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1 Prosthetic care: innovation and progress in modern dentistry

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Discover prosthetic care: innovative techniques and materials in modern dental technology.

In the world of dentistry, prosthodontics is a crucial aspect. It deals with replacing missing or damaged teeth with artificial alternatives to improve not only the function of the dentition but also the aesthetic appearance. This article introduces you to the complex and fascinating field of prosthodontics, which ranges from traditional methods to the latest advances in material science and digital technology. The article highlights the different types of prosthodontics, the materials and technologies used, the detailed treatment process and discusses challenges and innovations in this field.

1.1 Types of prosthetic care

Prosthetic care in dentistry includes various approaches and techniques to restore missing teeth and jaw structures. These range from fixed to removable solutions and combined methods to maximize functionality, aesthetics and comfort for the patient.

Fixed prosthetics: 
This type of prosthetics refers to dentures that are permanently fixed in the mouth and cannot be removed by the patient.

Materials: Crowns can be made from a variety of materials, including composite, ceramic, metal alloys, or a combination of these. The choice of material depends on several factors, such as the position of the tooth in the mouth, aesthetic considerations, and chewing force .
Areas of application: They are used to restore damaged or severely carious teeth, to maintain the shape and function of a tooth after root canal treatment or as part of a bridge or implant.
Manufacturing process: The production of a crown usually begins with the preparation of the affected tooth, followed by taking an impression. Modern CAD/CAM technologies now enable crowns to be manufactured more precisely and quickly.

Design: Bridges consist of two or more crowns that span adjacent teeth, with one or more artificial teeth in between.
Biomechanical aspects: They must be designed to withstand the chewing forces while exerting an even load on the abutment teeth.
Patient comfort: In addition to functionality, patient comfort is also crucial, especially in terms of fit and feel in the mouth.

Integration into the jawbone: Implants are artificial tooth roots that are inserted into the jawbone. They integrate with the bone through osseointegration and form a stable base for the dentures attached to them.
Long-term success: Implants have a high success rate and can last a lifetime with proper care and regular check-ups.

Removable prosthetics: 
This category includes prostheses that can be removed by the patient and are used particularly in cases of extensive tooth loss.

Partial dentures:
Design options: Partial dentures can be made from different materials such as acrylic or metal and can be attached to the remaining teeth with clasps or other retaining elements.
Anchoring systems: They can be attached to the remaining natural teeth using brackets, attachments or telescopes.

Full dentures:
Adaptation to the oral mucosa: Full dentures must be carefully adapted to the shape of the oral mucosa and jaw to ensure comfort and functionality.
Aesthetics: Aesthetics plays an important role, especially in the design of the visible tooth area.

Combined prosthetics: 
This uses a combination of fixed and removable prostheses. This offers flexibility and can be used in complex cases to take advantage of the benefits of both methods.
Combination of fixed and removable dentures: Such solutions are often necessary when certain conditions in the patient's mouth do not allow for purely fixed or removable prosthetics.

This variety of prosthetic solutions offers individual treatment options tailored to the specific needs and expectations of each patient. The selection of the appropriate prosthetic approach depends on various factors, such as the extent of tooth loss, the health of the surrounding tissue, the aesthetic requirements and, last but not least, the patient's personal preferences. With the ongoing development of new materials and techniques, the spectrum of prosthetic care is constantly expanding in order to achieve optimal functional and aesthetic results and thus improve the quality of life of patients.

1.2 Materials and technologies in prosthetic care

Prosthetic care has undergone a significant evolution through the development of new materials and technologies. These advances offer improved solutions in terms of durability, aesthetics and patient comfort.

Traditional materials: 
Traditional materials have been the basis of prosthetics for decades and have proven themselves through their reliability and compatibility.

Gold alloys: They offer excellent processing properties and high biocompatibility, but are less commonly used due to cost and aesthetics.
Non-metal alloys: Cheaper alternatives such as cobalt-chromium are often used for denture bases and metallic frameworks.
Titanium: Known for its biocompatibility and strength, titanium is often used for implants and metal-ceramic restorations.

Aesthetics: Ceramics offer excellent aesthetic properties that are close to those of natural teeth.
Wear resistance: Modern ceramics are very resistant to abrasion and discoloration.

Polymethyl methacrylate (PMMA): Commonly used for denture bases, PMMA offers good aesthetics and adaptability.
Adaptability: Plastics can be easily adapted to the individual conditions of the patient’s mouth.

