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Prosthodontics

What is a Prosthodontist?

Prosthodontists are specialists in the replacement of missing teeth and is recognized as a specialty by the American Dental Association. Prosthodontists must complete an extra three years of intense, formal training in addition to dental school in an accredited setting. Proper research and decision making will allow you to see if a prosthodontist is right for you. Prosthodontists are qualified to offer care in state-of-the-art procedures and techniques, such as:

  • Dental implants 
  • Porcelain Crowns & Veneers
  • Complex care management
  • Full-mouth rehabilitation
  • Dentures
  • Partial dentures
  • Replacing missing teeth
  • Geriatric dental needs
  • Traumatic injuries
  • Temporomandibular disorders

Rigorous training and experience provide prosthodontists with a special understanding of the dynamics of a smile, the preservation of a healthy mouth, and the creation of tooth replacement. By understanding these qualities, a prosthodontist can custom tailor a treatment solution for you.

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What Can a Prosthodontist Do?

Restore Broken Teeth - Dental Crowns

Crowns cover or “cap” a tooth to restore the normal function and appearance of a tooth. Crowns may be made from metal, ceramic, or both. Crowns are indicated for teeth with large or broken fillings, have had a root canal, that are fractured, worn,misshapen and/or discolored. Crowns are cemented onto the existing tooth and becomes the outer layer of the tooth as a whole.

What to Expect

Usually 2-3 visits – At the first appointment, a preparation of the tooth is performed under local anesthesia, and impression is made of the tooth or teeth. A temporary crown is made of acrylic or resin, which will protect the tooth until the next appointment. At the second appointment, the final restoration is fitted to the tooth and cemented. For teeth in the smile line, sometimes visit to a dental laboratory technician will be necessary in order to match the color of the adjacent teeth for a perfect match.

Consider Crowns If You…

  • Have a broken tooth or large filling
  • Want to replace a silver filling with something more esthetic
  • Can’t have a new filling on a tooth
  • Had a root canal performed on the tooth
  • Want to match the color of one tooth to another
Replace a Missing Tooth - Dental Bridges

A dental bridge gives you the appearance of a real tooth in cases where a tooth is missing. To replace a missing tooth with a bridge, at least one tooth on either side of the space must be prepared for a crown. Then a false tooth is added between the crowns, and the entire bridge is cemented to the prepared teeth that looks like a three units crown. The patient cannot remove the bridge, and special flossing aids are available to keep it clean. A bridge is a seamless way to give you a unified, natural looking smile by replacing the missing tooth.

What to Expect

Usually 3 visits – At the first appointment, an impression is made of the tooth or teeth, and a temporary bridge is made which will protect the tooth until the next appointment. The second appointment will consist of preparations of the adjacent teeth to the missing space and the temporary bridge will be fitted along with a more detailed impression. At the third appointment, the final bridge is fitted to the tooth and cemented. For teeth in the smile line, sometimes visit to a dental laboratory technician will be necessary in order to match the color of the adjacent teeth for a perfect match.

Consider Bridges If You…

  • Have one or more missing teeth
  • Have adjacent teeth that are discolored or have broken fillings
  • Cannot receive a dental implant
Attractive & Durable Alternatives to Fillings - Inlays & Onlays

Tooth inlays and onlays are sometimes used instead of fillings to replace a smaller amount of tooth structure loss due to decay. Inlays and Onlays fit INside and ON top of the remaining tooth respectively. They can be made of gold, ceramic/porcelain or composite resin. Defective or unsightly “fillings” can be replaced by these tooth-colored restorations and then micromechanically bonded to the tooth. This bonding process may actually improve the strength of the tooth and help seal the inlay to the tooth better than a filling.

What to Expect

Usually 2 appointments – At the first appointment, the unhealthy decay or old filling is removed. An impression is made of the tooth, and a temporary restoration is made which will protect the tooth until the next appointment. At the second appointment, the final inlay/onlay is fitted to the tooth and cemented.

