Many people use prosthesis all around the world and in our country. The number of people who have full or partial prosthesis is increasing day by day. These types of removable prostheses are of great importance in restoring lost aesthetics as well as in regulating chewing function and speech ability. Intraoral prostheses are much more easily adapted when compared to other prostheses attached to the body. They are considered to be the prostheses closest to the lost tissue in terms of aesthetics and function. However, after the construction is completed, an adaptation period is needed for the cheeks, lips, jaw joint, tongue and brain to get used to the prosthesis. Any difficulties experienced during this period can be easily overcome by working together with your dentist .

Purpose of Prosthesis ?

The aim of prosthetic treatment is to restore the functions lost by the patient, to correct the impaired speech and to improve the aesthetic appearance. In this way, oral health is largely corrected, and individuals who have to live with missing or damaged teeth are also supported psychologically. Because people who have to live with missing or damaged teeth usually avoid smiling .

This situation causes functional disorders as well as damage to the person ‘s self – confidence. Various prosthetics applied to such patients aim to increase the quality of life of individuals .

Prosthetic dental treatment is applied to provide an aesthetic appearance to the patient by using prosthesis instead of the teeth lost over time. Prosthetic dental treatment can be done for the following reasons :

• Prosthetic dental treatment plays a critical role in rearranging the mechanism in the mouth .
• When there is damage to the tooth enamel, prosthetic dental treatment can be performed to ensure the correct sound .
• Aesthetically uneven, misshapen, broken or poor looking tooth enamel is corrected with prosthetic dental treatment to achieve the desired appearance .
• This treatment method aims to renew the surrounding tissues in the mouth, improving the person ‘s function, aesthetics and speech characteristics and raising the standard .

How to Protect Damaged Teeth ?

Over the years, people ‘s teeth can wear down due to reasons such as eating, chewing, swallowing and grinding their teeth at night. In addition, some areas of the teeth can break as a result of cavities and accidents. In such cases, the lost structures of the teeth are replaced with prosthetics called crowns. These crowns can be made of porcelain, acrylic or metal alloys specially produced for dentistry. Thanks to recent developments in dentistry, these structures can look quite natural .

Dentures Made as a Result of Tooth Loss Are Generally of Two Types :
• Fixed prostheses such as crowns and bridges that are placed on the remaining teeth in the mouth and cannot be removed by the patient .
• Removable prostheses that can be inserted and removed by the patient whenever he / she wishes .

Partial and Fully Removable Dentures ( Palate Dentures )

Removable dentures have been used for many years to replace missing teeth due to total or partial tooth loss. These dentures are placed in the mouth by receiving support from both the teeth and the toothless jaw area. The stability of these dentures in the mouth varies depending on the structure of the supporting teeth and tissues. Complete dentures cannot receive support from teeth because there are no teeth in the mouth. While full dentures in the upper jaw resist gravity with the vacuum effect, the mobility of the tongue, lip and cheek muscles in the lower jaw negatively affects the stability of full dentures. It will be possible for lower jaw dentures to become more stable over time as the muscles adapt to the denture and muscle tone increases .

If removable dentures are preferred in partial tooth deficiencies, more stable dentures can be obtained by obtaining additional support from the teeth with the help of crochets or precision holders. The most important advantages of these dentures are that they are economical and can be made in a short time. The disadvantages can be listed as follows : crochets wear down the supporting teeth and cause them to decay, excessive forces acting on the teeth cause the supporting tissues to collapse, the destruction of the jawbone does not stop due to insufficient force transmission to the jawbone, and the need for night removal .

Fixed Prosthesis Application

Fixed prosthesis application is the process of replacing missing or excessively depleted teeth, by combining science and art, using materials similar to the tooth texture and color .

Laminate Veneer Prosthetics
They are extremely thin porcelain veneers that are bonded to the front surfaces of the teeth. With these veneers, the gaps between the teeth can be closed, the dimensions of the teeth can be extended and their shapes can be rearranged. In addition, the appearance of broken, cracked, badly shaped or overly colored teeth can be improved. Porcelain laminates can also be used to provide permanent whiteness to people who are not satisfied with their tooth color, to design a smile, to correct teeth discolored by antibiotic use, to correct slightly crooked teeth, and to correct slight crookedness that does not require orthodontic treatment .

How are Laminate Veneer Dentures Made ?

For the production of porcelain laminates, your tooth is first specially prepared. This preparation is usually done by removing a very thin layer of enamel from the front and cutting surface of the tooth, usually less than 1 millimeter. Then, measurements are taken from your tooth. With these measurements, porcelain laminates in the right shape and color for your tooth are prepared in the laboratory. Laminates are permanently placed on the front surface of your teeth using special adhesives, thus completing your smile .

Advantages of Porcelain Laminate Veneers are as follows :

• Porcelain veneers do not stain and their colors remain constant for a long time.
• Porcelain veneers correct misaligned teeth that would otherwise take a long time to correct with braces in 2-3 sessions.
• Porcelain veneers permanently whiten your smile and increase your self – confidence.
• Porcelain veneers can restore tetracycline discolorations, fluorosis and large fillings.
• Gum tissue tolerates veneer porcelain well, so it is a biocompatible material.
• Porcelain veneers that provide the “Hollywood Smile” can be selected in the desired color.
• Porcelain veneers erode less tooth tissue than crowns.
• Porcelain veneers have a translucent color transition like natural tooth enamel.
• Porcelain veneers can close the gaps between teeth.
• Porcelain veneers can lengthen and reshape teeth according to desired specifications.
• Veneers repair broken, worn or misshapen teeth.

