Cosmetics & Restoration of Dental Volumes:
Dental Prostheses
Cosmetics & smile restoration has two main components:
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cosmetics & restoration of tooth-related volumes ("white esthetics score")
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cosmetics & restoration of gum-related volumes (“pink esthetics score”)
This page presents this first part.
1. Which type of dental volume restoration to choose?
The loss of dental tissue can be linked to several causes: a cavity, a crack or a break in a tooth, the loss of a filling, etc. Depending on the volume of this loss, the restoration technique used will be different:
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low volume: direct dental chair technique
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fillings of limited volume (decay by replacing amalgam, fracture, tooth in bad position),
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fillings of the furrows of the lacteal or permanent teeth ( preventive sealing of the furrows ).
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large volume: indirect technique with an imprint sent to the laboratory.
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large volume fillings or partial covering on a posterior tooth (significant decay, loss of a filling, fracture of part of the tooth, etc.), we speak of inlay or onlay .
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partial covering on an anterior tooth, we speak of a facet ,
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total covering of the tooth on existing dental root, living or devitalized, we speak of crown ,
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absence of one or more teeth (root extracted, agenesis), we speak of implant or bridge,
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replacement of several missing teeth, adjacent or not, with a partial removable prosthesis (removable because it is not bonded, partial because it does not replace all the teeth),
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replacement of all the upper or lower teeth with a complete removable prosthesis often called "denture".
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From left to right: Inlay, Onlay, Crown
Bridge
2. Which material to choose to restore a tooth volume?
Advances in the field of dental materials make it possible today to offer several types of materials depending on the restoration:
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Resin
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Hybrid ceramic
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Metal-ceramic
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Ceramics
For small volumes, the composite resin will be used. It is composed of several materials of different nature, size or origin. This mixture creates a material whose mechanical characteristics, in particular the transfer of tension and polishing, are superior to those of the materials used in its composition.
For larger volumes, several criteria will be taken into account:
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the location, anterior or posterior,
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the thickness of the volume to be replaced,
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the forces exerted on the missing part,
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the desired final aesthetic.
For example, in the case of total covering of the tooth, we only use ceramic-ceramic crowns in order to avoid potential aesthetic problems of appearance of a greyish border at the level of the gum linked to the underlying metal screed of the metal-ceramic crown.
3. Which technology for making the dental prosthesis?
As part of a large volume restoration, we will make an impression which we will send to the prosthesis laboratory with the prosthetic project.
According to the project instructions, the technician will rely on a zirconia machined yoke and will “mount” by hand the different successive layers of ceramic corresponding to the different layers of the teeth (dentin and enamel). At each layer, the technician must perform an intermediate cooking. This longer technique achieves an optimal natural result.
Another technique consists of designing the restoration by computer and then machining it in a ceramic or resin block. The aesthetics can then be improved by surface makeup. This technique is often indicated for cases of bruxism.
Other links that might also interest you
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Dental implant
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Gingival graft
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Bone graft