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Fixed prosthodontics are permanent prosthetics used in dental restoration to replace decayed or missing teeth or portions of teeth. Common examples of fixed prosthodontics include inlays, porcelain veneers, crowns, and bridges. They can be made of metal, porcelain, or resin, and may last for five to 15 years.
The smallest types of fixed prosthodontics are inlays, onlays, and porcelain veneers; these restorations cover only a portion of a tooth. Crowns are used to fill a large part of a cavity along a visible tooth, while bridges are the largest fixed prosthodontics, replacing one whole tooth or two adjacent teeth. A good candidate for fixed prosthodontics has healthy supportive tissues and abutment teeth to support the restoration. In addition, the patient must be willing and able to practice good oral hygiene, including brushing the prosthesis and surrounding tissues at least once a day. Some types of restoration will require a special threader to guide dental floss for proper cleaning.
Most fixed prosthodontics are made at a dental laboratory and shipped to the dentist’s office within a few days. To build a good fit, the dentist will take an impression of the teeth; to get the best impression, the gingival tissue is pushed back with a retraction cord or other method. In some situations, a dentist will provide a temporary prosthesis to ease pain until the permanent restoration is ready.
Before attaching the prosthesis permanently, a dentist must prepare the tooth by removing any decaying tissue. Both hand cutting and rotary instruments can be used to prepare the gum and contour the top of the tooth to provide a better place for attaching the prosthesis. If the tooth has extensive decay or a fracture, the dentist may provide retention aids such as core buildup, pin retention, or post and core to help support the restoration.
A wide variety of materials can be used to create fixed prosthodontics, depending on the specific needs of the patient. Various metals such as gold alloy or nickel alloy generally last longest, but many patients dislike the appearance. On the other hand, porcelain and ceramic restorations, which achieve the best color match, often chip and wear down the opposite teeth.
Restorations made of both porcelain and metal last longer, but are still prone to fractures. All resin prosthodontics are the cheapest available; however, they tend to wear down quickly and fracture easily. Many patients choose porcelain for highly visible front teeth and longer lasting metal for less noticeable restorations on molars.