Surgical preparation of edentulous jaws for orthopedic treatment

Preparing teeth for prosthetics begins with an examination by an orthopedic dentist. It determines the scope and list of measures that will be required to effectively restore the integrity of the dentition.

The basis of preparation is accurate diagnosis. The condition of both jaws can be assessed using a panoramic X-ray - orthopantomogram. It allows:

• see the condition of all teeth;
• assess the condition, volume, structure of the bone tissue of the jaws;
• identify diseases that may interfere with prosthetics (periodontitis, root cysts, etc.);
• determine the condition of soft tissues, the depth of periodontal pockets with periodontal disease, etc.

Based on the diagnostic results, the doctor determines what preparation measures will be required.

Therapeutic preparation

Therapeutic preparation is necessary for the purpose of sanitation of the oral cavity. First of all, professional teeth cleaning is carried out:

• removal of hard dental deposits using ultrasound, less often - mechanical cleaning;
• removing soft plaque using the Air Flow method;
• polishing, fluoridation (remineralizing therapy).

Preparing teeth for prosthetics includes mandatory removal of foci of infection and inflammation. Treatment of caries and complications in the form of pulpitis, periodontitis is carried out, and therapy for inflammatory diseases of the gums and soft tissues of the oral cavity (periodontitis, gingivitis, glossitis, etc.) is prescribed.

Therapeutic preparation also includes removal of the pulp of teeth to be replaced. Afterwards, endodontic treatment is carried out - treatment and filling of the root canals.

Preparation for prosthetics for implantation

If implants are chosen as a support for the crown, the preparation of the oral cavity for prosthetics is the implantation itself and additional surgical operations for its implementation, such as bone grafting, sinus lifting, etc. The entire complex of measures for the implantation of artificial roots is carried out according to a high-precision digital protocol:

1. CT and 3 D scanning of the jaws . Using computed tomography and intraoral scanning, a three-dimensional virtual model of the jaws is created, depicting the condition of the oral cavity with high accuracy and detail.
2. Modeling of future crowns . The future orthopedic design is modeled digitally and the position and shape of the teeth are selected.
3. Virtual placement of implants . The location of the implants is determined according to the virtual model of the jaw, taking into account future crowns, bone volume, localization of the facial nerves and other features.
4. Making a surgical template . Based on a digital impression of the patient’s jaw, a real projection is made in the form of a positioning mouthguard, with the help of which it becomes possible to accurately comply with the selected conditions for the placement of the implant at the time of surgery.
5. Implantation . Depending on the clinical situation, either classical two-stage implantation or implantation according to a one-stage and/or one-stage protocol is performed. After this, the process of osseointegration—engraftment of the implant into the bone—begins.

The long preparatory stage ends with permanent prosthetics - installation of a crown on an implant, usually screw-fixed. As a result of correctly performed implantation, the patient receives a flawless smile without any risks or complications.

Surgical preparation

Surgical preparation involves the removal of teeth that cannot be treated. For example, highly mobile ones, having a large root cyst, granulating periodontitis, etc.

Osteophytes and exostoses, if present, are also removed. They are outgrowths of bone tissue and can interfere with the installation of a denture.

Surgical preparation of teeth for prosthetics may also include removal of excess soft tissue due to hypertrophy of the mucous membranes and gums.

Implant placement also refers to surgical preparation. Osteoplastic surgery, the implantation of artificial or natural bone tissue to achieve the required volume of bone in the jaw, can also be used as a preliminary stage. One of the types of such an operation is a sinus lift, raising the bottom of the maxillary sinus.

How is prosthetics performed?

Once the oral cavity is prepared, the prosthetic process can begin. It consists of several stages:

• Preparation of teeth that will be involved in prosthetics: depulpation, removal of excess tissue.
• Taking impressions for subsequent production of a jaw model. Also, instead of impressions, intraoral photography can be used, followed by the formation of a three-dimensional digital model of the jaws.
• Design and manufacture of prosthesis.
• Fitting.
• Installation on permanent cement.

Orthopedic training

Orthopedic preparation involves attention to secondary tooth deformations after removal of those located nearby or “antagonist” (located on the opposite jaw) teeth. It involves creating special plates and trays to move protruding teeth to create space for dentures on the opposite jaw. It may also be necessary to make special trays to relieve the masticatory muscles. This is necessary for bruxism and increased muscle tone to prevent damage to structures.

