The following series of blogs will cover the different areas of dentistry. The aim is to
simplify and explain the jargon that patients encounter in the normal course of dental
visit. It is based on the Ontario Dental Association’s procedure categories and
descriptions.
Prosthetics Fixed
In the previous blog we discussed removable prosthetics – namely variations on
dentures. Fixed prosthetics or bridge work covers a range of artificial teeth that are
attached to the teeth or other supporting structures and remain in the mouth. That is to
say they are not removed on a daily basis for resting tissues and hygiene.
Abutments (retainers)-crowns/onlays/inlays
Like real bridges that have abutments, so to do dental bridges. Generally there is one
abutment on either side of the missing tooth or teeth. To ensure stability, the more teeth
being replaced the more abutments are needed to support the artificial teeth.
Abutments may be full crowns (see the previous blog) or if conditions permit partial
crowns and inlays. They may be straightforward or very complex constructions
depending on individual needs and circumstances.
Pontics
To again use the world at large analogy, the artificial tooth (teeth) that are between the
abutments are referred to as pontics or the bridge. Pontics like crowns are made from
various materials and are specific to the individual needs of your mouth.
Repairs/removal
Bridges like crowns and fillings may need repairs and maintenance. Where possible the
repair will take place in the mouth. However, sometimes the problems of an abutment
are such that the whole bridge must be removed to remedy the problem. Removing a
cemented bridge is no easy feat. If the goal is to remove it in one piece, then there may
be complications. Usually the safest means of removal is to cut it off. This renders the
bridge useless afterwards – so a new bridge is needed.
Removable partial dentures, though trapping significant amounts of plaque, are easier
to clean. Fixed bridges are harder to keep clean, so recurrent decay is a very real
concern. Hence the occasional need for repairs.
Repairs reinsertion/recementation
Once a bridge has been removed in one piece and repaired, it must be reinserted. This
may take as much time or longer depending on the repairs, than when it was initially
placed.
Fixed bridges are cemented back into place with a dental cement.
Fixed bridges that are supported by implants may be cemented in place or screwed into
place. This will be determined by the original construction. If screwed in, the bridge can
be relatively easily removed and replaced. If cemented, the same concerns, risks and
difficulties apply as with conventionally cemented bridges.
Splinting
Teeth ravaged by gum disease may be maintainable when they are splinted together.
There are several ways to splint teeth to improve their stability, but the best aesthetics
and function is generally using crowns that are “splinted” or tied together. They are not
by definition replacing missing teeth, but acting as one long pier.
The process of fabrication is identical to that of crowns and bridges.