aesthetics. Implants are commonly used for single tooth loss, multiple tooth loss, complete edentulism, and orthodontic anchorage.

A- Implant-supported removable prostheses
B- Implant-supported fixed prostheses

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