What are the options for dentures?
The loss of one or more teeth is not only an aesthetic problem, it also affects chewing and speaking functions. The only remedy is to replace the lost teeth prosthetic measures bring.
Dental prosthesis is a generic term that describes ways in which tooth defects or entire teeth or groups of teeth can be replaced. A distinction is primarily made between whether the dentures are fixed or is removable.
To include fixed dentures For example, crowns or bridges that can replace tooth parts or gaps. Alternatively there is removable Dentures that usually replace a group of teeth or a large part of the teeth. The removable dentures include, for example Full denture or Partial dentures as the telescope- or the Model casting prosthesis. Combinations, i.e. fixed-removable dentures, are also possible.
Furthermore, the anchoring of dentures differs: Is a denture such as the full denture anchored only by soft tissue or is a denture attached by teeth or implants? Implants have created a new dimension in fixed dentures for patients without their own teeth, which was unimaginable a few years ago.
Which dental prosthesis is individually suitable depends on the jaw, teeth and general health of the person concerned. In addition, careful planning and pretreatment, as well as your own oral hygiene, are decisive for the durability of a denture.
A crown is a fixed denture to build up individual teeth, the portion of which above the gums has been partially destroyed by caries, trauma or the like. To do this, the tooth is prepared in a specific shape so that the crown fits perfectly. The tooth is ground relatively steeply so that the crown is sufficient Retention, so has hold.
After grinding, an impression is made and the crown is made by a dental technician in the laboratory, so that it is usually completed after a week. The crown as a fixed dental prosthesis is divided into its materials and designs. Full cast crowns are made entirely of metal, but can also be used as Veneer crown contain metal only as the bottom layer and be veneered with ceramic or plastic on the outside. There are also jacket crowns that are made entirely of ceramic or are also known as jacket crowns.
A crown can also compensate for a malformation or a misalignment and thus restore the aesthetics. The cost of a crown is between 250 and 800 euros, depending on the version.
You can find more information on the main page: The tooth crown
A dental bridge is a fixed dental prosthesis to fill gaps, which is anchored on natural teeth or implants with the help of crowns. The teeth or implants are called Bridge piers called the crowns as Bridge anchor and the replaced teeth as Intermediate link. Depending on the construction, one differentiates between these types of bridges:
- single span bridges fill a single gap
- multi-span bridges close several gaps
- End pier bridges indicate that the pontic lies between two abutment teeth
- Cantilever bridges only hang from one pillar, the other end is exposed
- Hybrid bridges are carried by an implant on one side and a tooth on the other
- Maryland Bridge / Adhesive Bridge: This bridge is specially designed for an area of the teeth that experiences little stress and is therefore in the front. The bridge pontic is only attached to the neighboring teeth by means of two wings and is an aesthetically high-quality restoration. The dental bridge represents the alternative of a gap treatment to the implant, which is required by patients when an implant is not possible, for example due to insufficient bone.
The cost of a bridge varies depending on the size and requirements of the materials. A three-unit bridge that fills the gap in a lost tooth is roughly in the range of 800 to 1500 euros.
Find out more at: The dental bridge as a dental prosthesis
The term denture is a parent term, which describes a variety of types of removable dentures. For the layman, the classic denture is a full denture, which is often called "third teeth" referred to as. The full denture is intended to replace the entire teeth and consists of a plastic base with integrated plastic or ceramic teeth. The cost of a full denture in the upper and lower jaw is between 800 and 1000 euros. Ceramic teeth are a bit more expensive than plastic teeth, but they don't wear out as quickly.
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In addition to full dentures, there are also partial dentures that replace part of the teeth and fill gaps. A distinction is made here between model cast prostheses and telescopic prostheses. Model cast prostheses are anchored to the remaining teeth by cast metal brackets, the teeth to be replaced are either made of plastic or ceramic. Telescopic prostheses work via a double crown system. The remaining teeth are through a Primary telescope, a cemented crown covering what is called a snug fit into the denture Secondary telescope can be fitted. The telescopic prosthesis offers a good hold and a high level of aesthetics. In terms of price, it is therefore usually more expensive than a model cast prosthesis and depends on how many teeth are still there.
The palate plate
The palate plate in the upper jaw is necessary in some jaws in order to maintain the hold of a dental prosthesis through sufficient suction. Due to gravity, a prosthesis without a palatal plate would simply fall off.
Also read: Denture of the upper jaw
However, some patients have problems with it due to strong gag reflex and cannot tolerate a palate plate. In the upper jaw, a completely palate-free prosthesis can only exist with a number of six teeth or implants. If there are fewer teeth or implants, the prosthesis must have a certain part of the palate in order to guarantee the hold. The palate plate is therefore always present in the case of full dentures, for example.
