Dentures

Dental prostheses are the replacement of one or more missing teeth. Occasionally, this is also referred to as “prosthodontics”; however, strictly speaking, dental prosthodontics is the dental specialty that explicitly deals with the planning, production and insertion of dental prostheses.

In the course of life, natural teeth can fall out or be extensively damaged. Possible reasons for this include periodontal disease, caries and other inflammations. Teeth can also wear down and become brittle. Accidents also often lead to tooth loss.

Dental prostheses should not only serve to improve the aesthetics of the front part of the mouth, but also support speech formation and maintain chewing functionality. The primary goal of dental prostheses is always to protect the health of the remaining teeth (if any) and prevent bone loss. Also, dental prostheses must never impair the taste of food. They must also be durable. Intolerances (for example, of certain metals), allergies and other effects on the body as a whole must be taken into account.

Aesthetic dental prostheses are understood to be forms of prosthetics that place particularly high demands on the appearance of the teeth. It is no longer possible to distinguish good aesthetic dental prostheses from natural teeth. This can be achieved using special ceramics with increased light refraction (translucency) (see: “Aesthetic Dentistry”).

A large number of materials can now be used for dental prostheses. However, the most common materials are metals (e.g., titanium or gold), all-ceramics (e.g., zirconium oxide, pressed ceramics, glass ceramics, layered ceramics or IPS e.max) and various plastics.

In many cases, different materials are combined with one another. For example, in the case of metal-ceramic dental prostheses, the framework is made of metal, which in turn is veneered with all-ceramic materials.

There are different types of dental prostheses. It is not possible to give a general answer as to which is the right one in your individual case. Each method has its advantages and disadvantages, which must be coordinated and weighed up in each individual case. Therefore, it is important to receive a thorough, well-founded and detailed professional consultation prior to any treatment.

An important goal in the selection of a suitable dental prosthesis is to place as little stress as possible on the neighboring healthy teeth. Therefore, as little tooth structure as possible should be ground down and the extraction of any remaining teeth should be considered as a last resort.

A basic distinction is made between removable and fixed dental prostheses. There are also combined dental prostheses, which are a combination of removable and fixed elements.

The following types of dental prostheses are offered in dentistry today:

Fixed dental prostheses:

• Veneers
• Bridges
• Dental crowns, partial crowns, onlays and inlays
• Adhesive prosthetics
• Fixed implant-supported prosthetics (on 4–8 dental implants per jaw)

Removable dental prostheses:

• Crown attachment prosthesis
• Double crown prosthesis (“telescopic prosthesis”)
• Complete dentures
• Clamp prosthesis (“model cast prosthesis”)
• Removable implant-supported prostheses (ball abutment, Locator prosthesis, magnetic attachments, bar restoration)

From a technical point of view, dental implants in themselves are not (yet) dental prostheses, but are the basis to which dental prostheses can be attached. From a technical point of view, dental implants in themselves are not (yet) dental prostheses, but are the basis to which dental prostheses can be attached. The advantage of such implants is that they can be used to replace missing teeth without having to grind down the neighboring teeth. In addition, dental implants prevent bone loss of the jaw.

Dental implants can be used as “bridge abutments” to enable fixed implant-supported dental prostheses. Thanks to the latest methods, this is now possible with just six implants per jaw. Such fixed implant-supported prostheses are considered to be the leading method in the discipline of prostheses, as they enable the complete reconstruction of the natural tooth by means of artificial dental prostheses.

Veneers are all-ceramic shells that are primarily used for aesthetic purposes. In the case of tooth gaps, bridges are particularly useful if the neighboring teeth are already damaged. 

Adhesive prosthetics, in which artificial teeth are “glued” to the neighboring tooth with the help of a bar, is an elegant method, especially for children and adolescents. Dental implants are not an option for them as their jaws are still growing.

Strictly speaking, (partial) crowns, inlays and onlays are not dental prostheses but tooth preservation measures. In terms of billing, however, they are treated as dental prostheses, which is why we also refer to them as such here.

Traditionally, however, a prosthesis is understood to be a partial or complete prosthesis. These are quick and comparatively inexpensive solutions, but they make major sacrifices in terms of dental aesthetics. In the case of such prostheses, there are also frequent restrictions in the ability to taste. Perhaps the biggest disadvantage, however, is that such prostheses often do not fit snugly enough, which many patients perceive as a significant reduction in their quality of life.

Telescopic prostheses and attachment prostheses are already regarded as high-quality dental prostheses. Natural teeth that are still present are used as abutments to attach the prosthesis to. This ensures a stable hold.

However, the premium choice in the discipline of removable dental prostheses are implant-supported dental prostheses. The prosthesis is anchored to at least four implants in the upper jaw and at least two implants in the lower jaw. The result is characterized by extremely high user comfort and impressive stability.

