Types of prostheses complete absence of teeth. An overview of the types of prosthetics in the complete absence of teeth

Fixed dentures, in comparison with removable structures, have a longer service life, are more comfortable to wear, are better fixed, and have an aesthetic advantage. In addition, they allow you to keep the bone tissue healthy and prevent its atrophy.

The non-removable option of orthopedic treatment is suitable for young and middle-aged people, as well as for anyone who suffers from intolerance to removable structures. It is optimal for public people due to its aesthetic qualities and the absence of speech problems.

Types of fixed dentures

In dental practice, several types of fixed structures are used, which differ in their design, purpose and method of fixation.

Micro prostheses

Overlays. We are talking about veneers (from the English. Veneer - to give an external gloss, mask), which serve to change the shape and color of the teeth. High-quality onlays are made of ceramic and fixed to the surface of the tooth with cement. Their thickness is from 0.2 to 1.5 mm.

Tabs. They replace light-polymer fillings and, in comparison with them, are more reliable and aesthetic. Like veneers, inlays serve to restore the shape and color of partially destroyed teeth, but are fixed not on the surface, but directly inside the crown. The most popular tabs are ceramic. But they are also made of gold, chromium-cobalt alloy, zirconium dioxide.

Crowns

Crowns are single prostheses for teeth, the crown part of which is destroyed by more than 50%. With their help, damaged teeth become strong again, perform their chewing and aesthetic functions. Crowns are made from the following materials:

• metal (chrome-cobalt alloy, gold);
• cermet (with a base of alloys precious metals, chromium-cobalt and chromium-nickel alloy);
• ceramics (porcelain, zirconium dioxide).

Bridges

Bridge structures consist of three or four crowns. One or two crowns in the center of the bridge serve as prostheses, and two crowns at the edges are used as a support. They are used in the absence of one or two adjacent teeth, provided that there are supporting teeth on both sides.

Prostheses for the entire jaw on implants

In the complete absence of teeth, the most the best option– prostheses for the entire jaw, which are attached to implants (four or six). Such structures are also called conditionally removable. They consist of two such parts:

• non-removable (implants with a base for a crown);
• removable (artificial teeth with built-in metal-ceramic crowns, which are put on bases fixed on implants).

The removable part can only be removed by a dentist.

Such modern designs of a new generation are also called telescopic prostheses, because the features of the docking of their parts resemble the principle of the structure of a telescope.

Pros and cons

Fixed structures are characterized by the following advantages:

• high aesthetic effect (they look more natural than removable ones, they also do not have any fasteners that are visible to others);
• long service life (removable structures serve an average of 5 years, while ceramic microprostheses and crowns - 10, 15 and some even 20 years, and implants - throughout life);
• strong fixation (unlike removable options that may fall out);
• ease of care (they do not need to be removed several times a day, like removable ones);
• prevention of bone atrophy (not removable dentures take on chewing load, preventing bone loss).

Flaws:

1. Tooth preparation (removal of hard tissues of the tooth, if necessary).
2. Creating an impression of the prepared tooth.
3. Fixation of a temporary prosthesis (made of plastic, filling material).
4. Fabrication of a permanent prosthesis.
5. Fitting.
6. Installation.

Prostheses on implants are installed differently:

1. Insertion of implants.
2. Making a prosthesis.
3. Fixation of the prosthesis on implants.

Fixation features

Features of fixation of fixed dentures are that for the installation of some of their types, grinding of supporting teeth is required.

We are talking about veneers (the only exception is very thin Hollywood veneers, which do not require any enamel processing), crowns and bridges. In the last two cases, it is often necessary to remove the nerve and seal the canals of the supporting teeth.

After such preparation, the teeth will no longer be able to function fully if the veneer, crown or bridge is removed from them.

Care

Fixed dentures require the same care as real teeth. To maximize their service life and maintain aesthetic qualities, it is recommended:

• give up bad habits(the habit of biting nails and hair ends, cracking nuts, peeling seeds);
• protect artificial teeth from mechanical damage (mouth guards for the night with bruxism - pathological grinding of teeth, for the duration of traumatic sports);
• limit the use of products with dyes (cements on which onlays, inlays, crowns and bridges are fixed can change color);
• don't miss prof. check-ups at the dentist (every six months).

Prices

The average cost of fixed structures is as follows:

• overlays - 12,000 rubles for one veneer;
• tabs - 5,000 rubles per unit;
• crowns - 4,000 rubles for metal, 8,500 rubles for ceramic-metal and from 13,000 rubles for ceramic;
• bridges - the cost of the crown, multiplied by three or four (depending on the design);
• prostheses on implants - from 100,000 rubles.

In terms of cost-quality ratio, non-removable prostheses with metal-ceramic crowns are leading. They are quite durable and quite aesthetic.

For single crowns, however, metal-free ceramics are a better option, albeit relatively expensive. One and a half times more expensive than ceramic-metal ones (8,500 and 13,000 rubles, respectively), they provide the maximum aesthetic effect - ceramics look just like a real tooth.

In addition, metal-free ceramics are hypoallergenic, which cannot be said about metal-ceramic structures. Otherwise, their differences are insignificant: the service life and installation process are the same.

