Types of Dental Prosthetics
Dental prosthetics can be used for complete or partial restoration of the dentition. This article describes modern types of prosthetics and evaluates the advantages and disadvantages of each. It provides a comparative analysis of materials used in their manufacture, including cost considerations. In addition, our clinic’s experts provide recommendations on choosing the most suitable option based on your medical history.
Article Contents:
Main Types of Dental Prosthetics
These are custom-made orthopedic structures designed to replace missing teeth. They are installed to restore the aesthetic appearance and chewing function, as well as to correct speech impairments.
Depending on the type of intraoral retention, there are three main types of dental prostheses:
- Fixed prostheses—designed to replace missing parts of a tooth (bridges) or damaged teeth (crowns, inlays, veneers);
- Conditionally removable dentures are removed only by service or repair specialists and are attached to posts embedded in the jaw;
- Removable — metal or plastic. They are attached to healthy teeth using various types of fasteners. This type of construction is divided into complete and partial replacement of teeth.
Full Dentures
Made of hypoallergenic acrylic plastic, they are designed to restore teeth where they are missing. They consist of a base and a crown that fits against the gums. A well-made artificial denture stays securely in place due to the negative pressure between the gums and the base of the denture. As a rule, lower dentures are even more prone to shifting, and the dentist recommends the use of special adhesive compounds.
Partial Dentures
They are installed when there are supporting teeth and correct defects in the dentition or marginal defects. They are used in various combinations made of metal, plastic, and acrylic. Modern prosthetic dentistry offers several options for partial dentures, which are secured using clasps, clamps, and other types of attachments. Chewing pressure is evenly distributed across both the jawbone and the denture.
Types of Removable Dentures
This category includes structures that can be removed, cleaned, and reinserted independently without the assistance of a specialist. They are indicated for complete or partial tooth loss and can be either permanent or temporary. Removable dentures include the following types.
- Laminates;
- Clips;
- Immediate dentures;
- Quadrotti.
Removable prosthetic devices serve an aesthetic function and facilitate better chewing of food. The advantages of this prosthetic method include quick installation and relatively low cost. Permanent devices have significantly more disadvantages.
First, dentures must be replaced every two to three years due to gum tissue atrophy. Second, thin-layer dentures do not fit securely in the mouth and can cause speech impediments. Third, the materials used wear out quickly and are not particularly durable. Below are detailed characteristics of each type of removable denture.
Suction-type or plate dentures
The cheapest and simplest solution for prosthetics in cases of complete or severe tooth loss. The denture consists of a base and crowns, made from individual impressions. Hard hypoallergenic materials (acrylic, plastic) or soft nylon are used to make the base.
Where multiple dental implants are present, the dentures are attached to them using clasps. In cases of complete edentulism, the base is secured by suction to the gum tissue. For more reliable retention, dentists recommend using special adhesives (creams, glues).
Fully removable upper dentures have certain design features. They completely cover the palate, which increases the contact surface area and, consequently, improves the reliability of intraoral retention. Similarly, lower dentures are not recommended, as dentures without a palatal component do not stay in the mouth as well.
Dentists do not recommend this type of denture for several reasons.
- Due to the high stress on the gums, hard and soft tissues atrophy rapidly, requiring frequent replacement of the prosthesis;
- Design features often disrupt osmotic balance and can trigger an inflammatory process;
- Patients complain of a lengthy adjustment period, discomfort while wearing the prosthesis, and unpleasant sensations during vomiting;
- Prostheses do not fit securely in the oral cavity, restoring chewing function by less than 65%;
- The materials used in manufacturing are not particularly durable, and plastics can cause allergic reactions.
Removable prosthetic devices remain in demand because they are inexpensive, quick to fabricate, and easy to maintain.
Immediate dentures
Also known as “butterflies” or “beetles,” these are temporary dentures covering 1–3 teeth. They are typically placed prior to implantation for the period required for the titanium posts to integrate. A removable prosthesis is necessary at this stage to preserve chewing function, maintain aesthetics, and prevent tooth wear.
The design gets its name from its resemblance to the outstretched wings of insects and their supporting structures. The base is usually made of a soft material colored to match the gums, while the crown is made of white acrylic plastic. The prosthesis is attached to healthy teeth using a clasp, which is virtually invisible when smiling or speaking. Express restorations are affordable, completed in two to three days, and look aesthetically pleasing.
Immediate prosthetics.
