Demand for beautiful teeth is showing continuously increasing tendency nowadays also. The appearance of new materials and technologies makes it possible for the dentist to satisfy the highest aesthetic demands also.
The replacement of missing teeth because of tooth loss is one of the important areas of dentistry. Without the tooth replacement the chewing ability suffers, disturbance in sound production and speaking might appear, the facial harmony is disrupted, which might lead to huge changes in the features of the face and this may cause a severe psychic problem for the patients. We can divide the replacements into two groups: fixed and removable tooth replacements.
The fixed implants are fixed on the tooth with dental cement after an adequate polish, and they cannot be removed by the patient. We make a crown when the tooth is damaged so badly that the original function and aesthetics can not be re-established with conservative treatments (fillings, inlays). In case of preparing a bridge the tooth or teeth beside the missing tooth or teeth will support the replacement. Most of the fixed tooth replacements have a metal framework, which can be made of alloys of precious metals (gold), or non-precious metals, as well as titanium. On this metal framework comes the porcelain, which is used for covering and is available in different shades of colour, so it matches the colour of the teeth in the mouth. Covering crown purely made of metal may only be used in the invisible molar region. In case of front teeth the aim is to reach the best aesthetic effect, and the application of metal free replacements gives a great opportunity in order to reach this goal. Considering their construction they can be purely porcelain (so called jacket) crowns without frameworks, as well as nowadays the state of the art the so called Procera crowns. The framework of the Procera crowns is made of zirconia or alumina, which matches the colour of the covering porcelain. After polishing the tooth or teeth the dentist takes an imprint, the laboratory scans it and sends the information to Sweden. A computer controlled precision machine produces the framework of the tooth replacement based on the received parameters, and the dental technician in Hungary prepares the bodywork on to it. With the help of this procedure perfect aesthetic effect and high level of precision can be achieved.
If the extent of the damage of the tooth is so big, that it is unsuitable for making a crown, but the root is intact, then the missing part of the tooth must be replaced with a post. The post is made of metal, completes the tooth and makes it suitable for wearing a crown. The telescopic crowns are used to increase efficiency of the fixation, in dentistry we mostly use them to enhance the stability of the removable prosthesis. The basic principle of making of it is, that there should be enough teeth in good condition in the mouth. The telescopic crowns are built up from two parts: the primary crown is produced for the existing, polished tooth and it is fixed to it with cement, meanwhile the secondary part is in the removable denture and it is the exact negative copy of the primary part. Actually the primary and the secondary parts match to each other as the key does to its lock; the efficiency of the fixation is secured by the walls of the crowns, which friction with each other.
The temporary tooth replacement is such a replacement, which is worn by the patient until the preparation of the final tooth replacement. Both the dentist and the dental technician can make it, it is made of plastic. The main function of it is to protect the polished teeth.
We call a replacement removable tooth replacement, which is fixed in a detachable way to the remaining teeth and to the basement of the mucosa at the bone, so it can be easily removed by the patient also. The removable plated tooth replacement can be partial or complete tooth replacement, it depends from the number of teeth remaining in the mouth. Complete, removable, plated tooth replacement is prepared for toothless mouths. Considering its fastening the anatomical structure of the upper jawbone and the suction of the palate is ideal to keep the dentures in place. On the other hand in case of lower dentures the often unfavorable anatomical structure makes it hard to prepare stable dentures. Hard acrylic or flexible plastic can be used as material for complete, plated tooth replacement. We distinguish from the point of view of wearing time permanent and temporary dentures. We mean under a temporary denture a denture, which is worn until the permanent is prepared, which has several advantages: it speeds up the healing time of wounds, decreases the time needed for the patient to get accustomed, and it is aesthetically favorable.
In the case of partial, plated tooth replacement there are still some teeth left in the mouth, which enhance the stability of the tooth replacement. The material of the replacements is a combination of metals and plastics, that is why in daily use the dental literature calls them metal plated tooth replacements. Their advantage is, that the replacement is thin, the size of the base plate can be reduced, therefore the time needed to get accustomed to it is significantly decreased, and disturbs less the sensing of taste. The tooth replacement can connect to the remaining teeth with the help of links or so called fine mechanical fasteners. With the help of the last solution preferable aesthetics and great precision can be achieved. The ensemble of removable and fix tooth replacement is called combined tooth replacement.