The result of orthopedic treatment largely depends on the qualifications of the orthopedic dentist. On our website you can find information about all the clinics that effectively practice the restoration of the dentition with the help of fixed structures.

In the absence of teeth in the cavity, a complete denture is used. The procedure is prescribed in cases where the use of implantation becomes impossible. Adentia is the complete absence of teeth. In most cases, it occurs in older people. It is worth understanding the types of dental manipulations to restore teeth.

In the absence of teeth in the cavity, a complete denture is used

Adentia occurs under the influence of several factors, among them:

• Wear of tooth enamel.
• Periodontitis and related diseases.
• Refusal of dental care or untimely application for it.
• Neglect of the rules of oral hygiene.
• Injury to the teeth.
• The presence of chronic and hereditary diseases.

Even if in your oral cavity missing three or four teeth, then you will feel the strongest discomfort. And when it comes to their absolute absence, we can state a fact - this condition of the teeth is a complex pathology that entails a variety of unpleasant consequences:

The combination of all of the above troubles develops a psychological disorder in a person. He feels inferior, withdraws into himself. There is only one way to return to a full life - dental prosthetics.

Fixed dentures

One of the most reliable ways to restore the dentition is to install a fixed structure. This technique is rarely used, since its cost is quite high. The dental prosthesis is fixed on the supports of the implants, which are implanted into the bone tissue. Implants are an artificial tooth model, which is made from high-quality titanium that can be implanted into deep layers of bone tissue.

Removable prosthesis

Fixation of non-removable structures is of three types:

In any situation, the final choice of fixation method is determined by your attending physician. Prosthetics should not cause discomfort.

Removable dentures

Removable structures are of three types:

• attachments;
• clasps;
• clasp.

Attachments are called prostheses in the form of plastic caps, which are attached to the double locks to the lower or upper jaw. They are tightly fixed in a metal cavity and firmly adhere to it, which makes it possible to periodically update them with new ones. Most dentistry clients are distrustful of this type of structures, since, at first glance, they seem to be insufficiently reliable and rigid. But in a number of situations, this technique becomes an alternative to inserting an implant into the jaw. The main advantage of the method is that there will be no discomfort, prostheses do not affect speech function, it is convenient to chew food with them. Attached to the root of a natural tooth.

Clasps are called prostheses, the frame of which is fixed using a metal arc. The sky is open, which provides convenience and comfort. There is no feeling foreign body while wearing and eating.

Clasp prostheses basically contain a metal shackle, which is covered with plastic, and artificial teeth are located at the top. The frame is made of cobalt chromium alloy or titanium, the base is made of acrylic or nylon. The installation of such structures occurs when two or more teeth are lost in a row. Fastening occurs when using locks called clasps. Such designs are affordable, easy to care for. Service life more than ten years. The disadvantages will be the possibility of rubbing the soft tissues of the oral cavity and their visibility with a wide smile. To carry out the hygiene of prostheses, it is necessary to remove them from the oral cavity.

Indications for prosthetics

The main indications for the installation of prostheses:

Before proceeding with the installation of prostheses, the doctor must apply a set of preparatory measures. It consists of processing the oral cavity and taking measurements for the production of the structure. If a row of teeth is missing completely, then the dentist needs to implant an implant to be able to fix the structure in the future.

Contraindications for prosthetics

There are a number of situations in which it is not recommended or prohibited to carry out dental prosthetics. In practice, they are rare, however, every professional dentist must be sure that his patient does not suffer from any of the following diseases:

1. Allergy to the components that make up the design.
2. Rejection of local anesthesia.
3. Any infection at the acute stage.
4. Acute diabetes mellitus.
5. The presence of oncological tumors.
6. Exacerbation of mental disorders.
7. Problems with blood clotting.
8. Exhaustion or anorexia.

Most of the contraindications are temporary, and with careful selection of the type of prosthetics, some of them become irrelevant.

Advantages of removable structures

Before proceeding with the installation of prostheses, the doctor must apply a set of preparatory measures

Removable dentures have a lot of advantages. This technique can be used in the most severe cases, when other methods of tooth restoration cannot be applied. These dentures can be worn at any age. Their cost is low and varies depending on the material of manufacture. It is worth paying attention to the fact that the time to get used to such a prosthesis is very small, since each design is made and adjusted to the individual characteristics of a person. The removable design does not press on the tongue, which prevents the appearance of a gag reflex. If the prosthesis breaks, a partial restoration is possible.

Caring for removable devices is quite simple. It is necessary to rinse the structure under running water after each snack, or more often. Special solutions are used to clean the prosthesis.

Disadvantages of removable structures

The negative aspects include the risk of bone tissue atrophy with prolonged wear of structures. In order to reduce this likelihood, it is sometimes recommended to remove teeth at night. Complete removable dentures are short-lived relative to permanent structures. After some time, you will have to apply for a new prosthesis or restoration of the existing one. Quality dentures should last more than ten years.

Manufacturing materials

There are two types of removable dentures in the complete absence of teeth: acrylic and plastic.

Acrylic designs are the most common due to their low cost. Acrylic is used both for prosthetics of the entire row of teeth, and for the restoration of several.