Clasp dentures
One of the highest-quality modern types of prosthetics for partial edentulism. The design is characterized by comfort, aesthetics, and durability. Additionally, the chewing load is evenly distributed among the supporting teeth, which significantly slows down bone atrophy. Healthy teeth on both sides of the jaw are required to install this type of prosthesis.
Boxer dental prosthesis for 20,000 consists of three main parts.
- A metal frame made of titanium, precious metal, or a cobalt-chromium alloy (KHS);
- A base made of nylon or acrylic with plastic teeth;
- A retention system (clasp, Kramer, telescopic crown).
The metal framework is based on an arch, which distributes the load and ensures the strength of the entire structure. In the upper jaw, it can be positioned in three locations—anterior, central, or posterior—or as a closed ring. In lower jaw prosthetics, this element is positioned only anteriorly.
The arch does not come into contact with the mucosa and is only slightly thicker than it. A nylon or acrylic base with a crown is welded to it. The thickness and volume of the base are reduced thanks to a sturdy metal framework. This increases comfort when wearing the clasp and makes it one of the best types of dental prostheses. The reliability of intraoral retention depends on the type of attachment to the abutment tooth.
Clasp-retained
These are the hooks that are attached to healthy crowns and transfer pressure to them, keeping the denture from shifting. They are usually made of metal, but can be made of nylon if they are located in the smile zone (almost invisible). Cramer attachments have the following advantages:
- Secure fit;
- Comfort; quick adjustment;
- No need to grind down your own tooth;
- Affordable prices (compared to other options).
One drawback is their poor aesthetic appearance, but this applies only to metal clasps. In addition, such clasps negatively affect the condition of the abutment teeth and accelerate their decay. The reason for this lies in the hook’s lack of flexibility, which is necessary for its removal or placement. As a result, it becomes loose and gradually erodes the enamel. However, this problem can be solved by installing a cermet crown.
Lock-retained
The prosthesis is secured by a metal microfiber or an attachment consisting of two parts. One of them is located in the prosthesis itself, and the other is in the cermet crown on the abutment tooth. The design of such fasteners is reliable and redistributes about half of the bite load to the healthy dentition.
The advantages of the Begel attachment denture are:
- High aesthetics—the attachment is located on the inner surface of the tooth and is therefore completely invisible;
- Secure fit;
- Lifespan—about 7 years;
- High restoration of chewing function;
- No pain or discomfort, quick adaptation.
Among the disadvantages is the significantly higher cost of production, which is due to its complexity. Dental prostheses also require grinding down your own teeth to fit the metal-ceramic structure.
Telescopic crown-retained
Although technically this is the most complex method, it is the most effective way to secure a denture in the mouth. The attachment consists of two parts: a metal cap and a metal-ceramic crown. The first is placed on a healthy tooth that has been prepared, and the second is attached to the denture framework. During installation, the crown is attached to the cap, ensuring the most secure fixation. Therefore, when asked which clasp denture is better, one can confidently answer that this is the one.
The advantages of products with a telescopic crown are:
- Reliability;
- Durability;
- Aesthetics.
The main disadvantage of this type of design is its high cost, since the crowns must be attached to at least four abutment teeth.
Quadrotti
The name of the design comes from the Italian “QuattroTi,” the latest development by European scientists in the field of prosthetics. In terms of manufacturing and fixation, the prosthesis resembles a clasp, but the material used is different. Instead of metal, Dental D acetal (monomer-free) plastic is used. It is distinguished by its increased strength, 100% hypoallergenicity, and lightness.
QuattroTi prosthesis.
This material improves the performance of the denture without compromising other important properties. The weight of the structure is reduced, its strength is comparable to that of metal, and there is no risk of allergic reactions. In addition, the Quattrotti acetal clasp is completely invisible on the teeth.
The QuattroTi clasp denture outperforms its clasp counterparts in the following areas:
- Aesthetics — the material used for the clasps is available in ten different shades of white;
- Comfort — the design is lightweight and unobtrusive, so patients adapt quickly, and speech is not impeded;
- Long service life — at least 7 years;
- Hypoallergenicity — unlike metal, acrylic, and plastic, “Dental-D” does not cause allergic reactions.
QuattroTi dentures are as strong as their metal counterparts but have one significant drawback. There is no redistribution of chewing pressure to the supporting teeth, since the abutments only hold the prosthesis in place and do not provide support. All pressure is exerted on the gum tissue, which can cause pain when chewing. Additionally, Quadotti are more expensive.
Crowns
Crowns made of various materials are cemented onto specially prepared teeth. Preparation involves pre-treatment, if necessary, and polishing. After preparation, a prosthetic of anatomical shape is created based on the impression taken, and a temporary fitting is performed; one month later, the dentist corrects any identified defects in the artificial crown and permanently secures it with dental cement.