If a large number of teeth are missing or if they have been completely lost, the result is impaired pronunciation and chewing functionality. In the case of existing tooth gaps, the jaw bone also recedes over time, which is why neighboring teeth can also collapse into the tooth gap. The opposing tooth of a tooth gap also lengthens over time because the opposing bite is missing at this point. The result is jaw joint problems (craniomandibular dysfunction) and often gastrointestinal problems due to the limited chewing functionality. In such cases, dental prostheses are used, which should be carried out as soon as possible.

The costs for dental prostheses cannot be given as a lump sum, as they basically depend on the extent of the restoration, the type of prosthesis and any necessary accompanying treatments. It is important that an overall concept is worked out before treatment: At first glance, the inexpensive solution is always the most attractive. However, the financial advantage of a cost-effective solution quickly disappears when extensive follow-up costs are incurred after a few years that were not previously considered. Especially in the case of extensive dental prostheses, planning should therefore be carried out well in advance.

We always inform our patients about alternative treatment options, which are individually tailored to your situation. You are welcome to make a no-obligation consultation appointment at our practices in Landstuhl or Kaiserslautern, where we will present individual solutions to you in detail.

For each form of dental prosthesis, the statutory health insurance companies pay a fixed subsidy. Nevertheless, there may be a financing gap, since a personal contribution remains to be paid. Private supplementary dental insurance offers the solution. Private co-payments for dental prostheses can also be claimed against tax in individual cases.

The situation is different for privately insured patients. The amount of the cost coverage depends on the respective insurance plan. As a rule, private insurance companies cover around 70%–100% of the costs incurred. 

The US health care provider TRICARE bears 50% of the expenses.

In order to guarantee the long life of the dental prosthesis, it is important to provide careful and regular care of the teeth and the prosthesis. Smoking significantly reduces the durability of the prosthesis. We recommend our patients to have their teeth professionally cleaned once or twice a year.

Often underestimated and yet very important in connection with planned dental prostheses is the consideration of occlusion, i.e., the bite of the (artificial) teeth. The occlusion must be taken into consideration, especially in the case of extensive or even complete restoration. Bite defects can cause headaches, temporomandibular joint disorders and other extensive complaints (craniomandibular dysfunction). In addition, this significantly reduces the durability of the dental prostheses.

The dental specialty of gnathology deals with precisely these problems. Before the treatment, the dental prostheses are aligned and planned using functional analysis in such a way that the correct occlusion is guaranteed. Therefore, it is advisable to use a dental practice that also specializes in this area for planned comprehensive treatment.

First, the current condition is always determined. An exact analysis is carried out with the help of X-ray images and other diagnostic measures. If complaints are present, a detailed and thorough medical history must also be compiled. Based on the knowledge gained from this, a detailed consultation can then take place, which also includes the preparation of a detailed treatment and cost plan. Which prosthesis is the right one for the individual situation is discussed. Alternative treatment options are also discussed.

Once the planning and consultation are complete, implementation can begin. The extent of the treatment itself ultimately depends on the extent of the dental prostheses. Simple procedures (for example, the restoration of individual teeth with inlays, onlays, [partial] crowns or veneers) can be carried out in our practices in just one session thanks to Cerec 3D. However, larger restorations require more time and therefore also require several treatment appointments.

If the treatment has to be performed over several appointments or if it takes a long time to fabricate the appropriate dental prosthesis, the dental laboratory will fabricate a temporary prosthesis for the interim period.

In our dental practices in Landstuhl and Kaiserslautern, we offer a two-year guarantee on every type of dental prostheses we install.

Unfortunately, huge differences exist in the quality of dental prostheses. It is not only important to select the right materials, but also to create a suitable concept. The production and the type of integration also play a major role. It is important that general health aspects such as allergies and also gnathological aspects such as occlusion are taken into consideration. If great value is placed on the appearance of the teeth, then only extremely high-quality materials (e.g., enable a dental restoration that cannot be visually distinguished from natural teeth.

Ceramic materials can now be used to prevent the crowns from chipping. In the past, this problem was quite common with dental prostheses; today, this is no longer the case.

The expertise of the treating dentist is a particularly important factor. In general, it can be stated that practices in which several dentists with diverse specialties jointly design and carry out a treatment (“multimodal treatment concepts”) can also demonstrate a qualitatively better result.

Our dental practices in Landshut and Kaiserslautern specialize in every form of dental prosthesis. We offer:

• All types of high-quality dental prostheses
• Highly aesthetic solutions that are indistinguishable from real teeth
• High stability
• Specialists in prosthetics (Dr. Doryumu holds a Master of Science in Function and Prosthetics)
• Special, high-quality materials
• Over 30 years of experience
• 2-year guarantee
• Financing
• Optional: Good and yet inexpensive solutions at the price level of standard care
• Option of billing via TRICARE