Acrylic has several advantages:

• The installation of this material is shown to all age categories of patients.
• Acrylic dentures are indistinguishable from natural teeth.
• Installation and removal are not difficult.
• Short manufacturing time of the prosthesis, can be made and installed in one visit to the dentist.
• There is no need to purchase special care products.

However, there are also disadvantages, among them:

• Prolonged wearing of an acrylic prosthesis leads to the release of methacrylate. This substance in high concentrations is toxic to the body. An allergic reaction may occur.
• Poor hygiene provokes the appearance of bacteria that are provocateurs of inflammation of the oral cavity.
• In the process of wearing, adjacent teeth are rubbed, which leads to caries

With proper care, the shelf life of such prostheses will be long. Plastic structures are also installed both with complete and partial absence of teeth. Plastic structures are of two types:

1. Peresovannye. The advantage is fast production. The disadvantage is low quality.
2. Casting. Advantage - high quality of installation, imitation of the structure of the oral cavity. The disadvantage is the higher cost.

If your choice fell in favor of plastic prostheses, then you should understand their advantages and disadvantages.

Advantages of plastic structures:

Acrylic dentures are offered at an affordable price

• There is a possibility of temporary use.
• Acceptable price range.
• High aesthetic parameters. Good resemblance to the natural dentition.

Among the disadvantages of plastic are:

• Rapid wear of the prosthesis.
• Plastics contain many allergens that cause reactions.
• Poor hygiene leads to inflammation.

To install this or that material, consult your doctor.

Types of prosthetics in the complete absence of teeth are quite diverse. A more successful type of prosthesis is selected by a qualified specialist. It should take into account your anatomical characteristics, the degree of bone tissue depletion, identify all allergic reactions. Your financial ability is also taken into account.

High-quality prostheses during adentia will not cause inconvenience, they can fully provide chewing function and improve the aesthetic appearance of your oral cavity.

A person forced to resort to the installation of prostheses in the absence of teeth imagines that he will have to wear a terrible “ false teeth” which at night will need to be put in a glass of water, standing on the bedside shelf.

All these unfounded misconceptions come from Soviet dentistry, when things were bad with prosthetics. Now, even with the complete absence of teeth, you can get a high-quality, comfortable and realistic prosthesis.

Complete absence of teeth

Briefly about prosthetics in the complete absence of teeth

Complete loss of teeth, or a large number of them, is by no means rare. There can be many reasons for such an ailment, and, unfortunately, due to the current environmental situation and living standards, there are more and more of them. Most often, the patient loses all his teeth for one of the following reasons:

• Advanced diseases of gum tissues and periodontium.
• Late treatment of caries or complete lack of therapy.
• Natural wear of tooth enamel.
• Increased abrasion of fabrics.
• Severe injuries to a large number of teeth or the entire jaw.
• Violation of metabolic processes.
• Diseases of the internal organs.

Even if only a few teeth are missing, this is already felt and affects the chewing functions of the jaw. What can adentia lead to? If you do not correct the situation in a timely manner with the help of dentures, you may encounter irreversible consequences:

• Disorders of the gastrointestinal tract. A person without teeth is unable to fully experience hard food, and therefore his diet is poor and limited to soft foods. Monotony leads to nutritional deficiencies and poor digestion.
• Distortion of the facial oval - sunken cheeks, protruding chin, pronounced nasolabial folds and thinned lips.
• Distortion of speech due to the fact that in the absence of teeth, the ability to pronounce many letters and sounds is lost.
• Atrophy of bone tissue, thinning of the alveolar processes, as a result of which subsequent implantation becomes simply impossible.

The complete absence of teeth significantly reduces the quality of life and gives rise to a lot of complexes. Only complete prosthetics can solve the problem.

This procedure does not have many contraindications, however, for patients with the following diseases full prosthetics will not be available:

• Intolerance to any type of anesthesia (important when installing implants).
• Infectious diseases, mucous membranes and oral cavity in particular. Initially, you need to cure the disease and only then proceed to prosthetics.
• Diabetes.
• Oncology.
• Mental disorders.
• Poor blood clotting.
• Anemia or anorexia, as well as any other diseases that indicate the exhaustion of the body.

What prostheses can make up for the complete or almost complete absence of dental units?

Removable

Nylon

Dentures made of nylon are elastic and look very realistic, however, they do not restore the chewing function. In addition, these types of prostheses are not fixed securely enough in the mouth.

Acrylic

The design is made of acrylic plastic - a fairly durable material that is compatible with mucous tissues and looks as natural as possible.

With a competent approach, a specialist can manufacture and deliver a completely realistic design with imitation of the color of the gums and enamel.

The basis can cover both part of the gum and close it all, depending on the size of the structure.

This design is ideal for permanent wear, and at the end of the adaptation period, it almost does not feel like something foreign.

Acrylic prosthesis can be left in the mouth overnight!

Based on beam fixation

This type of structure is based on a beam that takes on all the vertical load.

In order for the pressure on the implants to be distributed evenly, they are connected by a horizontal beam, in which there are places for fixing the orthopedic structure.

In the prosthesis itself, recesses are made under the shape of this beam, and when the two parts are connected, special locks are snapped into place, which ensure a secure fit.