Consider Inlays or Onlays If You…

  • Have a broken tooth or large filling
  • Want to replace a silver filling with something more esthetic
Rebuild Your Entire Mouth - Full Mouth Rehabilitation

People with severe dental problems such as rampant decay and severe grinding (bruxing) may be candidates for a full mouth rehabilitation/reconstruction. Teeth shortening can be caused by teeth grinding (bruxing), acid reflux (GERD), and other habits and medical conditions. As the name implies, full mouth restoration refers to rebuilding of all of the teeth in a patient’s arch or mouth. Full mouth rehabilitation combine esthetics with the science of restorative dentistry to restore the health, function and beauty of the smile. In some patients orthodontics may also be employed to help properly position mal-aligned teeth. Crowns, bridges, veneers and/or dental implants may be used in a full mouth reconstruction.

What to Expect

A Full mouth reconstruction is a complex service and one that prosthodontists have been trained to perform. Your prosthodontist will use proven techniques and technologies, in order to minimize the time you must spend in the dental chair. Typically several appointments (5-6) are necessary, depending on the complexity of your case.

Consider Mouth Restoration If…

  • You have noticed that your teeth are becoming shorter or are breaking
  • You have various missing, broken or discolored teeth
  • You have had previous one-time procedures that haven’t solved the whole mouth problem
  • You want a comprehensive solution
Implant Teeth That Look & Feel Real - Dental Implants

Dental implants are medical grade titanium screws that are placed in the upper or lower jaw to provide support for replacing a missing tooth. Implants replace the root portion of a missing tooth and will support single crowns, multiple tooth bridges, and full or partial dentures. Modern technology makes it possible for these implant-supported replacement teeth to look, feel and function as close to natural teeth as possible.

Implant Crowns are attached to an implant once it has fully healed. Typically the bone around an implant heals for 4-6 months before the crown can be fabricated. The implant crowns can either be screw retained, or an abutment can be attached to the implant and the crown can be cemented onto an abutment similar to a crown cemented onto a natural tooth.

Implant Bridges are similar to traditional bridges in that they are connected to 2 or 3 implants (just as a traditional bridge is attached to 2 teeth). They can be either screw retained, or cemented onto a torqued abutment.

What to Expect

We will act as the treatment planner when it comes to deciding whether you can receive implants. Evaluation of the spaces for the new teeth will be done, and a CBCT (Cone Beam Conventional Tomograph) will be taken so that the bone levels can be evaluated. If enough bone is present, then we will place the implant in our office. If any additional grafting or major reconstruction is planned, then an oral surgeon or periodontist will surgically place the implant. If it is stable, a fixed temporary tooth made of acrylic can be put on that same day. If it is not stable due to poor bone quality, a removable flipper or essix retainer will be given to the patient. After 4-6 months of healing, the implant will be stable for a final crown. An impression of the implant is made, and the lab fabricates a crown to be screwed onto the implant or cemented.

Consider Dental Implants If…

  • You are missing one or more teeth
  • You have a tooth that is unrestorable
  • You want the look and feel of natural teeth so that you can chew, speak, and smile again.
  • You do not want a dental bridge
  • You do not want a partial denture
Implant a Permanent Denture in One Day - All-On-Four

A fully implant supported prosthesis can be retained on a many number of dental implants. The most common and straightforward is the All-on-four protocol All-on-4 prostheses can replace a full upper or lower set of teeth on four dental implants. Four implants are placed and then a full arch of denture teeth is screw attached the same day. The teeth are made of plastic resin, and pink acrylic retains the plastic teeth and provides soft tissue and lip support. After a period of healing the final restoration is screwed to the implants and are “fixed” for the patient, however the dentist can remove them, allowing for proper cleaning and repairing.

What to Expect

Several appointments will be used to create the temporary denture that will be delivered on the day of surgery. Once the prosthesis has been made and approved by the patient the surgery procedure will be scheduled. This is an all day procedure in which all remaining teeth in the arch are removed, implants are placed into the bone, and a full set of teeth are fixed to the implants. The patient will be under sedation if needed, as well as pain medications to be comfortable. An oral and maxillofacial surgeon will be performing the surgical component of treatment, while the prosthodontist will have the temporary prosthesis and attach it to the teeth. This is one of the most influential changes a patient will see with their smile. They leave the same day with a new set of temporary teeth. After 4 months of healing, the implants are ready for the final teeth. A new set of teeth is made of acrylic with a titanium connect bar, tried in for evaluation by the patient, and then screwed onto the implants.