Dental Crowns
This type of prosthetic restoration is made from various materials:
- Metals — cobalt alloys, chromium, and precious metals. In modern dentistry, it is used only for prosthetics on chewing teeth, as it looks unnatural. Metal crowns are the most durable and inexpensive crowns (if manufactured by KHS);
- Crosswork — a combination of a metal base and a ceramic coating. A more expensive and aesthetic option, no less durable than the previous one;
- Ceramic is pronounced “lithium” and is a durable material that perfectly matches natural tooth enamel in terms of transparency and color;
- Zirconium dioxide — the best dental prostheses are made from it. It is durable and aesthetically pleasing, but expensive;
- Plastic — used as a temporary restoration or to cover metal structures. They darken, deteriorate, and stain quickly, but are very inexpensive.
Crowns — the best way to restore teeth that are more than half destroyed. Placing crowns restores the ability to chew food properly and smile.
Bridges
Prosthetics: Veneered prosthetic structures designed for 1–2 (rarely 3) teeth. Longer structures are not suitable, as they do not bear the chewing load and therefore do not increase in strength. Bridge prostheses consist of a series of monolithic crowns attached to abutment teeth or implants. They are made from modern materials such as ceramic, zirconia, and metals. Depending on the method of attachment, they are divided into several types.
Adhesive
This type of prosthesis is recommended for those who wish to preserve their healthy abutment teeth. A distinctive feature of this bridge type is its attachment via a thin horizontal fiberglass plate. It is fixed to the inner surface of a single dental block. Although the design is very durable, it offers several other advantages:
- Aesthetics — the attachment is located on the lingual side and is therefore invisible;
- Safety — healthy teeth don’t wear down:;
- Low cost—achieved by reducing material usage.
The disadvantages of cantilever prosthetics include their fragility (average lifespan of less than two years) and the thickening of the abutment teeth. The latter factor results from the forces exerted during placement and requires time to get used to.
Cantilever
Since it supports only one side of the tooth, it is suitable for correcting single defects. The abutment block (one or more) rotates, and the crown is secured using a zirconia or metal-ceramic cantilever. Cantilever bridges can only replace incisors with canines, as this type of fixation is not considered sufficiently reliable.
This design can be used for approximately five to seven years, but it is not strong enough to slow bone resorption. In addition, the abutment will gradually shift, so a cantilever should only be installed if the teeth cannot be supported on both sides. For the same reason, this type of prosthesis does not correct apical defects.
Composite
This type of bridge is used when the axes of the abutment teeth are not parallel to each other. The structural elements are connected in a movable manner using hinges, clasps, and ball-and-socket systems. The main advantage of composite bridge prosthetics is the ability to restore obliquely positioned teeth. In addition, they are made of metal and are therefore very durable (they can be used for 12–15 years).
Combined
Medium-strength metal dentures are characterized by increased durability and do not require significant tooth extraction. However, they are less aesthetic and are therefore used only for molar restoration. If part of the denture is visible, metal can be combined with metal-ceramic. For example, crowns for teeth #7 and #6 should be made of cobalt-chromium, while crowns for teeth #5 and #4 should be made of metal-ceramic. This allows for a reduction in the cost of the prosthesis without compromising the appearance of the smile.
Micro-dentures
Microdentures are used for partial crown destruction, chips, and damage to tooth enamel. They serve as an intermediate step between fillings and the installation of a prosthesis. Microdentures are secured using composite materials, metal, ceramics, cement, or special adhesives.
Veneers and Lumineers
These are thin ceramic veneers designed to correct defects in the front teeth:
- Cracks;
- Chips;
- Stains;
- Enamel discoloration;
- Gaps; irregularities;
- Enamel thinning.
Vinnel — dental veneer.
Lumineers, which are 0.2 mm thick, are more expensive but have a 20-year lifespan, do not require significant tooth preparation, and are held in place with adhesive. Porcelain veneers are less expensive but require the removal of about 0.7 mm of tooth structure; the veneers are cemented in place and have a lifespan of up to 15 years.
Inlays
This prosthetic method is suitable for restoring tooth crowns. Prosthodontists take impressions, based on which a microprosthesis is fabricated from metal or composite material. It is cemented in place and is several times stronger than a conventional filling. If the crown is completely destroyed, inlays made of artificial metal or metal-ceramic are installed.
