Fixed restorations

Almost every doctor and patient encounter a problem during a dental attendance, and likely at the beginning of it: should the restoration be fixed or removable?

Nowadays doctors and patients usually choose fixed restoration (unless some clinical situations prevent the use of this technique), because it is safer, longer lasting, easy to care of, and last but not the least: pleasant.

Fixed prosthesis means that a prosthetic device is engrained with cement on the tooth, and the patient cannot remove it. Removable restorations can be easily cleaned – you may say, and add: but what about fixed restorations? Fixed prostheses are easy to clean, just like your original teeth. There is no difference between a restoration and a tooth in this aspect.

Types of fixed restorations? if a tooth needs to be “repaired”, but it is too damaged to use filling or inlay, we make a crown. A crown nowadays looks like just an original tooth, and you have to be an expert or a former patient to tell that your teeth were crowned. When two or more teeth are missing, but there are enough teeth on each end of the gap, we use a device called bridge. When a tooth is in fair condition, we use an inlay or on onlay to repair the damages. Inlay is better known as filling, and it is for simply filling a cavity in a tooth. Onlay is pretty much the same, but it is used to replace a cusp. Veneer is a thin layer placed on the surface of a slightly damaged tooth to protect it from further damages or simply to improve its appearance.

Materials and techniques: almost every fixed prosthesis has a metal frame. The frame is made of gold or non-precious metal or titanium. Of course metal is covered with porcelain at the end of the treatment. The so called aesthetical porcelain can be coloured to resemble the colour of the original teeth. There is only one case when we use full metal crown: if it is needed in the grinders’ area, because in this case the crown cannot be seen at all.

If we want to place a crown on a tooth that is exposed, because it is in the front side of your mouth, we can use metal free prostheses to achieve the best result. Some metal-free prostheses are made of porcelain, and don’t contain any metal at all, in other cases a metal frame (zirconia) is made, and our doctors use a special technique to do the whole prosthesis.

Sometimes we cannot use a crown, because the tooth is damaged, but the root can be in a condition that allows the use of a cog. The cog is a metal device which allows us to use a crown even in those cases, when the tooth is seriously damaged.

Though this article is about fixed restorations, a fixed prosthesis needs a temporary prosthesis in the beginning of the attendance. The temporary prosthesis is made of plastic, and has only one purpose: to protect the teeth until the fixed prosthesis is done.