Removable dentures - Causes, symptoms and treatment. MF.
With loss of even one tooth, the entire dental system is affected. To avoid negative consequences( changes in the temporomandibular joint, changes in bite, deformation of the chewing surfaces of the dentition, etc.) with teeth loss, it is necessary to perform prosthetics( restoration of missing teeth).When there are few teeth( 1-3 teeth), most often you can do with fixed prostheses. When the defect of the dentition is large( 6 or more teeth), resort to removable dentures.
Removable dentures are called removable, because they can be removed and worn at any time independently, without injuries to surrounding tissues, teeth and damage to the prosthesis itself.
Dental prosthesis should be considered as a medical device restoring the integrity of the dentition, its chewing capacity and improving the appearance, as well as preventing further destruction of the chewing system.
Before the beginning of prosthetics, it is necessary to undergo a thorough examination with an orthopedic dentist. The doctor determines the cause of tooth loss, a clinical picture, examines the dentition, makes panoramic X-ray photographs, all this allows you to put the right diagnosis, make a treatment plan, choose the design of the future prosthesis.
Types of removable dentures
Removable prostheses are partial( plate and clasp) - are used for partial loss of teeth, and complete - with complete loss of teeth.
Plate prosthesis
Partial removable plate prostheses are medical orthopedic devices that restore the basic functions of the dentoalveolar system( for example, chewing).These prostheses are non-physiological, i.e.the pressure that occurs during chewing, they transmit to tissues that are not adapted for this( on the mucous membrane of the oral cavity), and through it - to the alveolar process and the body of the jaw, the palate. Thus, over time, cause atrophy of bone tissue.
They are shown in the following cases:
1. In case of defects in the dentition, which can not be repaired by an immovable bridge prosthesis in order to normalize the chewing function;
2. When removing a large number of teeth at the same time;
3. In the absence of even a single tooth( aesthetic prosthesis);
4. How is the prosthetic( holding, strengthening teeth)?
5. With a serious condition of a person in need of artificial limbs;
6. In case of allergic reaction to metal prostheses.
Contraindications are determined by the presence of orthopedic materials, their properties, the general somatic state:
1. Plastic allergy and its components;
2. Diseases of the oral mucosa, if they can not be healed therapeutically;
3. To people with epilepsy, schizophrenia. People whose work is related to a certain profession( lecturer, announcer, singer).
Partial removable plate prostheses consist of: plastic base, clasps( bent) and standard garniturnyh artificial teeth.
Partial removable plate prosthesis with bent clasps
A number of unpleasant moments are connected with the basis of the prosthesis. Covering the hard palate, it causes a violation of taste, temperature sensitivity. Often there is a speech disorder, self-cleaning of the oral mucosa, its irritation, sometimes the appearance of a vomiting reflex. The size of the prosthetic base depends on the number of teeth preserved in the mouth, the severity of the arch of the hard palate, the degree of atrophy of the alveolar part of the jaw, etc. The less the teeth are preserved, the larger the size will be the basis, and vice versa, the more teeth, the smaller the basis.
Bent clamps in places adjacent to natural, their own teeth, because of permanent injury can cause them excessive abrasion, in this area can occur inflammation of the gums.
The advantage of these prostheses can be considered simple in manufacturing and cheap. Deficiencies in the basis of the plate prosthesis caused dentists around the world to reduce its size( to a thin jumper), and replace the plastic with metal. So, most likely, the design of the arch( clasp) prosthesis was born.
Clasp prosthesis
Clasp prosthesis is a modern and comfortable type of removable denture. It consists of a cast metal frame, a plate basis and artificial teeth. The frame includes:
- The saddle is part of a cast frame, which carries a plastic base with artificial teeth.
- Coupling elements( arcs), which provide the connection of saddle and support-retaining elements.
- Supporting devices( clamps, attachments, telescopic systems).
With the saddle, the vertical and horizontal forces arising from chewing are transferred to the mucosa of the prosthetic bed. The number of saddles depends on the number of defects( lost teeth).
The main advantage of this prosthesis in comparison with the plate prosthesis is the distribution of the masticatory load closer to the physiological( the gum loading is transmitted not only to the gum, bone tissue, but also to the supporting teeth, and distributes it optimally between the mucosa and the remaining natural teeth).
In addition, the use of the arc reduces the size of the structure, making it more compact and comfortable to use. The arc partially covers the palate or sublingual space, so the function of speech is not disturbed, sensitivity is preserved, there is no inconvenience in eating, adaptation to the prosthesis is faster.