Implant-supported dentures
The best prostheses that can be installed as quickly and effectively as possible for the long term are implant-supported structures. They are classified as conditionally removable devices. This is because only a specialist can remove or install them. The prosthesis consists of an artificial jaw with teeth, titanium posts, and abutments. Compared to traditional implantation, this prosthetic method has several advantages:
- Installation within 1 day;
- No need for bone grafting;
- Can be placed without age restrictions;
- It’s not about the number of teeth, but their condition.
The All-4 technique is suitable for restoring both jaws. This procedure is performed one day after preliminary oral rehabilitation. Two posts are attached to the front surface of the patient’s jaw without any angle, and two more posts are attached at an angle. The abutment is attached to the artificial root, which is then attached to the acrylic prosthesis.
All-6 uses six implants, although the technique is similar to the previous method. It is suitable for people with significant bone loss, reduced bone density, and periodontal disease. Implantation using this method provides more reliable fixation and is more expensive, as it requires more material.
Classification of dentures by material
Several types of materials are used for prosthetics that meet the requirements and standards of modern prosthetic dentistry.
Acrylic.
A versatile type of plastic characterized by flexibility, lightness, and affordability. It is used in the manufacture of all types of removable dentures, as well as denture bases on PIMs. Among its disadvantages are durability and brittleness (over the past 5 years).
Acryfree.
High-strength, completely hypoallergenic, moisture-resistant Bi plastic. Its elasticity and resistance to mechanical damage make it ideal for removable dentures. It has a service life of at least 10 years.
Nylon
A modern, elastic, flexible material characterized by low density, light weight, and hypoallergenic properties. Suitable for the manufacture of removable dentures—bases and attachment elements. Disadvantages include insufficient strength and brittleness—nylon products must be replaced every 5 years.
Silicone
The removable structure of a flexible denture is called silicone, but this material itself is not used in prosthetic dentistry. Patients confuse it with nylon or plastic without asystole.
Plastic
It is widely used in dental practice for the manufacture of artificial teeth, temporary crowns, and liners for metal dentures. Among its advantages are its low cost; among its disadvantages are its fragility and susceptibility to staining; it lasts for two years; it is used in the manufacture of liners for dentures; it has been used in the manufacture of dentures for many years.
Acetal
A range of non-human-derived polymeric materials characterized by high strength and resistance to harmful chemical and physical influences. Durable, fully biocompatible, and hypoallergenic; used in the production of the new generation of Quadrotti.
Zirconium
The strongest material used in prosthetics. It possesses excellent aesthetic properties and is durable (lasting for decades). A potential drawback is wear on the enamel of the opposing teeth. It is used in the fabrication of fixed prostheses, including crowns for implant-supported restorations.
Ceramics
In its pure form, ceramic-based porcelain is rarely used in dentistry due to its increased brittleness. However, its derivatives—various types of glass-ceramics—are widely used. They are used to create the most expensive and aesthetically appealing fixed restorations—crowns, veneers, and laminates. Their service life is at least 20 years.
Metal-ceramic
This term refers to a combination of a metal base and a ceramic coating. Its advantages include strength, aesthetics, and durability. With proper care, metal-ceramic restorations can last more than 10 years. They are used in the fabrication of fixed restorations.
Composite materials
Polymer-based multiphase composites consisting of inorganic fillers, silicon hydride, and organic matrices. They are characterized by high strength and a long service life. They are used as fillers for microprostheses.
Which dentures are the best and most comfortable
Each prosthesis design has specific properties that determine its area of application.
For upper teeth
Incisors and canines are visible, although they bear less load than the chewing teeth. Fixed prostheses—crowns, zirconia, glass-ceramic, and adhesive prostheses made from laminates—are best suited for prosthetics. Braces with bicuspids are practically invisible, and it is recommended to install durable, inexpensive metal or composite prostheses instead. If there is a small defect on the front surface, a veneer or laminate is placed on the front surface, and on the back—on the back.
Crowns on the front teeth.
For lower teeth
The upper and lower teeth are also located in the smile zone, so a fixed restoration for them should be as aesthetically pleasing as possible. The recommendations are the same as in the previous section, as this allows the dentist to save a little on the lower midline bite.
For partial tooth loss
In most cases, cheaper plate-type dentures are used, but they deform the gums, do not fit properly, and cause discomfort. The optimal solution in this case is a full set of dental implants.
For temporary dentures
In such cases, an immediate test is usually performed. Cantilever designs can also be used as temporary solutions.
For children
The best type of dental prosthesis for a child depends on the specific situation. Typically, during the dental development period, a child requires a butterfly prosthesis to correct the bite.