Modern materials: 
The introduction of new materials has significantly expanded the possibilities in prosthetics, especially in terms of aesthetics, weight and biocompatibility.

High performance polymers:
Stability: Materials such as PEEK ( polyetheretherketone ) offer high strength and low weight.
Weight advantages: These polymers are significantly lighter than traditional materials, which increases comfort.

The largest part consists of glass particles that are bound by a matrix. This is closest to the hardness of natural teeth .

Biocompatible alloys:
Titanium: Due to its excellent biocompatibility and corrosion resistance, titanium is the material of choice for many implants.
Corrosion resistance: These alloys are resistant to corrosion, which increases their longevity in the oral environment.

Digital technologies: 
Digitalization has revolutionized prosthetics, from diagnosis to manufacturing.

CAD/CAM systems:
Precision: Computer-aided design and manufacturing systems enable extremely precise production of prosthetics.
Individualization: Each restoration can be precisely adapted to the individual circumstances of the patient.

3D printing:
Prototyping: Rapid production of prototypes for prostheses and scaffolds.
Cost efficiency: 3D printing enables cost-effective and rapid production of customized solutions.

These materials and technologies enable dentists and dental technicians to develop individual, functional and aesthetically pleasing prosthetic solutions that meet the needs and wishes of patients. By combining traditional practices and modern innovations, prosthetic care is continuously improved to achieve optimal results.

1.3 Treatment process and planning in prosthetic care

The prosthetic treatment process involves several steps, from initial diagnosis and planning to the fabrication and fitting of the prosthetics. Each step is critical to ensure that the patient receives a prosthetic solution that is both functionally and aesthetically optimal.

Diagnosis and treatment planning: 
The foundation of any successful prosthetic treatment is careful diagnosis and planning, taking into account the patient's individual needs and specific oral health. A comprehensive examination, including x-rays and digital scans, allows the dentist to evaluate the condition of the remaining teeth, jawbone and gums. Interdisciplinary approaches involving collaboration with other specialties such as orthodontics or periodontics may be required to treat complex cases.

Steps of prosthetic treatment: 
Prosthetic treatment typically begins with the impression, which can be done either digitally or classically. These impressions serve as the basis for the production of the prosthetics. The accuracy of these impressions is crucial for the fit and comfort of the finished prosthesis. The prosthesis production itself can include both manual techniques and machine processes, including CAD/CAM systems. Particular emphasis is placed on the choice of materials, the precision of the production and the aesthetic design.

Aftercare and adjustments: 
After the prosthetics have been fitted, aftercare is an essential part of the treatment process. Regular check-ups and adjustments are necessary to ensure the longevity of the prosthetics and to maintain comfort and function. Patient education on how to care for and handle the prosthetics is also very important, as appropriate care is crucial to the success and longevity of the prosthetic treatment.

1.4 Challenges and complications in prosthetic care

Despite modern technologies and materials, challenges and complications can arise in prosthetic care. A thorough understanding of these aspects is crucial to respond effectively and achieve the best possible outcomes for the patient.

Dealing with complex cases: 
Complex cases, such as significant tooth loss or atrophied jawbone, require tailored, often innovative solutions. This may include the use of specialized implant techniques, bone augmentation procedures or the development of individual prosthetic designs. The ability to respond individually to the anatomy and needs of each patient is crucial for success in such situations.

Management of complications: 
In some cases, complications such as prosthesis breakage or pressure sores may occur. Prompt and efficient management of these complications is important to ensure patient comfort and satisfaction. Repair methods and preventive measures, such as regular check-ups and adjustments, are crucial to minimize such problems.

Long-term care and prosthetic care: 
Long-term care, including regular check-ups and care of the prosthetics, plays an essential role in maintaining functionality and aesthetics over time.

1.5 Conclusion

In conclusion, prosthetic care makes a crucial contribution to modern dentistry. It plays an essential role in restoring the functionality and aesthetics of the teeth, which contributes significantly to improving the quality of life of patients. Advances in material science and digital technology have expanded the possibilities in prosthetics, leading to more precise and aesthetically pleasing results. An individual approach that includes accurate diagnosis, careful planning and comprehensive aftercare is important for success. Despite the challenges and possible complications, prosthetic care offers effective solutions and promises further improvement in treatment outcomes in the future through continuous innovation.