With the help of a beam prosthesis, it is possible to restore both the entire dentition and part of it.

The bar prosthesis is only conditionally referred to as removable, however, it should be removed only if it is necessary to clean or replace it.

fixed

Metal-ceramic

In order to make a fixed prosthesis in the complete absence of teeth in the mouth, it is necessary to initially install 4 dental implants, on which the denture will be based.

A fixed structure made of high-quality metal ceramics will be much more convenient than a removable denture, as it serves as an imitation of a full-fledged dentition.

Gum deficiency will be filled with ceramics, which are painted in the color of the oral mucosa.

Based on zirconia

This type of prosthetics is considered the highest quality and modern, due to the fact that the material itself is highly durable and lightweight. The weight of a zirconium dioxide prosthesis is several times less than the weight of a metal structure.

This material has a translucency that is identical in depth to natural tooth enamel, so that dentures cannot be outwardly distinguished from real teeth.

Clasp prosthetics

Most orthopedists agree that clasp prostheses are a successful combination of reliability, strength and beauty. Before installing a prosthesis of this type, supports are implanted in the patient. Clasp prostheses of the new generation have 3 types of fixation:

1. Fixation with metal hooks or fastening on clasps.
2. Attachment of a removable prosthesis using micro-locks installed on the implant.
3. Fixation of the structure on telescopic crowns - after the implant is implanted into the bone, a primary crown is placed on it, and a secondary crown is placed on the removable prosthesis itself. It is worn on implants and securely fastened in the oral cavity.

Are there any differences between complete dentures of the upper and lower jaw

Upper jaw teeth

Making a prosthesis for the upper jaw is somewhat easier than for the lower. Because the the upper jaw has more points of support of the basis, for example, the sky.

Thanks to the large valve area, the prosthesis can be securely fixed on the gum, and the chewing load can be distributed much more evenly.

Even with the complete absence of the dentition, the prosthesis of the upper jaw will not move during meals and cause discomfort to the owner. For its manufacture, both flexible nylon and rigid acrylic can be used.

lower jaw teeth

The need to make up for the complete absence of teeth in the lower jaw presents certain difficulties for the prosthetist, since the area for the basis is extremely small. Due to the abundance of folds of mucous tissues and the tongue frenulum, the prosthesis cannot be fixed using valve mechanisms. Located near the tongue and cheeks can push and displace the structure, causing discomfort to the patient.

Therefore, if at least one healthy tooth has been preserved in the lower jaw, the best solution would be to install a conditionally removable prosthesis. The peculiarity of structures of this kind is as follows:

• The prosthesis is securely fixed in the oral cavity on titanium screws implanted into the bone tissue.
• There is no need to implant all the roots of the dentition - a few supporting ones are enough.
• The denture can be removed at the dental office for a quick cleaning.

In the absence of teeth on the upper and lower jaws at the same time, the doctor can offer 2 different prostheses. The opinion that only structures made of the same material should be used is erroneous.

How to carry out prosthetics in the complete absence of teeth

Before proceeding with prosthetics, the patient must undergo full examination health status, check the condition of the oral cavity and the prosthetic bed.

The specialist first of all pays attention to how atrophied the alveolar processes and mucous membranes are. All this allows you to determine the nuances in the design of the future prosthesis. The main stages in the manufacture of a prosthesis are approximately the following:

• Removal of impressions of the jaw for the subsequent work of dental technicians.
• The casting of the prosthesis.
• Basis manufacturing.
• Definition central occlusion thanks to the blinds.
• Relief modeling.
• Finishing processing.
• Delivery of the resulting prosthesis to the patient and the first fitting.

These are approximate steps in the manufacture of a prosthesis. The exact sequence depends on the specific type of prosthetic construction.

Conclusion

Of course, total loss teeth is a difficult and painful situation for a person who had to face it. However, a high-quality and professionally made denture can be outwardly indistinguishable from real teeth, restoring not only the aesthetic appearance of a smile, but also chewing functions.

It happens that there are no teeth left in the mouth, and there are no conditions, time or opportunity for prosthetics on implants. In this case, doctors resort to lamellar structures.

In modern dentistry, the manufacture of removable dentures is still relevant. This is the fastest and most cost-effective way to restore a large number of extracted teeth.

Removable lamellar prosthesis in the complete absence of teeth is a type of dental structures consisting of a base plate (base) and artificial teeth on it.

(picture 1 - complete removable dentures)

Complete replacement

If crowns are preserved on the jaw, elements will be added to the structure to strengthen the device on it. These can be wire clasps in the form of hooks or pelota. The latter are processes of plastic of the same color and from the same material as the basis of the prosthesis itself.

Lamellar removable structures can be complete. They restore absolutely all previously lost teeth in the jaw. Partials are also made. They are used when one part of the teeth is preserved and the other is removed. In both types of prostheses, the basis is single and continuous.

The removable structure consists of a base, artificial crowns and fixing elements.

The basis is made from:

• acrylic plastic.

This is a classic material that has been used in dentistry for a long time. The product of pink color is disguised as the color of the gums.

In case of an allergy to the material or multiple reactions in the patient, a transparent base is chosen. It contains a smaller amount of monomers that cause an immunopathological process.