How is Prosthetic Dental Treatment Performed ?

Prosthetic dentistry offers effective methods for providing intraoral restoration using fixed, removable and implant – supported prostheses. These procedures attempt to restore the natural appearance and function of tooth enamel. The material to be used is selected based on the patient ‘s needs and oral structure. Zirconium and laminate restorations are generally preferred. Prosthodontists make material and method selections with multi – faceted evaluations. The construction of fixed prostheses is carried out in the following steps :

• Taking Measurements and Preparation : The restoration begins with shortening and adjusting the tooth in the laboratory in accordance with its original form. After a precise measurement is taken, a design is made according to the color tone according to the enamel color .
• Preliminary Rehearsal: The intraoral compatibility of the prosthesis made of materials such as zirconium or metal is rehearsed.
• Final Rehearsal: In the last step of the restoration, the porcelain structure designed in the laboratory, the connection between all teeth and tissues are checked and the patient ‘s approval is obtained. Color, texture and aesthetic appearance are evaluated. The structure is sent to the laboratory to be polished to make the enamel structure shine .
• Polishing and Cementation: After the restoration comes from the laboratory, it is tested in the mouth for the last time and the patient ‘s approval is obtained. After the prosthesis is fixed with adhesive, the excess parts are cleaned and the process is completed .
• Patient Information: The lifespan of the restoration depends on personal care and the health of the surrounding tissues. Therefore, the patient is informed about care techniques and appointments are made for routine check – ups .

Types of Prosthetics Used in Fixed Prosthetic Dentistry ?

Fixed, removable or implant- supported dentures can be used in prosthetic dental treatment. These dentures are made of various materials and are selected according to different needs :

• Metal -Supported Porcelain Coating: The outer part of this prosthesis is porcelain and the inner part is made of metal. This material, which has low light permeability, can be aesthetically satisfying but can give an artificial appearance. It is generally preferred for the back teeth due to its dark color tone .
• Ceramic Coating: It is one of the most frequently used coating types in terms of aesthetics. It is widely used in the restoration of front teeth because it is a reinforced porcelain material and has good color harmony .
• Zirconium Coating : It is the coating closest to the natural appearance and has high light transmittance. Its inner part is made of zirconium and its outer part is made of porcelain. This coating is often preferred due to its aesthetic and natural appearance .

Implant – supported crowns and bridges

Implant – supported crowns and bridges are fixed prostheses made using titanium root screws placed by surgeons into the jawbone. These implants are restorations produced after they have completely fused with the bone ( usually taking 2-6 months ). Depending on the patient ‘s condition, restorations can be made of metal, metal – porcelain, zirconium – porcelain or porcelain alone .

Pediatric Dentistry ( Pedodontics )

can be defined as a field that evaluates the oral and dental health of individuals from birth to the end of adolescence ( between the ages of 0-15 ) and applies all kinds of protective, preventive and therapeutic methods in this age group .

Field of Study Include :

• Treatments to prevent tooth decay ,
• Decay treatments and restoration of milk and permanent teeth ,
• Extraction of teeth that cannot be treated ,
• Ensuring regular alignment of teeth with appliances to prevent the negative effects caused by early tooth loss ,
• Diagnosis, treatment and long – term follow – up of traumatic injuries to teeth and surrounding tissues ,
• Monitoring tooth eruption and tooth development, preventing deviations from normal ,
• Protective and preventive orthodontic treatments,
• Diagnosis, treatment and monitoring of periodontal diseases seen in childhood and young individuals .

In addition to healthy children, children who require special care, those with chronic systemic diseases, those with syndromes, and those with physical and/or mental disabilities also benefit from the examination, treatment and follow-up services of the department of pediatric dentistry .

The initial examination, diagnosis and treatment planning of patients applying to Pediatric Dentistry Clinics are performed by specialist physicians. Dentists who have completed their postgraduate education in the Department of Pediatric Dentistry also provide the same services. When necessary for diagnosis, patients are directed to the Department of Oral, Dental and Jaw Radiology Clinic together with their parents and the necessary radiographs are taken. After the treatment planning is completed, appointments are made for patients in need of treatment.

The treatments of our patients who are young, who cannot adapt to dental treatments due to physical or mental disabilities, who cannot cooperate, who have syndromes, and who come from distant regions and need multiple dental treatments at once are performed in the day operating room and general anesthesia unit in our hospital. These treatments are performed by an anesthesiologist and a pediatric dentist under operating room conditions .

Our patients whose treatment is completed are put on a regular follow – up ( recall ) program at periods determined according to their caries risk and special needs. Pediatric Dentistry Clinics should be thought of as a dental health center that should be visited regularly until the child ‘s growth and development process is completed. Regular and long – term visits create the foundations for a healthy mouth and teeth that the individual will have throughout his / her life .