PROSTHODONTIC SERVICES

About Prosthodontics

Prosthodontists are experts in the restoration and replacement of your natural teeth. After completing four years of dental school, they complete an additional 2 to 3 years of specialized training in an American Dental Association (ADA) accredited graduate program.  Prosthodontics is one of the nine ADA recognized dental specialties.


Read more about our treatment options here:

TMD

The temporomandibular joint (TMJ) is the anatomical articulating region between the condyle of the mandible and its corresponding fossa in the sphenoid bone of the skull. This complex gliding hinge joint involves the surrounding ligaments and interposed cartilaginous disc and synovial fluid lubricant. With several moving parts and given its complex nature, it is no wonder that many people experience temporomandibular disorder (TMD). A number of signs and symptoms, including clicking, popping, crunching (crepitus), and pain in the joint and surrounding musculature, combine to define this often-debilitating disorder. Proper evaluation of the joint and surrounding tissue, as well as the occlusion of the teeth, is critical in establishing a proper diagnosis and treatment plan. Because the mutual protection of the anterior and posterior teeth in functional working and nonworking movements is critical in the balancing of the TMJ in its proper anatomical position, the evaluation of the teeth and bite is a starting point in evaluating TMD. Diagnosis and treatment often involve the fabrication of occlusal guards and orthotic devices in order to regain stability in a joint destabilized by the occlusion.

Dental Implants

Dental implants are cylindrical tooth root analogs made from an alloy of primarily titanium. They are used for supporting abutments of various kinds in the restoration of teeth. The titanium cylinder is surgically placed in the jawbone and over a period of about six weeks undergoes a process called osseointegration whereby it very nearly fuses to the bone. After the implant fixture is osseointegrated, it is ready to be used in the restoration and replacement of teeth.

Implants are used in several unique ways in order to replace missing teeth:

1. Individual crowns -  An implant can replace a single tooth by way of support for an abutment crown, which is the visible component of a tooth in the mouth.

2. Bridges - Two or more implants can be used to support abutments and a bridge where two or more adjacent teeth are missing.

3. Full arch fixed tooth replacement - Hybrid dentures are strong restorations made with denture teeth, acrylic and a metal substructure, which is secured by screws and supported by abutments fastened to implant fixtures. These “fixed detachable” hybrid dentures are unable to be removed except by your dentist.

4. Full arch removable tooth replacement  - Implants can be used to help hold removable dentures in the mouth by way of attachments such as Locator or Conus abutments. These implant-retained overdentures are much more stable than their non-implant supported counterparts.


In order to assess whether you are a good candidate for dental implants, your prosthodontist will need to obtain a scan of your bone in the area of interest called a cone beam CT scan or tomographic survey. Once it has been determined that there is enough bone and your medical records have been reviewed to determine that there are no contraindications to surgical treatment, the planning process for dental implants can begin. A treatment plan is formulated based on your specific needs and the implant fixture sizes and locations are predetermined by use of dental models, your CBCT scan, implant planning software and occasionally a wax-up or radiographic guide. Planning and placement of dental implants is only one part of successful dental treatment, but it is an important first step in your personalized dental care.


Once dental implants are placed and the teeth have been restored, you will need to be sure to follow a proper maintenance protocol to ensure the best long-term outcome. Brushing and flossing at home as well as periodic prophylaxis visits are necessary to keep an eye on your implant restoration and detect problems early. The most common complication with dental implants is abutment screw loosening, which is an easy fix. Bone loss around implant fixtures is another problem which occurs and can be related to inadequate hygiene and maintenance.

Porcelain Veneers

Porcelain veneers are designed to improve the appearance of your smile, specifically the color of your teeth. These are thin ceramic shells that easily bond right on top of your teeth, vastly improving the appearance of your smile. It’s impossible to tell the difference between these bonded teeth and natural teeth. Best of all, porcelain veneers can last for over a decade.


Two appointments will be needed to prepare your teeth for veneers – one for diagnosis and treatment planning, and another for a mold to be taken of your teeth in order to design the veneers. The bonding will take place at the third appointment.


Post-surgery treatment is mostly routine. In fact, you can brush and floss as you normally would. You might notice some sensitivity, but that will dissipate after 1-2 weeks. Call the dentists at Southeastern Dental Specialists for help if you need it.

Crowns

When teeth are damaged by cavities, wear or trauma, there is often insufficient remaining tooth structure to place a filling. These teeth can often be restored with crowns. The crown treatment procedure involves trimming the tooth around the outside, including most or all of the enamel and some of the dentin. The shell of enamel which protects the tooth is then replaced by a hard and usually tooth colored material such as porcelain or tetra zirconia phosphate. Crowns are fabricated in a lab using impressions of the teeth, stone models and often CAD/CAM computer design and milling in order to create a sturdy, esthetic, accurate and predictable restoration which should last a decade or more. Crowns meet the teeth at the margin of the tooth preparation and are cemented on the teeth in a way which makes them unable to be removed. Cleaning this margin by brushing and flossing near the gumline is critical to maximize the longevity of the crown.

Dentures

Complete dentures: Complete denture treatment is a way of replacing all the teeth in either upper or lower arches with a cost-effective removable prosthesis that is both esthetic and convenient. Once it has been determined that the remaining teeth in an arch are going to be removed, there are two ways of proceeding with complete dentures. Immediate dentures involve having the denture fabricated before the removal of teeth and then delivering them on the day the teeth are removed. This has the advantage of you not having to be without teeth. Standard or delayed dentures involve removing the teeth and shaping the bone first and then beginning the denture fabrication process after a period of healing (typically 6-8 weeks). Although this means that there is a period of time with no teeth, it has the advantage over immediate dentures of being able to visualize and test the wax-up stage of the denture in the mouth and get the benefit of a more stable form of the healed supporting tissues prior to denture delivery.


Partial dentures: When several teeth are missing, an economically favorable way to replace them can be removable partial denture or a removable dental prosthesis (FDP). There are three basic types of removable partial dentures which are available. A metal framework RDP has a cast metal framework which supports the resin flanges and teeth, and typically has cast assemblies surrounding teeth for support stability and retention. A resin RDP has only polymethylmethacrylate (PMMA) resin and no metal framework. Resin partials typically have wrought wires on either side for retention. A flexible frame RDP has a flexible resin such as nylon and gingival colored clasps. Sometimes alternative support structures are used for retaining the RDP such as dental implant attachments or tooth supported extracoronal resilient attachments (ERAs), which are connected to crowns. These permit the retention stability and support of the partial without visible clasps.


Implant overdentures: When teeth are missing, so is the stability, retention and support which is typically provided by their anchorage in the jawbone. Implants can compensate for this loss of function by providing new bony anchorage by means of precision attachments. These are studs which protrude from the gingival and connect to the removable or complete denture by means of a nylon insert (Locator) or by a direct metal to metal tapered cylindrical connection (Conus attachment). By this means, additional stability, retention and support are provided to the removable prosthesis. This can sometimes allow an upper denture palate or a visible tooth-borne clasp assembly to be removed, thereby improving the appearance and function of the removable denture.

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