Consider All-On-4 If…

  • You are tired of perpetual dental problems and are looking for a longer-lasting solution.
  • You have a denture already that is ill-fitting and you want a fixed option
  • You have failing teeth and want a prosthetic option
Create Affordable, Removable Dentures - Standard Dentures

Complete Dentures: Dentures are removable prosthetics for replacing all missing teeth. By matching each individual’s unique smile and bite, dentures can improve facial appearance and self-confidence. Dentures can also solve speech issues caused by missing teeth and improve chewing and quality of life.

Immediate Dentures: Immediate dentures can be placed the same day as your teeth are removed. These dentures allow you have a prosthesis while your gums are healing so that you can resume your normal life. This temporary solution is highly recommended to assist in the process of getting used to a removable appliance. Typically, the immediate denture is replaced after your gums heal with either a conventional complete denture or an implant complete denture.

Partial Dentures: For patients missing at least one tooth, a removable partial denture (RPD) may be recommended. This type of denture uses the residual teeth to hold and retain the removable prosthesis in place. There are many different designs for removable partial dentures and it should be custom tailored to you. Typically, a removable partial denture is made of a metal framework base with pink acrylic to replace the soft tissue and plastic denture teeth for chewing. The number of missing teeth and their location will affect the comfort and stability of the removable partial denture. Dental implants can help retain a partial denture, and can eliminate unsightly clasps on the front surfaces of the teeth. We can offer you many designs for your removable partial denture or provide other alternatives to consider including dental implant-supported crowns and bridges.

What to Expect

To provide the best fitting prosthesis, a series of impressions are made. These impressions are molded to the cheeks and gums to provide maximum coverage. At the second appointment, a “wax-rim” is tried in as a template for the new teeth positions with the front teeth arranged as you wait. Color and shape of the new teeth are selected at this appointment to match your individual characteristics. We evaluate lip support, esthetics, phonetics, and function during this phase.

At the following appointment, all of the teeth are arranged in wax and a final approval is given by the patient prior to processing. The denture bases are processed in pink acrylic and the denture teeth are incorporated into the positions that were approved in wax. After 24-48 hours another appointment is made to evaluate sore spots and other concerns. Like getting used to new shoes, there will be adjustments that will have to be made for comfort. Typically, 1-2 follow up appointments are required.

Consider Dentures If…

  • You are looking for a more affordable tooth replacement that you can remove at nighttime for easier cleaning.
  • You want to restore the fullness of your face for a more youthful appearance.
  • Dental implants are not an option
Fit Implants to Snap Current Dentures Into - Implant Retained Dentures

The Implant retained denture is a denture that has specialized attachments that snap onto dental implants like a button on a coat. Implants are placed in the jaw, and allowed to heal for 4-6 months, and the use of your existing denture can still be possible. After healing, a new denture will be fabricated and snaps will be luted into the underside of the new denture. Your prosthodontist will teach you how to place it, and how to remove and clean it properly. Different strengths of snaps can be used for those who experience more or less retention.

What to Expect

First, a thorough evaluation of your bone and gums will be performed to see if there is enough to retain dental implants. A CBCT (Cone Beam Computed Tomograph) will be completed by an oral and maxillofacial surgeon to accurately plan the location of the implants. Then the implant surgery will be performed and 2-4 implants will be placed to retain an implant denture. Your existing dentures can still be worn through this healing phase.

While healing is occurring, the new implant denture can be fabricated, as described in the same fashion as a complete denture.

Once implants are healed, snaps are placed onto the implants and picked up into the denture with a luting acrylic. Once the acrylic sets, adjustments are made and when the denture is inserted into the mouth, it clicks into place. Before leaving our office, we will ensure that you can insert and remove your denture on your own.

Consider Snap On Dentures If…

  • You would like a more stable denture that is held by implants
  • You don’t want to rely on adhesive to hold the denture in
  • You have a dry mouth and conventional dentures are unacceptable

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