The need to replace missing teeth in the anterior part of the oral cavity is obvious but rehabilitation in the posterior region of the mouth is equally important. The mouth and its arches are in a dynamic equilibrium, in which the teeth are supported by each other. If there is an absence or dental loss, the structural integrity of the arch is interrupted causing an imbalance in the oral cavity. The teeth adjacent to the dental absence and the antagonists move into the edentulous space, tilting or extruding.
The absent teeth can be replaced by the fixed prosthesis, this can be removable partial, dentosoportada fixed partial prosthesis or implant-supported fixed partial prosthesis. To be able to choose one type or another, it is essential to take into account the biomechanical, periodontal, aesthetic and economic factors, with the patient’s wishes being one of the most important, although both types of treatment can also be combined.
The fixed prosthesis covers from the restoration of a single teeth to be able to perform a rehabilitation of the entire dental occlusion. It is also possible the complete restoration of the teeth separately and thus achieve the improvement of the aesthetic area of the face, of the smile. This type of prosthesis improves comfort, as well as the patient’s chewing capacity, while maintaining the health and integrity of dental arches. Sometimes the patient’s self-image and self-esteem also rise.
WHAT ARE DENTAL BRIDGES?
The fixed partial denture or dental bridge is a permanent prosthetic device that is attached to your teeth, which replaces other missing teeth. The tooth that serves as a joint element for a fixed denture is named as a pillar. The artificial tooth that is supported by the pillar tooth is the pontic. This pontic joins the retainers. Usually if the abutment teeth are periodontally healthy and the edentulous space is correct and straight, a fixed partial prosthesis can be performed with a long lasting life in the patient’s oral cavity. In order to perform a dental bridge or any dental treatment it is essential to obtain a medical history. This should be brief and concise. Equipment exploration, medication, analytics, trauma, surgical interventions and allergies should be taken into account.
In the general dental history it is necessary to take into account the reason for consultation, the cause of the dental loss, the habits that the patient has, the periodontal state of the teeth, the restorations, the existence of previous removable partial dentures, oral surgery treatments and if there is any type of craniomandibular dysfunction.
THE TYPES OF DENTAL BRIDGES AND INDICATIONS
Dental bridges or fixed partial dentures can be of three fundamental types:
- Conventional fixed partial denture
- Fixed Adhesive Partial Prosthesis
- Implantable fixed partial prosthesis
The dentosoportada conventional fixed partial denture is the one that is placed on teeth when there is an edentulous area that includes few pieces. The usual configuration of this type of prosthesis uses a pillar tooth at each end of the edentulous space to support it. The fixed partial adhesive prosthesis constitutes a conservative restoration reserved for situations in which the abutments do not show defects and a single tooth is missing, such as an incisor or a premolar. This type of prosthesis requires one pillar per distal and another per mesial of the edentulous space. The fixed partial adhesive prosthesis is cemented directly on the lingual or palatal face of the adjacent abutment teeth.
The implant- supported fixed partial denture is ideal in cases where there is an insufficient number of abutment teeth, their strength is inadequate to support a conventional fixed partial denture or the patient’s attitude and / or the combination of intraoral factors discourage the choice. of a removable partial denture. In this type of prosthesis, the placement of an implant is used as a pillar in a space of three or more long teeth. It is possible to replace an entire arch with a complete implant-supported prosthesis.
Fixed partial dentures can also be classified, according to the number of teeth to be replaced and the position of the edentulous species in the arch, in simple or complex. The simple one is the one that replaces a single tooth and the complex one requires the replacement of more than one tooth. It is important to keep in mind that the best treatment is to do nothing. Even so, sometimes it is impossible not to do any treatment but it is necessary to rehabilitate the masticatory function with the placement of a fixed prosthesis. This type of prosthesis is used when there is a very extensive caries, agenesis, avulsions, fractures, dental malpositions, abrasions or attrition, when an occlusal rehabilitation, retention of union elements or space between teeth is required.