• Nylon or thermoplastic.

Bases-plates of flexible prostheses are made from them. Such material is considered cleaner and less likely to cause allergic reactions. The advantage of a nylon product is that it is thinner and lighter compared to acrylic designs.

Artificial teeth are made from acrylic. The material has more layers, which increases their strength and naturalness. The most famous brands are Acryrock, Ruthinium (Italy), Ivocral Vivodent (Liechtenstein), Yamahachi (Japan), Anis (Russia).

Ceramic or metal-ceramic artificial teeth are used extremely rarely. Their fixation in the prosthesis is worse. They are held by some design features.

Plastic teeth are attached to a base made of the same material. There is a chemical bond between them, which is stronger and more reliable.

To further strengthen the prosthesis on the teeth, fixing elements are added to partial removable structures.

• Metal bent hooks - clasps;

(picture 2)

• Special processes of plastics of the basis - dentogingival pads;

(picture 3)

Advantages of removable lamellar dentures

1. Relatively quickly produced. It takes an average of 2-4 weeks. The term depends on the conditions in the oral cavity, the number of missing teeth, etc.).
2. Relatively low cost for a large volume of prosthetics.

Flaws

• The design takes some getting used to.

Usually adaptation takes from several days to two or three weeks. During this period, speech and the sense of taste may be disturbed. The plate of the upper prosthesis covers the hard palate, on which the receptors are located.

• Large amount of basis.

Complete removable structures occupy the edentulous gum and jaw bone. This is necessary for better retention of the prosthesis in the mouth.

• After the start of wearing, dental structures often begin to rub the mucous membrane.

This is a normal habituation process. It can be compared to new unworn shoes. The problem is solved by periodic observation at the dentist and their correction - grinding and polishing.

In people who previously wore removable dentures, addiction passes faster. After adaptation, speech is restored completely. Taste perception is partially compensated by the receptors of the tongue.

• All removable dentures require periodic replacement.

Chewing load through the plate is transferred to the jaw unphysiologically. Gradually, the bone under the dental structure begins to atrophy and dissolve. Called his mobility.

This is normal for complete and partial removable dentures. Therefore, the average service life is 3-5 years. Each new device is slightly larger than the previous one.

Acrylic and non-acrylic (flexible) dentures also have their advantages and disadvantages. Nylon is lighter and thinner. They take up less space in the mouth than the same acrylic, but are not repairable.

In case of damage, a fracture, such a product will require replacement. For example, a missing crown can be welded to an acrylic structure.

Dentures in the absence of a large number of teeth

Depends on specific clinical picture in the mouth. It is necessary to take into account whether the lower or upper jaw needs to be restored, how many teeth and how they are located on it, how much of the preserved jaw bone.

The principle works here: "the larger the adentia, the larger and more uncomfortable the dental products."

The evolution of dentures

Consider them from the most convenient and effective designs to the least comfortable:

1. Bridge - a fixed prosthesis made of artificial crowns on the patient's own teeth.
2. Byugelny (arc).
3. Partial removable plate.
4. A complete removable product, where the bridge is the most convenient, physiological.

Separately, designs on dental implants are distinguished. Under the conditions and possibilities of the client, this option will be the most effective and comfortable for the patient.

There are cases when about half or slightly less stable teeth in good condition are preserved on the jaw. Then the dentist can make arc (clasp) removable dentures.

The best among them, in terms of chewing efficiency and service life, will be arc prostheses. They are secured with a lock.

Slightly less reliable are clasp products on clasp fixation. They have special molded hooks.

Arc structures require that the teeth where the prosthesis is held are stable, without caries and significant damage. The patient should not suffer from certain diseases - periodontitis and periodontal disease. The process requires particularly careful and good brushing of the teeth.

If a person has diseases of the supporting dental apparatus, then there is the possibility of prosthetics of missing teeth with acrylic partial removable structures. In this case, new artificial crowns are welded to them without replacing the prosthesis itself.

Partial removable devices are a more budgetary and simplified alternative to clasp products. They are easier to make, but less comfortable and effective when chewing.

The loss of the last tooth in the jaw leads to the manufacture of complete removable devices, or to complex designs on implants.

Prostheses in the absence of teeth of the upper jaw

This type is considered one of the most difficult in modern dentistry. This is especially true for the long-term extraction of the last teeth.

The difficulty of the technique lies in the difficult work of a dentist that requires experience and appropriate skill. Prosthetics in the absence of teeth of the upper jaw includes the correct determination of the height of future crowns and the position of the lower jaw to it.

Fundamentally complete removable constructions and prostheses on implants are not mutually exclusive. If there are conditions for installing the latter, they can also be installed after wearing removable products.

In addition, in cases of absolute absence of teeth in at least one jaw, complete removable dentures are made after implantation. They are used for the period of osseointegration.

This is necessary so that a person gets used to proper chewing at a comfortable height of the teeth. After the time required for engraftment, removable products will be replaced with crowns or other structures on implants.

Before the start of the procedure, at least 3 weeks must pass from the date of the last tooth extraction. The finished device on the upper jaw completely covers the hard palate, reaching along the posterior border to its transition to the soft palate.

