Dentures

Dentures

Dentures are appliances made to restore the chewing function, speech contribution and aesthetics of teeth and tissues lost in the mouth for various reasons, while also helping preserve the health of the remaining tissue. They are divided into three types: fixed, removable and implant-supported dentures:

1) Fixed dentures:

These are dentures made using the neighbouring teeth on either side of the gap as support in cases of partial tooth loss. Types include:

– Crown:

For teeth whose aesthetics and function cannot be restored with a filling, this involves reducing the tooth and giving it back an appearance and strength suited to its natural shape.

– Bridge:

For one or more missing teeth, this is the process of filling the gap by taking support from special crowns made on reduced neighbouring teeth. In this way, the chewing pressure that would fall on the gap is shared by the reduced neighbouring teeth. Alternatively, if the patient's circumstances allow, an "implant" can be placed so the neighbouring teeth are spared from being cut down and from being placed under excessive pressure.

Fixed dentures can also be classified according to the material used in their construction:

– Full metal:

Generally preferred at the back molar region when there is not enough space, and when resistance to chewing pressure is required. Over time there is a possibility of discolouration at the gumline and, in sensitive individuals, allergy. It is the cheapest fixed denture method.

– Metal-supported porcelain:

The metal underneath the porcelain is there to provide strength, but because it does not transmit light, the metal substructure somewhat overshadows the aesthetics of the porcelain. Over time the metal can cause discolouration at the gumline. It is inexpensive.

– Zirconia-supported porcelain denture:

Thanks to the light transmission of the zirconia substructure, it achieves an aesthetic result closer to natural teeth while also preserving durability. It is more biocompatible with tissue. It is expensive.

– Empress (pressed / reinforced porcelain):

Another method for a natural-looking appearance, though it has lower durability in long bridges. It is more biocompatible with tissue. It is expensive.

2) Removable Dentures:

These are preferred for patients with partial or complete tooth loss where a fixed denture cannot be made. Various applications are used to increase patient comfort and aesthetics when using these types of dentures. Types include:

a) Complete Denture:

These are dentures made for patients who have lost all their teeth, taking support from the jaw and mucosa. Usage performance varies from person to person.

-Implant-supported complete denture

Implant applications are used to fix complete dentures in the mouth and prevent movement during use. With implants placed in the jawbone and dentures made taking support from them, the denture gains support not only from the soft tissue but also directly from the bone at several points, providing ease of use and patient comfort. This method gives patients the feeling of chewing with their own teeth, which is why it is frequently preferred.

-Tooth-supported complete denture (Telescopic Application)

If the patient has a few small, usable teeth remaining in the mouth and partial denture types are not preferred for aesthetic reasons, the teeth are shaped to remain under the complete denture. Crowns are placed on the teeth, fitting into a socket prepared under the complete denture. With this application, the teeth and surrounding tissue are preserved, the patient's aesthetics are achieved, and the patient's complete denture is stabilised.

b) Partial Denture

In cases of partial tooth loss where a fixed denture such as a bridge cannot be made, this type of denture sits over the missing areas taking support from the soft tissue, and takes support from the remaining teeth by various methods.

– Clasp denture:

The simplest partial denture method. A metal clasp extending from the body of the partial denture is used to gain support from the teeth. If the teeth being used for support are in a visible location, this creates aesthetic problems. As the partial denture moves during use, the clasps surrounding the teeth rub against them, and wear (decay) can occur on the tooth surface over time. Clasps can also flex over time, weakening their grip on the tooth and making the partial denture more mobile.

– Acetal application:

A method applied to somewhat reduce the aesthetic problem of the clasp denture. It is essentially the same as the clasp denture, but the clasp and body of the partial denture are made not from metal but from a special tooth-coloured plastic material called acetal. Due to less friction, it does not damage the tooth as much as metal. The clasps do not deform but can break. Over time, there is a possibility of colour change and odour due to external factors.

– Precision Attachment Denture:

A method developed to provide an aesthetic appearance, make the partial denture more stable, and prevent possible damage to the teeth. A component called a precision attachment is used to help the partial denture grip the teeth. In this method, the two teeth closest to the partial denture receive a porcelain crown carrying the male part of the precision attachment. The female part of the attachment is placed on the part of the partial denture adjacent to the tooth.

3) Implant-supported dentures

In mouths where all teeth have been lost, some patients still want a completely fixed denture that never comes out. In this case, a certain number of implants are placed in the jaws at set intervals. Bridge-like dentures, rather than a palate-covering denture, are then made on top of them.