The most popular Cosmetic dental procedure by far are dental implants. Not all cosmetic dentist perform them, but they are highly functional.
Common functions of dental implants include:
- Mouths with several teeth supported by implants in which distinguishing real and prosthetic teeth is difficult.
- Mouths in which individual prosthetic teeth closely resemble real teeth, making them difficult to distinguish
- Implants retained by a ball and socket fixture can decrease lower denture movement.
- A series of implants can be used to stabilize a bridge
Dental implants are mostly used to hold dental prosthetics. Current implants utilize a biologic process known as osseointegration, in which bone merges tightly to materials like titanium and certain ceramics. It is possible for implanted prosthetics to handle mechanical loads for many years. (pp103–107)
In replacing individual teeth, an abutment screw is used to secure the abutment to the implant. The dental prosthesis, known as a crown, is secured to the abutment using cement or a small screw. The two pieces may also be blended into one piece during manufacturing. (pp211–232)The same methods can be used to secure multiple prostheses either as a fixed bridge or removable dentures.
A fixed denture is an implant supported bridge, or multiple teeth, that is adhered to the dental implant in such a way that the prosthetic is not removable by the user. Most bridges connect to at least two implants, though the patient’s own teeth may also be used as to anchor the bridge. In most cases, there will be more teeth than implants. The teeth that are used to attach the bridge to the implants are known as abutments and those in between are called pontics. Bridges are attached to abutments in much the same way as a single tooth. A fixed bridge can be used to replace any number of teeth, from two adjacent teeth (a fixed partial denture) to an entire arch (a fixed full denture). In either case, the hardware is fixed because it is not intended to be removed by the wearer.
Removable dentures supported by implants are known as implant supported overdentures (p31). This type of prosthesis is not permanently locked in place and may be removed by the wearer as needed using simple finger pressure. To allow removal, a small connector is used to connect adaptors in the prosthesis. There are several types of connectors, including buttons, bars, magnets or balls. Facial prosthetics can help to correct facial deformities due to disease (like cancer) or injury. These types of prosthetics may also either fixed or removable, depending on the patient’s situation and the nature of the injury or disease.
Orthodontics make use of Temporary Anchorage Devices (TADs), smaller diameter implants that create anchor points that can generate force, aiding in tooth movement. In order to allow teeth to moved, force is applied in the direction of the desired movement. When this force is applied, it triggers the periodontal ligament to restructure the bone. This restructuring involves removing bone in the direction of movement and creating bone in the other direction and requires a fixed anchor point. Because implants lack the periodontal ligament, bone is not reconstructed when tension is applied. This makes implants great anchor points for orthodontic treatments. Most implants used for orthodontic treatment are very small and do not completely osseointegrate, allowing the the hardware to be easily removed when the course of treatment is complete.
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