The wider the design area, the better its retention in the mouth. Technically, the fixation of a removable prosthesis on the upper jaw is implemented as a rubber suction cup or valve. Good fixation is likely even with significant atrophy.

If it is not possible to prosthetize with crowns, a compromise solution is made to reduce the size of the dental device. They put removable structures based on a beam or on special balls, multi-units, reinforced on dental implants. This solution is well suited for people with a pronounced gag reflex.

Dentures for partial absence of teeth

In the mouth, it is possible to manufacture the following types of products:

• Removable designs:

1. arc with locking;
2. clasp with clasp fastening;
3. partial removable (acrylic or non-acrylic).

• Products on implants.

Fixed dentures in the absence of teeth

Regardless of the type of construction, this variety is more comfortable and durable. However, it is more expensive than similar removable devices.

Such a prosthesis may look different. It can be like one large horseshoe bridge from a block of artificial crowns. It is fixed on several implant supports, at least six for one jaw, more is better.

Or it will be a combination of several bridges on implants. The design can be performed in the form of individual teeth. Each of them is placed on its own implant.

A combination of individual crowns and bridges is possible. The choice of design is dictated by the conditions of the oral cavity, the expediency and financial capabilities of the patient.

Multi-link constructions consist of bridges and single crowns. They are considered more promising, better in terms of maintainability in case of damage to one of the artificial crowns.

Types of prosthetics in the absence of teeth

Restoring adentia on the jaw can be done with fixed artificial crowns on implants or removable dentures of various designs. Each type has its own advantages and disadvantages. A compromise option may be a combination of the first and second methods. These are lightweight and reduced in size removable products with a more effective fixation on dental implants.

Above, we examined the methods of prosthetics of the upper jaw in the complete absence of teeth.

Making a design for the bottom is usually more difficult. This is especially true for complete removable species. It is believed that any dentures in the lower jaw wear out faster. It is impossible to create a suction valve here. Language gets in the way.

Therefore, lower complete dentures often become floating. They are mobile while eating and sometimes when talking, when there is very little jaw bone left. The problem is solved by special fixing creams (Korega, Protefix) or by installing dental implants with multi-unit.

Methods of prosthetics in the absence of a tooth

Methods are dictated by the specific clinical situation in the mouth.

If the extracted tooth was between two others, then you can often get by with a fixed, more comfortable prosthesis. These include bridge structures and products on implants.

What to do if an end defect appears after the removal of the last root molar? The way out of the situation will be removable devices or artificial crowns on implants.

Options for prosthetics from the most physiological, comfortable, durable and effective to the least convenient:

• Implant + artificial crown.

(picture 1)

• Bridge prosthesis. In a very limited number of cases, a one-way console device. The second lateral incisor of the upper jaw is missing here. Or it concerns the manufacture of a prosthesis for a long-extracted tooth. The artificial hanging cantilever crown will be smaller than the missing one.

(picture 2)

• Removable partial denture - butterfly. Used as a temporary solution. Short-lived, takes up a lot of space, requires more hygiene, removal at night. Due to the gradual atrophy of the jaw bone underneath it will need to be replaced relatively soon.

Price

The price of removable dentures depends on the number of missing teeth, the type of construction and the material from which it is made. The price range varies.

The approximate average cost of a plate partial removable denture starts from 8,000 rubles. A complete removable device - from 14,000 rubles. Arc (clasp) - from 22,000 rubles.

The cost of construction on implants depends on the number and type of implants, the manufacturer and associated surgical procedures (bone grafting, raising the bottom of the maxillary sinus).

From this article you will learn:

• what are the types of dentures
• pros and cons of different removable dentures,
• removable dentures of a new generation without a palate - price 2020.

Removable dentures are dentures that the patient can remove and put on himself. As a rule, they are made only with in large numbers missing teeth - in cases where there is no possibility of fixed prosthetics or through.

In addition to traditional types of removable dentures last years conditionally removable dentures on implants, as well as removable dentures of a new generation without a palate, are gaining popularity. Below you can learn about the advantages and disadvantages of both traditional and modern types of prostheses.

Types of removable dentures -

What kind of dentures is better to put in will depend primarily on the number of preserved teeth. One type of prosthesis is more suitable for the complete absence of teeth, the other - for their partial absence. Below we will analyze all types of removable dentures that can be made with complete or partial absence of teeth ...

1. Removable dentures in the absence of teeth -

The absence of abutment teeth in their complete absence leads to the fact that the chewing load can be transferred from the prosthesis only to the alveolar processes of the jaws (gingiva), which always leads to fairly rapid atrophy of the gums, i.e. to a decrease in height. The latter circumstance leads to the fact that removable dentures should be changed on average every 2.5-3 years, because. the prosthesis ceases to correspond to the tissues of the prosthetic bed.

Another problem of prosthetics in the complete absence of teeth is the fixation of the prosthesis (especially when it comes to the lower jaw). There is even the term "suction cup prostheses" (Fig. 1). We are talking about plastic prostheses, which are relatively well fixed during prosthetics of the upper jaw, but in the lower jaw it is impossible to achieve good fixation of the prosthesis in principle if they are not installed under the prosthesis.

