Belcenia Dental Center - Dental practice in Hendaye

BRIDGES

A bridge is a fixed prosthesis that replaces one or more teeth by resting on the adjacent teeth.

WHAT IS A BRIDGE?

"Bridge" in English, the bridge uses the neighboring teeth as pillars on which it is sealed or glued.
There are several types of bridge, indicated according to the edentulousness: the most common are bonded bridges and conventional bridges.
Bridges can be made of metal, metal-ceramic or entirely ceramic, depending on the case. They are made by the dental technician and fitted by your dental surgeon.

BONDED BRIDGES

Bonded bridges allow the replacement of a single tooth (or even two, in some cases) by relying on the adjacent teeth using bonded metal fins.

They are generally used to replace an anterior tooth.

When this bridge can be fitted, it is a very aesthetic solution and does not cause much damage to the neighbouring teeth on which it is anchored.

The prosthetic tooth can be made of metal or covered with ceramic. On the other hand, the fins cannot be covered with ceramic. They are therefore metallic in colour, but generally not visible or very discreet.

CONVENTIONAL BRIDGES

For this type of bridge, anchoring on the teeth bordering the gap is most often done by means of dental crowns and sometimes inlays or onlays. As with dental crowns, the elements of the bridge can be metallic, metal-ceramic or entirely ceramic (in certain cases only).

The teeth bordering the missing tooth are prepared to receive the bridge.

ADVANTAGES

The main interest of these techniques in the treatment of single edentulism is their non-invasive nature.
Their speed of installation compared to an implant or a conventional bridge, which requires longer follow-up and is more complex to produce, should also be taken into account.
In addition, with the evolution of bonding techniques and materials, they represent a solution of choice for the possibility of re-intervention that they offer, combined with satisfactory durability.
These different techniques are also a possible alternative to implantology when it is contraindicated.

TO KNOW

Bridges must be checked very regularly to detect any possible onset of decay at the anchors, but also to detect possible suffering of the supporting teeth due to the increase in forces at their level.

Good oral hygiene is strongly recommended. It is important to brush your natural teeth twice a day for two minutes, as well as your bridge. Use interdental brushes and/or dental floss to perfect your brushing.

These different types of bridges are indicated for people with single edentulism and when the adjacent teeth are healthy or slightly damaged for the purpose of tissue preservation.

Depending on the clinical context, a therapeutic choice adapted to your case will be proposed to you by your dental surgeon.

THE IMPLANT GRADUALLY REPLACES THE BRIDGE

The bridge and the implant are two techniques frequently used to replace one or more missing teeth.

However, with the advent of dental prostheses on implants, the number of bridges made tends to decrease.

Indeed, when a bridge is made, the teeth that support it must be prepared and then support the load of the replaced teeth.

With implants, the neighboring teeth are not touched and the chewing forces are taken care of by the implants. They thus preserve the future of the neighboring teeth and the alveolar bone that supports them.

CROWNS

Prosthetic crowns are used to reconstruct very dilapidated teeth, whether they are devitalized or not. They are caps that crimp the remaining tooth stump to consolidate it and restore the shape and functions of the teeth.

For devitalized teeth, the crown must be anchored in the root by a tenon (or pivot or inlay-core). This tenon can sometimes be integral with the prosthetic crown, but it is most often independent.

Main steps in making a prosthetic crown

The tooth is prepared and a temporary resin crown is placed.
If the tooth is devitalized, a tenon is placed in the tooth, either directly or by passing through an impression of the inside of the root.
An impression is taken and sent to the prosthetist so that he can make the crown.
The crown is placed after a fitting.

Crowns consolidate and restore the shape of teeth

The choice of crown meets qualitative, financial and aesthetic criteria.

The different types of crowns:

The resin crown or temporary crown

It protects the tooth during the design stages of the definitive crown. However, over time, the resin becomes porous and microbes pass through; it is therefore necessary to avoid keeping it for too long.

