The advances in prevention and the development of implantology, have significatively reduced the use of removable prosthesis (that is, complete or partial dentures). Nevertheless, when it is indicated, it is done, trying to increase the retention of those appliances.
Complete dentures, (the ones that substitute the whole upper or lower arch) will be supported depending on the bone bases that the patient has. When teeth have been recently extracted the residual bone in the maxillae start to remodel. After some years it becomes smaller, and this precludes a worse stability of the denture. The placement of a minimum of two implants and, ideally, four, will let us create support structures that anchor the prosthesis, decreasing its mobility. Over those implants strategically placed we make titanium structures (locators or bars) and, in the complete denture, small attachments are adhered to fix it to those structures. Complete dentures that are modified this way are called overdentures.
In Clinica Padrós-Creus Muntaner we try that removable prosthesis have the adequate retainers so that the whole device is as much tolerable as possible.
Even though overdentures work correctly, it is always more comfortable to place fixed structures. These ones can only be done if the number of implants is sufficient. In these cases, we work with structures over intermediate pillars that allow that the margin of the prosthesis is located at the gingival level instead of at the bone level. This will allow more hygienic prosthesis. At the same time, they are threaded structures that are fixed to these intermediate elements through small screws that can be removed if needed. The acces to these screws is covered, but at least once a year the structures are dissembled so we can clean them thoroughly.
CEREC: Aesthetic ceramics through CAD-CAM
Clínica Dental Padrós-Creus Muntaner is a pioneer in the use of the Cerec System. The CEREC system is a CAD-CAM system that allows us to design and manufacture ceramic, sapphire or resin prosthetic restorations as an in-office procedure. We can manufacture inlays or onlays, crowns and veneers for dental aesthetic and conservative dentistry treatments, thanks to this 3D technology, which is used for the construction of great precision in the industry.
After the correct preparation of teeth, they are scanned. After, a computer designs the restoration individually. The information is sent through wi-fi to a milling unit that will make the restoration on a massive block made of ceramic, sapphire or resin.
This system gives exactitude, versatility and immediacy to the fixed prosthetic elements that is able to manufacture.
Exactitude, because it has been proved that CAD CAM systems have reached today a better adjustment than the conventional prosthetic treatment.
Versatility, because it permits to scan with an intraoral scanner, directly, the mouth of the patient, without the need of using impression materials (silicones). Nevertheless, if it is required to work over a dental cast, it is also possible if a model is printed using a 3D printer or if conventional impression has been taken with different materials, and the model is scanned.
Immediacy, because if needed, the mouth of the patient can be directly scanned, and the crown, veneer or reconstruction is manufactured “in situ”. In this instance, the patient will be in the office more time, so we are able to perform the whole manufacturing technique, but will be able to solve the problem in just one session.
Really, the CEREC system gives better quality, exactitude and speed.