In the complete absence of teeth, apply –

2. Dental prostheses with partial absence of teeth -

Complete removable denture lower jaw: before and after photos

Thus, a rarefied space is formed under the prosthesis, which holds the prosthesis. That is why patients often refer to such prostheses as suction cup dentures. Moreover, it is best to make complete removable acrylic dentures on individual impression tray(remember this term), which will ensure a more accurate fit of the prosthesis to the tissues of the prosthetic bed, and therefore improve its fixation.

Which dentures are better - nylon or acrylic ...
when prosthetics in such a situation with a complete removable nylon prosthesis, there will be no “suction cup effect” due to the high elasticity of the body of the nylon prosthesis. This means that with the complete absence of teeth in the upper jaw, it is best to choose a plate prosthesis made of acrylic plastic.

When prosthetics of the lower jaw with a complete absence of teeth, the fixation of an acrylic prosthesis almost always leaves much to be desired (as with nylon prostheses), and almost all patients complain of periodic prosthesis falling out when chewing and talking. Of course, a special prosthesis can also be used here, but still the most effective solution is a conditionally removable acrylic prosthesis supported by 2-3 implants (read about this type of prosthesis below).

In terms of comfort and chewing efficiency –
plastic prostheses are superior in these qualities to nylon prostheses, because. the latter deform uncontrollably under chewing load (due to the high elasticity of nylon), causing pain when eating.

Acrylic dentures with partial absence of teeth: reviews

A partial acrylic denture will have stiff wire clasps that will extend from the plastic base of the denture and wrap around the abutment teeth (Figure 7-9). It is due to them that the partial lamellar prosthesis made of plastic is fixed in the oral cavity (Fig. 10-11).

Removable partial dentures for the upper and lower jaws -

Because the clasps are clasped precisely by the extreme teeth (located along the edges of the defects of the dentition), then if the abutment teeth are located precisely in the smile zone, the clasps will be clearly visible on the front surface of the teeth. This can be avoided only if you give preference to other types of prostheses (nylon or clasp).

In a nylon prosthesis, the clasps are made of flexible pink nylon, and therefore they are almost imperceptible against the background of the gums (site). However, the fixation of a prosthesis with elastic clasps will be - to put it mildly, “not important”, besides, such an elastic prosthesis will also be painful to chew. And optimal solution with partial absence of teeth, there will always be only prosthetics with clasp-type prostheses (read about them below).

Acrylic dentures: pros and cons

In addition to the pros and cons that we have listed above, the advantages of plastic prostheses can also include: ease of manufacture, maintainability in case of breakage, relatively low cost - in comparison with all other types of prostheses (see cost below).

The disadvantages of plastic prostheses can also be attributed –

• dentures are quite massive and take up a lot of space in the oral cavity,
• when prosthetics of the upper jaw (both with complete and partial absence of teeth) - the basis of the prosthesis will completely cover the sky, which will cause a temporary violation of the articulation of speech, and also worsen taste sensitivity due to the overlap of taste buds located in the sky,
• when prosthetics of the lower jaw in the complete absence of teeth - the fixation of the prosthesis will be quite poor (as with nylon prostheses), and there can be only one way out of this situation - a conditionally removable acrylic prosthesis supported by 2-3 implants.

Service life of acrylic dentures –
the recommended average service life is 3-3.5 years. However, it can be adjusted depending on the rate of atrophy of the jaw bone tissue. With an increased rate of atrophy, the service life is reduced to 2.5 years, with a slow rate of bone tissue atrophy, it can increase to 5 years.

Plastic prostheses: prices 2020

Prices for acrylic removable dentures are for 2020. The first figure corresponds to economy-class clinics, the second - to clinics of the middle price segment (we recorded the lowest prices in paid departments of state dental clinics).

• Complete removable acrylic denture –
  → in the regions - from 12,000 to 20,000 rubles.
  → in Moscow - from 14,000 to 20,000 rubles. (but if from expensive materials and on an individual impression spoon, then the price will be about 25,000 rubles).

• On a partial removable denture –
  prices in most clinics will be similar to a complete removable denture (or only slightly less, but no more than 10-15%). But a butterfly prosthesis for one tooth - the price will be from 6500 rubles.

2. Removable dentures made of nylon -

These are the so-called soft removable dentures made of elastic nylon (Fig. 13-15). They are used for complete and partial absence of teeth. Thanks to the properties of nylon, dentures made from this material can be made thinner and lighter than plastic dentures. In addition, nylon has a high degree of elasticity and flexibility, which makes these prostheses more comfortable to wear.

In addition, removable dentures made of nylon have very good aesthetics and are almost invisible in the oral cavity. This is due to the fact that the gingival clasps of the nylon prosthesis (necessary for its fixation) are also made of pink nylon, which makes them invisible against the background of the pink gum shell. In turn, for plastic and clasp prostheses, the clasps are made of metal, and therefore they are clearly visible when they are in the smile line.

Dentures: photo

However, this is where the positive properties of such prostheses end. in the overwhelming majority of cases, they are negative, which is connected, paradoxically as it may seem, precisely with the flexibility and elasticity of such prostheses. All the negative properties of nylon are fully manifested precisely when chewing pressure is transferred from a soft elastic prosthesis to the tissues of the prosthetic bed.