Implants are artificial tooth roots that are used to anchor a crown, bridge or prosthesis in the jawbone. Furthermore, implants can also be used to anchor orthodontic appliances and to hold epitheses (= individually manufactured facial prostheses) in the case of defects in the facial area.
Nowadays, implants are surgically inserted into the bone under local anesthesia and are made of titanium or ceramic. Titanium is a particularly biocompatible metal that rarely causes rejection reactions. Screws or cylinders are preferred as the implant shape, as studies have shown that the prognosis of healing is greatest with these shapes.
The implantation cannot be carried out in every patient. Insufficient bone availability and medication that prevent the implant from healing are the most common exclusion criteria for implantation. Furthermore is a Implant placement Only possible in adult patients, since in children the skull and jaw growth continues and the implant does not grow with it, so that in this case the growth of a section of the jaw would also be inhibited.
Learn more about: Risks of a dental implant
Implant restoration is often associated with patience. If bone has to be built up ("augmented") in advance if the bone supply is insufficient, the time to implantation is extended by 6 to 9 months until the artificial bone or the bone graft heals. Most practitioners do not prefer immediate loading for implants, but rather a long-term healing phase. Depending on the implant, you have to wait 3 months (in the lower jaw) to 6 months (in the upper jaw) until the implant has completely grown into the bone and can be loaded with dentures.
The cost of an implant is purely personal contribution, which is measured at a price of 1000 euros or more without a denture on it. Since dentists set the prices for implants completely privately, there are particularly large variations in the price. See also: Cost of a dental implant
A veneer is a veneer that is attached to the outer surface of the tooth with a special dental adhesive. The veneer is wafer-thin and made of ceramic, which is why it can achieve highly aesthetic results. A veneer is therefore particularly suitable for replacing anterior teeth and can thus reconstruct small defects. Thanks to the advanced manufacturing technology and the brilliance of colors, the difference to the “real” neighboring teeth is almost invisible to the layperson. The costs for a veneer are higher than for a crown and can be integrated from 800 euros upwards.
The materials for dentures vary and determine the price depending on the design. Fixed dentures such as crowns and bridges are either made of metal, veneered with ceramic or not, or completely made of ceramic.
Metals can do this Precious metals like for example gold be, Base metals consist of Chromium - cobalt - molybdenum alloys.
Implants are made of either titanium or ceramic, as is the structure attached to them. The crown lying on top can consist of a metal framework veneered with ceramic or be made entirely of ceramic.
Removable dentures such as a full denture consist either entirely of plastic or a plastic base with ceramic teeth.
Partial dentures consist of metal parts with metal brackets or cast brackets and plastic or ceramic teeth. Telescopic prostheses are also a combination of metal and plastic or ceramic.
Without metal - is that possible?
With fixed dentures, it is possible not to use metal and to manufacture crowns, inlays, onlays, partial crowns, veneers and bridges entirely from ceramic. In the case of implants, there have recently been implants made of zirconium oxide, a type of ceramic in which the structure and the crown sitting on it are also made of ceramic and are therefore completely metal-free. With removable dentures, the full denture is made of plastic or a combination of plastic with ceramic teeth, which is also metal-free.
In the case of model cast prostheses, telescopic prostheses and similar removable variants, brackets and prosthesis brackets as well as the base are always made of metal. Metal-free variants are being researched, but are not on the market.
Cleaning the dentures
The cleaning of dentures differs in terms of whether the dentures are fixed or removable. Fixed dentures such as crowns or bridges are cleaned like your own teeth. It is cleaned with a toothbrush and toothpaste at least twice a day. The interdental spaces of crowns are cleaned with dental floss or interdental brushes; for bridge pontics, there is a special dental floss with a reinforced end and a fluffy center piece. This piece is threaded under the pontic so that it can also be cleaned underneath.
Toothpaste is not necessary for removable dentures. The dentures should be removed from food residues with a toothbrush and conventional washing-up liquid, also here at least twice a day, preferably immediately after eating. For harder deposits and tartar, ultrasonic cleaning is recommended, in which the dentures are placed in an ultrasonic bath and the ultrasonic waves blast off the deposits without stressing the materials. This process can be done once or twice a day. Denture cleaners in tablet form are also often used as support.
Home remedies such as diluted citric acid solution or acetic acid solution can also remove hard deposits, but are not as gentle as the ultrasonic bath due to the acid and can damage the materials of the dentures over a longer period of time.
Here you can find more information about: Cleaning a denture
Can I glue a denture?
A broken or broken denture, e.g. even cracked plastic teeth, cannot be glued independently. The fragments cannot be inserted properly and without gaps by hand, and the use of household adhesives in the oral cavity is absolutely counterproductive. The substances are not suitable for the oral mucosa, some are carcinogenic and can damage the oral flora.