Indications for the choice of the design of the clasp prosthesis depend on the topography of the defects of the dentition, on its length, the condition of the supporting teeth, antagonist teeth, the type of occlusion, and individual characteristics.
By way of fixation, there are several clasp prostheses:
• clasp prosthesis with supporting-retaining clamps.
Clasp prosthesis for upper jaw with cast clasps
This prosthesis is retained in the oral cavity with the help of support-retaining clamps. Such clasps not only fix the prosthesis, but also allow the distribution of chewing pressure between the mucosa of the prosthetic bed and the periodontium( gum, ligament of the tooth and alveolar bone) of supporting teeth. Clamera, in contrast to plate prostheses, cast. They are much stronger and less noticeable than bent.
• clasp prosthesis on attachments
Clasp prosthesis on attachments to the lower jaw
Attachments( lock fasteners) are a more complex attachment that consists of two parts. The first part is strengthened on the supporting tooth on an artificial crown. It is not mobile and is called a matrix. The second part of the lock joint enters the matrix. It is rigidly connected to the prosthesis and makes movement only with it.
Attachment element on the crown of the supporting tooth
This fastening is reliable and aesthetic, but it can break. The difficulty of replacing such a locking joint makes the area of their application limited.
• clasp prosthesis on telescopic crowns
Clasp prosthesis on telescopic crowns
Telescopic crowns are a system consisting of two parts - internal and external. The inner part is represented by a metal cap covering the stump of the tooth. The outer part is a crown with a pronounced anatomical shape. The inner part( cap) is strengthened on the tooth with cement, the outer( crown) is connected to the prosthesis. Fixation is reliable and aesthetic. Such fastening is shown at low clinical crowns of supporting teeth, when conventional support-retaining clamps do not provide a good fixation of the prosthesis.
A variant of the clasp prosthesis is the prosthesis of Quadrotti.
Quadro prosthesis
This is the same clasp prosthesis. Only its frame and clamper are made of high-quality monomeric molded plastic. The prosthesis has a natural appearance. As a rule, it does not have an allergic and toxic effect on the oral mucosa. The material does not absorb the microflora of the oral cavity. Quadrant frame is lighter in weight of metal frames. They are not conspicuous, and strong enough, almost like metal.
The skeleton of this removable prosthesis can be matched to the color of natural teeth. Due to its flexibility, it has the ability of elastic memory, i.e.adapts to anatomical changes in the jaw.
Quadro prosthesis
Positive properties of quadratic prostheses:
• No need to cover the supporting teeth with crowns;
• They are very flexible, so they rarely break;
• Aesthetic;
• Do not rub gums, do not change the function of speech;
• Resistant to food colorings;
• Can be used in people with traumatic occupations, as well as athletes.
Complete removable dentures
Complete removable dentures are used for complete loss of teeth. Complete removable dentures consist of a plastic base( usually made of dental acrylic plastics), and fixed in them artificial teeth.
Complete removable prosthesis
The task of such prostheses is to fill missing teeth;normalize the function of chewing and speech. Their fixation is due to adhesion( suction effect) and anatomical protrusions of the jaws.
Modern complete removable aesthetic aesthetic and wear-resistant. The service life of removable dentures is on average 5 years, but this does not mean that in 5 years they are necessarily subject to replacement. If you look after the dentures well, periodically adjust them, then their life can be extended.
Care of removable dentures
Removable dentures need to be cleaned as well as teeth, paste with a brush twice a day. And after each meal, rinse with running water.
Holders of removable dentures are not recommended to use viscous and sticky products. These products can stick to the prosthesis and can contribute to its breakdown.
It should be remembered that after imposing removable prostheses in the oral cavity, as a rule, pain appears. This is due to the gradual settling( pressure) of removable prostheses on the mucous membrane. To eliminate these sensations, correction of the prosthesis is necessary. They need a few.
The first one should be performed by your orthopedic dentist the next day after the prosthesis is applied, and before the visit of your orthopedist the prosthesis should be in the mouth for at least 4 hours, even if it is very painful. Otherwise, an effective correction will not be possible. The next 3-4 corrections should be made for two weeks as necessary.
Adaptation to removable dentures occurs on average within a month, someone may have more( 2-6 months).The timing of adaptation to removable prostheses depends on the size and design of the prosthesis, on the degree of fixation on the jaw, on the type of the nervous system, etc. All, the main desire and patience get used to the prosthesis.
It is necessary to protect removable dentures from mechanical and chemical damage. You can not polish and dent the dentures yourself. If cracks or breakages appear in them, you can not use them, you need to see a doctor for repair. And do not forget to go to preventive examinations every six months.