The high elasticity of the nylon prosthesis base leads to –

• to rapid atrophy of bone tissue under the prosthesis,
• rapid subsidence of the prosthesis and the need to replace it,
• painful chewing of food
• the need for frequent corrections of the prosthesis,
• in addition, the prosthesis has a rough surface, which leads to a fairly rapid formation of a bacterial film on its surface.

Removable nylon dentures: price

For removable nylon dentures - the price is indicated for 2020 (the first digit is the cost in economy class clinics, the second - in clinics of the middle price segment) ...

• complete removable denture - from 32,000 to 47,000 rubles.
• partial removable denture - from 26,000 to 40,000 rubles.
• butterfly dentures made of nylon (for 1-2 teeth) - from 17,000 rubles.

3. Removable dentures "Acry-free" -

Acry-free material was developed by Perflex Ltd (Israel) for partial and complete removable dentures. It has amazing aesthetic properties, i.e. the basis of the prosthesis is practically indistinguishable from the oral mucosa. The prosthesis clasps are also made of a translucent material, which makes them invisible - unlike the metal clasps of the clasp and traditional acrylic prostheses.

Cost of Acry-free prostheses –
the prices below are turnkey in clinics of the middle price category. The average price in Moscow for Acry-free prostheses in 2020 will be…

• partial removable denture - from 30,000 to 37,000 rubles.
• complete removable denture - from 40,000 to 47,000 rubles.
• prosthesis for 1-2 teeth - about 20,000 rubles.

4. Clasp dentures -

Let's say right away that there is nothing better than clasp prostheses with partial absence of teeth. Prostheses of this type differ from nylon and plastic prostheses in that they have a metal frame (arc) inside. The use of a reinforcing metal frame, on which a pink plastic or nylon base with artificial teeth is then installed, can significantly reduce the size of the prosthesis base.

So, for example, it is possible to make a removable prosthesis for the upper jaw without a palate, or rather, only a thin metal arc will pass through the palate. On the lower jaw in the sublingual space there will also be no massive prosthesis base, because. there will also be a practically imperceptible thin metal arc (Fig. 6). All this gives high comfort when wearing a prosthesis, talking, eating.

Removable clasp prosthesis on the upper jaw: before and after photos

Removable clasp prosthesis on the lower jaw: before and after photos

Fixation of clasp prostheses on the abutment teeth is carried out in two ways –

• Fixation with clasps(Fig. 20) -
  clasps are branches of a cast metal frame. Dentures with such a fixation system are very reliable and comfortable, but they have one drawback - metal clasps in some situations can fall into the smile line, and then they will be clearly visible.

  When you put on the prosthesis, the heads of the attachments fall into the locking mechanism (silicone matrix), and the prosthesis is securely held. Such a prosthesis can never fly off on its own. You can remove it only with a little effort by hand. With such a prosthesis, you can comfortably chew, confidently talk with other people, without fear of falling out of the prosthesis.

• Prosthesis on implants with a microlock of the beam type –
  2-3 implants are also implanted into the jaw, on which a metal bar is then fixed. In the projection of such a beam on the inner surface of the body of a removable prosthesis, a recess is made corresponding to the exact size of the beam, and one or more silicone matrices are inserted there, which, when the prosthesis is put on, will tightly wrap around the beam.

Covering dentures on intracanal implants -

There is also a covering prosthesis of another type. To implement such a prosthesis, it is necessary that the patient has 2-4 strong single-rooted teeth or at least the roots of teeth (preferably canines or premolars) left in the jaw. To make such a prosthesis, the crowns of the remaining teeth are first sawn off at the root, and their root canals are sealed.

Then, implants are screwed into the root canal of each root (Fig. 28), resembling large pins, which will have an element protruding above the root in the form of a metal head (i.e., just like a prosthesis on implants with push-button micro locks).

Recesses are made on the inner surface of the prosthesis in the projection of the metal heads, into which silicone retaining matrices are inserted in the same way. As a result, you get excellent fixation of the prosthesis, comfortable painless chewing of even hard food, and due to the preserved teeth roots, the atrophy of the bone tissue of the edentulous jaw slows down sharply, which helps to increase the life of the prosthesis.

Which dentures are better to put: a summary

We hope that our article on the topic: What are removable dentures better reviews- turned out to be useful to you! Below we summarize all the above and write the types of removable dentures in order of decreasing their comfort and convenience for the patient.

With completely edentulous jaws -

• conditionally removable prosthesis on implants,
• Acry-free prosthesis,
• and only lastly - a nylon prosthesis.

With partial absence of teeth -

• clasp prosthesis,
• Acry-free prosthesis,
• traditional acrylic prosthesis,
• nylon prosthesis,
• Dental prosthesis Sandwich.

Sources:

1. Personal experience as a dentist
2. “Orthopedic dentistry. Textbook "(Trezubov V.N.),
3. National Library of Medicine (USA),
4.https://www.realself.com/,
5. "Removable dentures: tutorial"(Mironova M.L.),
6. "Partial removable dentures" (Zhulev E.N.).