Therefore, a defective denture must be restored in the practice and the laboratory. An impression is taken at the dentist's in order to perfectly restore the denture and to ensure that it fits perfectly. After a waiting period of half a day to a full day, the repaired dentures can be reintegrated. In some cases, the repair is still covered by the guarantee period. Otherwise, private costs may arise that can be clarified with the dentist.
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Are dentures tax deductible?
For tax purposes, dentures fall under the services that are classified as "Exceptional costs“Can in principle be discontinued. To do this, however, they have to exceed the tax burden that is reasonable and therefore count as unreasonable costs. The reasonable costs depend on the income and are calculated as a percentage. Therefore, the person concerned should inform himself in advance how high his reasonable limit is and whether he can deduct the cost of the denture from tax. If anything is unclear, the personal tax advisor can help.
Dentures are not a modern invention. There have always been attempts to replace lost teeth. Bridges are among the earliest finds Gold platesattached with gold wire, e.g. among the Etruscans. The missing teeth were due Human or animal teeth replaced. The Romans were also familiar with dentures.
Not only were bridges or prostheses improved over time, but attempts were also made to replace natural teeth with artificially manufactured ones. This is how teeth were made from a wide variety of materials such as ivory, Wood or Carved animal teeth. In the 18th century it was possible to get teeth out porcelain to manufacture. It was not enough to just make teeth, but to make the entire set of teeth out of porcelain. In the 19th century the rubber discovered as a prosthesis material, making the prostheses much cheaper so that other groups of people could also afford a prosthesis. Today rubber has been replaced by plastic and artificial teeth are also made of plastic.
Fixed dentures: advantages and disadvantages
Fixed dentures are often more perceived as your own teeth than removable dentures. It is used with special cements and then stays in the mouth. The cleaning is carried out in the same way as with natural teeth, but it must be cleaned very carefully with dental floss and interdental brushes. Fixed dentures can also be perceived as more aesthetically pleasing - depending on the price range in which the corresponding removable counterpart is located. The hold, which often leaves a lot to be desired with a removable replacement, is definitely given here.
The loss of healthy tooth structure can be cited as a disadvantage, as the tooth has to be ground for a crown or bridge. Most of the time, however, this is already badly damaged, which is then bearable. Furthermore, fixed dentures can usually not be expanded if, for example, a bridge pillar is lost. You would then have to make a new denture.
A cheaper alternative to fixed dentures is the removable replacement, the prosthesis. It is suitable for a dentition in which there are still teeth of their own, even if it is a free-end position. In the case of complete tooth loss, the so-called full denture is the method of choice if implants are not used. The partial prosthesis consists of a plastic base that rests on the mucous membrane and covers the entire palate in the upper jaw. The tongue area is left out in the lower jaw, so that the prosthesis body is much smaller. Brackets that are attached to the remaining teeth ensure that the prosthesis is held in place. See also denture adhesives.
In addition to the plastic prosthesis, a cast metal prosthesis can also be used. Special clamp elements have to be used for this.These are support brackets that not only encompass the bracket teeth, but are also supported on the chewing surface. This prevents the prosthesis from sinking too much into the mucous membrane. Another type of attachment, which, however, requires considerably more effort, is the use of telescopes. To do this, teeth must be ground and crowned. The counterpart is incorporated into the prosthesis. Such a fastening has the advantage that no clip elements can be seen. However, removing the prosthesis can be difficult because the telescope can be very tight. With a cast prosthesis, sections of the base of the palate can remain free of metal. One then speaks of a skeletonized prosthesis.
Another way of attaching the partial denture is the attachment technique. Clamps are not used here, but after crowning some teeth, a groove is worked into the side or back of the crowns and the matching counterpart is inserted into the prosthesis, which can then be latched into the groove. In the absence of clips, the attachment is invisible.
If all teeth are missing, only a full denture is possible. Since there are no longer any teeth of its own, a hold can no longer be achieved with braces, telescopes or attachments. Therefore, the full denture only holds by adhesion to the mucous membrane. A prerequisite is a functional impression that takes muscle movements into account and a valve edge in the envelope fold. In addition, there is a viscous saliva produced by the parotid gland. In the upper jaw, given these conditions, a firm hold of the prosthesis can generally be achieved with normal jaw conditions. It is more difficult in the lower jaw, as the lever effect of the tongue is also added here. If a full denture cannot hold, all that remains is the insertion of implants.
The removable dentures have the advantage that they are easy to clean and can be expanded if necessary, see also denture cleaning. However, a partial or full denture gives the patient the feeling of a foreign body in their mouth. Over time, however, you get used to it. Even with a new prosthesis, speech can initially be disturbed, but that too disappears after a period of getting used to it. Saliva secretion can also be increased in the initial phase.
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