The ceramic-metal crown

It consists of a metal shell covered with a ceramic that has the same color as the teeth. The presence of metal under the ceramic does not allow for the same degree of translucency as natural teeth, which can give the crown an opaque appearance.

The all-ceramic crown

It uses highly advanced design processes. It is made of an extremely resistant ceramic framework, covered with a cosmetic ceramic of the same color as the teeth. These metal-free crowns have an excellent aesthetic result and superior biocompatibility to ceramic-metal crowns.

Our advice

A crowned tooth must be checked very regularly in order to intercept any possible start of decay at the joint

INLAYS AND ONLAYS

Inlays and onlays are alternatives to large-volume composite resins.

This is a modern filling technique that sometimes allows you to avoid a much more mutilating prosthesis for the tooth. The term inlay will be used when only one side of the tooth is affected by decay. The term onlay will be used when several sides are affected.

Why am I being offered an inlay or an onlay rather than a simple composite resin?

The mechanical resistance of inlays and onlays is much better than that of resins made directly in the office using traditional techniques.

In addition, they allow you to obtain a better quality seal than with a traditional filling and increase the reliability of the contact point with the adjacent teeth, which reduces the risk of recurrence of decay and problems of gingival inflammation.

In the case of large cavities, creating an inlay or onlay often makes it possible to avoid having to create a crown which would cause further deterioration of your tooth.

Technique of realization: A single session is enough!

Local anesthesia.
The tooth is prepared by cleaning the cavity.
A digital impression is made using a 3D camera.
The onlay is modeled before your eyes by your dental surgeon and machined in a few minutes in the laboratory of the Belcenia Dental Practice.
The onlay is tried and glued in the cavity of the tooth.

The chemical adhesion to the walls consolidates the whole and ensures a better seal opposing any bacterial infiltration.

This technique of realization in a single step avoids several anesthesias and preserves the health of the pulp as much as possible.

DENTAL PROSTHESES FIXED TO TEETH

A damaged tooth can be reconstructed with fixed dental prostheses.

There are several types used depending on the needs:

The prosthetic dental crown replaces the entire visible part of the tooth. It then covers the entire tooth and consolidates it.
The inlay replaces a small internal part of the tooth. We can also use the onlay which is a partial dental crown, placed on the external part of the tooth.
When one or more teeth are missing, they can be replaced by a bridge (or dental bridge) fixed to the neighboring teeth by an onlay or a crown.

A temporary dental prosthesis will be offered to you so that the tooth is protected.

COMBINED PROSTHESES

A combined prosthesis is a prosthesis made up of a fixed part and a removable part. The removable part on a metal plate, replacing the missing tooth(s), is connected to the remaining teeth using an anchoring element: attachment, hook, telescopic crown, etc.

These prostheses are generally used in patients for whom implantation cannot be performed or who cannot cover the costs of implant surgery.

IMPLANT-RETAINED DENTURE

There are two types of implant-supported dentures that can be offered to the patient:

Fixed dentures, which are dental crowns or bridges directly screwed or sealed onto dental implants.
Removable dentures on implants: these are partial or complete dentures, stabilized by means of attachment systems that often resemble small snaps.

GOOD TO KNOW

Whether you have a fixed or removable denture, it is necessary to adopt rigorous dental hygiene.

Removable dentures must be removed and cleaned after each meal, and the mouth rinsed.

REMOVABLE DENTAL PROSTHESES

Removable dental prostheses can be removed according to your needs. Partial or total, they are made according to the patient's needs and the number of teeth to be replaced.

Thus, a partial removable dental prosthesis only replaces one or more teeth. It rests on the gum and the remaining teeth.

The complete removable dental prosthesis will replace all the teeth in the jaw; it simply rests on the gum.

The choice of prosthesis depends on the number of teeth to be replaced and the materials used.

COMPLETE REMOVABLE PROSTHESES

Complete removable prostheses replace all the teeth on a jaw.

They can be inserted and removed at will.

