The loss of one or more teeth in a person can happen during his life, either for genetic reasons (congenital lack of teeth), or due to accidents (tooth-jaw fractures, tooth decay, etc.), or finally due to pathological diseases of the mouth (e.g. tooth loss from periodontitis, extensive tooth decay, etc.).

For whatever reason a tooth has been lost, it has the effect of reducing the functional capacity and also the aesthetics of the mouth. Therefore, its restoration naturally arises as an immediate priority for both aesthetic but mainly functional reasons.

The means and methods of prosthetic tooth restoration are divided into two major categories: fixed and mobile prosthetics. The immovable prosthesis has the ability to usually cover a small number of tooth losses, while the mobile prosthesis comes to offer a solution in cases where the tooth loss is extensive.

Immobile prosthesis

When we have a partial loss (loss of an extended part of the molar of the tooth, while its root is intact) or a complete loss of one or more teeth, then it can be restored with the help of inlays, veneers, crowns (cases) and bridges.

A veneer, an inlay/onlay, or a crown (case) are the most common means by which extensive molar loss of a tooth can be effectively covered. Their manufacture from very good quality ceramic materials has given us the possibility in recent years to have tooth substitutes not only of high strength, but also of excellent aesthetics. Bridges are also made from the same high-quality materials when we need to replace one or more missing teeth. In this case, after properly grinding the teeth adjacent to the missing area, we place the bridge (it is in the form of crowns that cover the ground teeth – supports and are united in the form of a single prosthesis with the artificial teeth that will replace the missing ones).

Today, the most suitable materials for the manufacture of such prostheses are ceramics, which, placed in suitable frameworks-cores, can provide prosthetic parts of excellent aesthetics.

Mobile prosthesis

When there are many missing teeth or the missing area is not defined by teeth that can function effectively as bridge supports or finally when the area of missing teeth is accompanied by a significant loss of supporting tissues (gums or the underlying jaw bone), then the most suitable way of substitution is through mobile prosthetic devices.

These appliances, which have both artificial teeth (acrylic, resin or ceramic), and artificial gums (usually acrylic), are divided into partial or complete dentures.

Complete dentures are placed on jaws that have no teeth at all. As a rule, they consist of an extended acrylic base - which plays the role of artificial gums - on which the artificial teeth are properly placed in the correct order and position.

Partial dentures, in turn, are placed in jaws with extensive but partial dentition (several but not all teeth are missing).

In these cases, the acrylic base of the denture is reinforced by plates, rods and components made of special metal alloys that give it rigidity and strength but also hold it {or hook} it effectively to the teeth supports. The noticeable difference between partial dentures and full dentures is that while full dentures rest exclusively on the gums, in partial dentures the rest of the teeth take on a significant amount of support.

A third hybrid category of removable dentures is on-board dentures. They are made according to the logic of complete dentures, even though there are only a few teeth left in the mouth (usually 1-4). In these cases, after the teeth are properly ground and covered with metal cast restorations (cases), they are embedded in the denture that is manufactured to offer it a better fit and support.

Implants

It would be a mistake to close the chapter on modern prosthetics without mentioning dental osseointegrated implants. Their value remains indisputable both in restoring the lack of one or more teeth, and in correcting the total absence of teeth.

It’s extremely important that missing teeth are covered without the need to grind adjacent teeth, as we have either single tooth restorations from implants, or multiple restorations with the help of bridges supported by implants.

In the second case, we can have restorations whose aesthetic and functional characteristics are far superior to a simple complete denture, since we can either restore the ascending patient with bridges on implants, or with on-implant complete dentures whose stability and application exceed by far simple full dentures.