The Oral Rehabilitation consists of the reconstruction of destroyed teeth, replacing missing teeth or other oral structures (gum and bone) and aims to return the chewing, phonetic and aesthetic patients.

For rehabilitation with the application of prosthesis a study is needed and planning of each case, requiring often a preparatory phase in which the intervention of multiple skills such as oral surgery, endodontics, periodontics at the dental implantology and are essential.

The re-establishment of a complete and well articulated teeth to avoid muscular, joint and the remaining own teeth, situations that may progress to pathological conditions is essential.

What are the primary differences between FIXED partial dentures and REMOVABLE partial dentures?

Fixed Partial Dentures
Fixed prothesesis (does not have to be removed)
May require bone grafting for implants
More costly than removable
May be difficult to clean under bridgework
Provides some support to facial form
Removable Partial Dentures
Removable prosthesis (must be removed daily)
May help avoid bone grafting
Generally more cost effective than fixed
Generally easier to clean because they are removable
Can create speech impediments
Can provide excellent support to facial form

After placed in mouth fixed dental prosthesis is not removed except by a healthcare professional. To be fixed on the patient's teeth, previously prepared to receive it, this solution stands out for its increased strength, stability, comfort and aesthetics in relation to removable dentures.

There are two types of fixed prostheses: a unitary prosthesis in a fixed bridge. The fixed prosthesis unit refers to a partial or total restoration of a tooth crown.

The full crown is a solution in which the natural tooth receives a fixed artificial crown. With this solution you can preserve some structure much destroyed teeth and restore function and aesthetics missing.

The bridge is fixed susbtituir indicated for the lack of one or more teeth. The elements are adapted in the toothless area with the gum and the whole structure is usually supported by at least two abutment teeth that are prepared for this purpose. This technique stands out as the crown, security, strength and aesthetic result.

Fixed partial bridge

Replacement with a Conventional Fixed Partial Denture (RPD) or bridges requires reduction of two or more adjacent teeth to make crowns that will be connected to each other with a false (prosthetic) tooth suspended between them.  A fixed bridge increases the functional forces placed upon the supporting teeth and complicates the use of floss between the teeth.  The number of natural teeth that require reduction is dependent upon the many factors, which include the number and span of missing teeth, the location in the jaw, and the condition of the involved teeth themselves.  Convetional bridges may need to be replaced if the supporting teeth develop cavities or periodontal disease.

As the name implies, removable dentures are those that can be drawn and replacing in mouth. Having regard to the constituent material of the infrastructure for artificial teeth, there are two types of dentures: acrylic prosthesis and skeletal prosthesis.
Acrylic prosthesis
Prostheses are made of acrylic material in order to acquire confecionadas the desired pigmentation manner that mimics the color of the gingiva and other oral structures missing. These prostheses are indicated for cases of people that have few or no teeth. This type of prosthesis, for skeletal prostheses (metal), is more volume and length and are supported by the mucosa.
Skeletal prosthesis
A skeletal implant is formed by a metal base (usually a cobalt-chromium alloy) acrylic associated with areas in the regions where it is necessary to reproduce the gum.

These prostheses, in addition to being stronger and less bulky than the acrylic prostheses are supported not only on the mucosa but also by natural teeth (via hooks), providing greater retention of the prosthesis and hence greater comfort in use.

To use skeletal implants is essential for the presence of healthy teeth, dentures because they are essentially supported by hooks which attach to natural teeth.

Implant-assisted Removable Partial Dentures (IRPD)

Implant-assisted removable partial dentures utilize a few select implants placed in strategic positions and connected to the overlying denture by means of some sort of stud chewed into the implant. These key implants may eliminate unsightly clasps, reduce the display of metal parts on the denture, and will increase the amount of stability and retention to the final restoration.
This implant restoration should be routinely evaluated at time intervals that are depended upon the conditions of the remaining natural teeth and the IRPD. The denture teeth and retentive elements will be subject to wear and will need to be replaced when necessary. Denture teeth will generally last for years but most retentive elements need to be replaced on a six-month or longer basis.

Replacement with a conventional Removable Partial Denture (RPD)

Indicated for patients who can accept having a restoration that is NOT permanently fastened. This restoration should be removed on a daily basis by the patient for oral hygiene access to the remaining natural teeth and the prosthesis. The RPD is made of a metal framework, denture teeth and acrylic. Some patients may not like the appearance of the clasps (metal arms) that engage the remaining teeth to retain the prosthesis, the display of portions of the metal framework, the denture teeth and acrylic. Replacement of worn denture teeth, as well as relining the prosthesis to maintain proper adaptation to the gums, is necessary over time.
The major advantages of an RPD are minimal preparations of the adjacent teeth (significantly less than a bridge), replacement of missing teeth, cosmetic replacement of the lost volume of gum and bone, reduced expense and easier access for oral hygiene. With an appropriate design, an RPD may be modified to add any teeth that may require removal in the future.

What is an implant overdenture?

An implant overdenture fits over a dental implant with various types of atachments that provide you with excellent stability and retention of your complete dentures. The implant overdenture is a full denture used to replace the teeth in a full-arch where all the teeth are missing. In essence, it is a larger version of the implant-assisted removable partial denture (IRPD). The denture can "snap" into place to afford you more comfort and improved chewing ability. Implant overdentures are held in place by various attachments selected by your restorative doctor to provide maximum retention and increased chewing ability. The implant overdenture is removable to facilitate cleaning of the implant supporting structure. Implant overdentures can be made to look extremely natural and feel comfortable. Pre-surgical prosthodontic planning for implant overdentures begins with diagnostic impressions for recording jaw relation and diagnosing possible dentures. These impressions help to determine the correct positioning of the teeth on the new dentures as well as to confirm the optimal location for each implant. They are also used to assure correct appearance and bite. Frequently, a template is produced from the diagnostic impression that is provided to the surgeon for guidance during implant placement surgery.
Most often, an upper overdenture will require placement of more implants than a lower overdenture due to the different nature of the anatomy of the upper and lower jaws. It may also be possible to fabricate an upper denture without a palate (roof of the mouth), which may be a more comfortable option for some patients.

The specific need for an implant overdenture can vary and the decision for this treatment option should be made with your restorative dentist. Many patients can benefit from the facial support provided by the extensions of the complete denture design. The number and type of implants should be decided upon following a detailed discussion between you and your dentist(s), a thorough examination, and careful consideration of your personal experiences with your current dentures.