Design of the prosthesis:

Careful monitoring and adjustments facilitate the adaptation period of the prosthesis

The creation of complete removable prostheses requires a series of very precise steps. Indeed, two or more impressions are necessary to record very precisely the position of the gum, tongue, lips and cheeks.

Snap fasteners:

If the contact surface between the prosthesis and the gum is not sufficient, or if saliva is lacking, the prosthesis can be stabilized using snap fasteners placed on implants.

Follow-up:

When wearing a complete removable prosthesis for the first time, an adaptation period must be planned, particularly for eating.

In the weeks following the fitting of the prosthesis, many adjustments may be necessary in order to perfect its morphology and ensure optimum comfort.

Over time, the jaw bone and gum may sag and cause the prosthesis to lose stability. This situation is remedied by performing a "reline", which will fill the free spaces between the prosthesis and the gum.

Our advice:

Full upper removable prostheses are often stable and comfortable.

On the other hand, for the lower teeth, the anatomical conditions make stabilization more delicate.

The installation of two implants with a very simple attachment system often solves this problem.

It is advisable to discuss this with your dental surgeon, who will direct you towards the solution best suited to your mouth.

STABILIZATION OF COMPLETE REMOVABLE PROSTHESES

The removable prosthesis on implants allows to stabilize a total removable prosthesis (denture) by fixing it on implants provided for this purpose.

This is a particularly interesting choice for patients who must wear a complete prosthesis but who cannot benefit from a fixed prosthesis on many implants, whether for anatomical reasons (insufficient bone volume) or economic reasons.

PRINCIPLES

Once the device is chosen, 2 to 4 implants are placed during a first appointment. After an osseointegration period of approximately 3/4 months, the device is loaded. The part of the prosthesis that is in contact with the gum is hollowed out in order to fix the attachments.

"Comfort, stability and chewing efficiency."

ATTACHMENT SYSTEMS

There are different types of attachment to fix the prosthesis. The most common are:

A snap-on device: (Novaloc - Locator)

The prosthesis then clips directly onto the dental implants with a male part screwed onto the implant, and a female part placed in the resin of the prosthesis (as with a snap-on). It is also possible to dose the resistance of the snap-on.

This device is used for both jaws, but mainly for the lower jaw or if the contact area between the gum and the device is insufficient. It provides good protection against withdrawal forces.

TO KNOW

Do not stay with an uncomfortable prosthesis, solutions can be offered to you.

Temporary removable prostheses, like complete dentures for use, can benefit from retention systems on implants.

LIVING WELL WITH A REMOVABLE PROSTHESIS

The first few days with your removable prosthesis: adopt the right reflexes to facilitate the adaptation period.

THE FIRST DAYS

The device may seem bulky, irritating or unstable. We therefore recommend that you wear it as often as possible from the start so that the adaptation can be done quickly.

Do you feel any discomfort when eating or speaking properly?

Chew slowly and in small quantities. Avoid foods that contain pips and seeds. Speak out loud to gain confidence in your speech.
Do not hesitate to report any inconveniences to us so that we can implement the best comfort solutions.

After a while, the device will be forgotten

ADJUSTMENTS

During the weeks following the installation, successive adjustments will have to be made in the office to ensure that the device is well adapted to your jaw and mouth.

MAINTENANCE

The appliance must be cleaned at least twice a day after meals, using a hard brush (reserved for this purpose) with soap or a specific product so that no deposits remain. The remaining teeth must also be brushed, as well as the gum on which the prosthesis rests.
If the prosthesis is not worn at night, it is more hygienic to leave it dry than to soak it in a glass of water. If your prosthesis has been left dry during the night, you can moisten it with lukewarm water before putting it back in your mouth.
There are also cleaning products, effective during the night, which ensure the longevity of the appliance.

TO KNOW

Dentures are subject to significant wear. In addition, over the years, the morphology of your jaw will change, the gum and bone will change. This is why it is recommended to have your prostheses checked regularly.

For optimal comfort, it is necessary from time to time to "rebase" the prosthesis, that is to say to readjust it by "recharging" it with resin.

Sometimes, it will be better to have it redone.