Prosthodontics

Your Local Wollongong Prosthodontist

Who is a Prosthodontist?

A prosthodontist is a specialist dentist who had extensive training in the field of reconstructive dentistry. Dental reconstructions can range from simple veneers to more complex full mouth and jaw rehabilitations.

What is the benefit of seeing a prosthodontist for a consultation?

A prosthodontist is trained to identify and diagnose hidden underlying problems that can present as simple issues. For example, repeated chipping of fillings especially at the front of the mouth. It usually indicates a traumatic bite and loss of teeth height. Another example is daytime tiredness which can be a symptom of sleep apnea. A delay or missing to identify the underlying cause can result in extensive damage that is more difficult to treat and can result in compromised health and overall quality of life.

Examples of extensive damage as result of poor dental care and delayed dental treatment.

Sometimes it is not possible to treat patients who lost all their teeth with implants for medical or financial reasons. Also, the bone and soft tissue anatomy may not provide a suitable environment for implant placement. Although fixed options are always the best alternative to teeth, fabricating a well-designed removable dentures can dramatically improve patient’s appearance and comfort. Prosthodontists are trained to take special impressions and bite procedures which improve fit and stability of a full denture.

Full Upper & Lower Denture Case

Full Mouth Rehabilitation Case With Full Ceramic Onlays & Crowns

Changing teeth length and contours might not be as simple as it looks. In many cases, full mouth treatment is required. It usually involves increasing the bite and placing onlay restorations on selected molar teeth. Onlays are chosen as they are the most conservative option and do not require much preparation, thus preserving the precious tooth enamel. Failure to increase the bite can result in repeated chipping or fracture of the newly placed front veneers or crowns. A prosthodontist is trained in raising the bite without causing trauma to the jaw joints. He or she can also individualize your future restorations to be in harmony with your face type and smile.

Implant Treatment Case

Removable partial plates or long-span fixed bridges were the gold standard to replace multiple missing teeth more than 50 years ago. Now with the recent advances in implant dentistry, it became possible to provide fixed replacement of missing teeth without the need to cut more teeth. Fixed implant option avoids covering the palate or areas close to the tongue with plate components which ensures comfort and ease of brushing. Our prosthodontist will plan your implant treatment to precisely locate implants in relation to nerves and other important anatomical structures in your jaw.

In this case, 4 implants in the back region and 2 implants in the front region of the upper jaw were placed. The implants were restored with a front fixed implant bridge and 2 implant crowns on either side of the upper jaw. 

Full Mouth Rehabilitation Case With Implants & Porcelain Fused To Metal Upper Fixed Implant Bridge & Lower Implant Crows

Failure to recognize underlying causes of dental problems can lead to failure of all or most of the teeth. Patients usually present with pain, bleeding gums, and difficulty in chewing. Unfortunately, patients will choose soft food over healthy vegetables and fruits as result of chewing difficulty. Socializing and outdoor gatherings can be stressful as patients struggle to avoid smiling and embarrassing situations like plates falling off. In this case, not only the dental health is affected but also the mental wellbeing of the individual. 

Failing dentition can be managed with full arch implant bridge.

In this case, an immediate full upper denture was made and followed by an immediate upper temporary acrylic fixed bridge which was fitted 2 days after implant surgery. After 9 months, the steps were taken to fabricate the final upper fixed implant bridge in metal veneered with porcelain. Four implants were also placed in the back region of the bottom jaw and restored with implant crowns after 3 months of healing. The remaining lower front teeth were built in composite resin and the two lower crowns were also replaced to fit the new raised bite. 

Full Mouth Rehabilitation With A Combination Of Fixed & Removable Prostheses:

Case 1:

Full Mouth Rehabilitation With A Combination Of Fixed & Removable Prostheses:

Case 2:

In some cases, fixed restorations with implants are not an option due to medical, bone anatomy or financial reasons. Another alternative will be building the remaining teeth with crowns and replacing the missing teeth with a removable plate. The crowns are milled in a way to allow a precise fit of the removable plate, thus providing better comfort and good plate retention. Whenever possible, the plates can be designed to allow no or minimal display of the metal wires for a more natural smile.

The rehabilitation procedure requires meticulous planning to ensure that the patient is happy with the final aesthetic outcome even before starting the treatment. It also involves making of a temporary denture as an interim means to plan and design the smile before fabricating the final cobalt chrome and acrylic plate.

Composite Resin Build-Up Case:

Composite resin can be used to veneer and buildup teeth as a less expensive alternative to ceramics. Ideally, composite resin should be used as an interim restoration to be replaced in the intermediate or long term by ceramics. The reason is that composite has less strength and wears more compared to ceramics. However, the composite resin available now in the market is much more durable due to recent advances in the technology of dental materials.

It is now possible for the composite resin restorations to function for years with minimal maintenance. Of course, it is expected of the restoration to chip, however repairs are simple and quick. That is why it is now widely used to benefit patients who need aesthetic dental treatment with limited finances. It is also the preferred option for younger patients who have teeth that are smaller or shorter than normal. In this particular case, the bite was raised and direct composite resin onlays were placed on the lower back molars to enable lengthening of all of the front teeth.

Our prosthodontist believes that everyone deserves a healthy mouth and a beautiful smile. She will discuss in details your specific dental treatment needs taking in consideration your personal and financial situations. She will also arrange for referrals to other different specialists in case complex dental care is required.

Full Mouth Rehabilitation With Ceramic Crowns:

In some wear cases, it is possible to build up the worn teeth with crowns if the tooth destruction is not severe. Patients need to consult with a specialist once they start realizing that their teeth are getting shorter and discoloring with time. If the tooth loss becomes more severe, fixed crowns will not be an option anymore, implants or removable plates will be needed to replace the failed teeth. In this patient, teeth were maintained and were built up by zirconia crowns to restore function and aesthetics.

Full Mouth Rehabilitation of Implants, Onlays and Veneers:

Some young individuals suffer from developmental disorders of the dentition, meaning that they have smaller teeth than normal and/or missing teeth. Those patients are most commonly managed with a multidisciplinary team approach comprising an orthodontist, a surgeon and a prosthodontist. In this case, teeth was orthodontically moved to create space for implants, four implants were placed afterwards to replace missing teeth, small teeth were built with conservative ceramic onlays and veneers.

 

Our prosthodontist believes that everyone deserves a healthy mouth and a beautiful smile. She will discuss in details your specific dental treatment needs taking in consideration your personal and financial situations. She will also arrange for referrals to other different specialists in case complex dental care is required.