Preparing teeth for prosthetics is a whole range of measures that are designed to prevent the difficulties of wearing artificial structures and are necessary to ensure oral health.

Depulping teeth for crowns

The installation of crowns and bridges involves depulpation - removal of the nerve of the tooth. This procedure deprives the tooth of nutrition, it becomes more fragile. However, this cannot be avoided - removal of the pulp during prosthetics in most cases is mandatory. This allows you to avoid a number of problems in the future during the operation of the crown.

As a rule, a crown is installed on a tooth with a damaged coronal part. That is, it is impossible to do without removing the nerve. If we are talking about installing a bridge, the supporting teeth are also processed for the subsequent installation of the structure. It is believed that to install a zirconium dioxide prosthesis, it is not necessary to depulpate the tooth, due to the fact that its thickness is minimal compared to prostheses made from other materials.

Psychological preparation

Most people are afraid of going to the dentist. A tense patient, shaking with fear, does not speak well and is difficult to interact with. The work of an orthopedist begins long before trying on a prosthesis. The first step is to establish emotional contact. If a doctor is friendly and shows attention, he inspires trust. The patient will be more open to discussing treatment methods, and nervousness will decrease. During the conversation, the dentist collects information about:

• patient complaints;
• past treatment experience and its results;
• the presence of common diseases and allergic reactions.

During the examination, the orthopedist pays attention not only to the condition of the oral cavity, but to the asymmetry of the face, recession of the cheeks and lips.

To assess the condition of the teeth and see hidden defects, an orthopantomogram (panoramic image) or CT scan is usually prescribed. This is not a whim of the doctor, but a desire to create a complete picture, taking into account all the details. In addition, the image can reveal inflammatory processes that are invisible during examination.

Based on the results obtained, different types of preliminary treatment are prescribed.

• Alekperov R.B. Orthopedic dentist

Question:

I don’t want to remove the nerves in the supporting teeth for the bridge. What are the options?

Answer:

A bridge prosthesis based on zirconium dioxide involves the production of thin crowns for supporting teeth, so in some cases it is possible to do without their heavy grinding and depulpation.

• Pak R.V. orthopedic dentist

Question:

When the teeth are ground, will they put something on the stump? Or just walk around with sharp fangs

Answer:

After the teeth have been prepared, protective temporary crowns are placed on them until the permanent prosthesis is installed.

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Financial issue

With extensive dental prosthetics, when the patient faces a fairly long treatment in several stages, for some people, and especially for pensioners, the issue of the cost of prosthetics arises.

Staged payment without increasing the price

A large amount of work on prosthetics often requires considerable funds; not all people can pay a large bill at a time.

Sometimes it happens that the patient cannot pay the entire bill at once, in one payment.

In such cases, the Lyubertsy Dental Clinic VUGI may offer the patient to split the bill into several payments during the production of the required orthopedic structure (14-30 days);

Orthodontic stage

Orthodontic methods are aimed at changing the position of teeth and their inclination. All attention at this stage is directed to the deformations formed after tooth extraction, therefore the following measures are taken:

• production of mouthguards, bite blocks;
• preparing the site for installing the prosthesis on the other jaw;
• creation of muscle relaxant mouthguards.

Such preparation can eliminate the need for depulping or grinding down a deformed tooth. This stage takes from several months to several years.

Bridge

The main preparation for bridge prosthetics consists of preparing the supporting teeth. When using metal-ceramic dental prosthetics, the teeth are subjected to significant grinding. Zirconium crowns are much thinner, so not as much hard tissue is ground down.

After this, impressions are made and the frame is modeled based on them. Then the crowns are cast and fired in a kiln. The bridge is tried on, adjusted and placed on temporary cement, giving the patient time to get used to it. After this, the structure is secured with permanent cement.

Preparatory treatment planning

The orthopedic dentist, together with his colleagues, other specialists, therapist and surgeon, plans to conduct the process of preparing the patient for prosthetics with precision down to the day.

After the preparatory and further treatment plan is ready, the patient’s schedule of visits to the clinic is clarified, dates and times are agreed upon, from what time to what time the patient should be in the clinic, based on the planned medical activities and his time capabilities.

When all the details are agreed upon, the full cost of treatment is also discussed in detail.

Basic issues of dental prosthetics

Dear friends, in this article we will try to answer the most asked questions by our patients about prosthetics and preparation for it, about the main stages of dental prosthetics, their order and important key points related to dental prosthetics.

Dental prosthetics is a multi-stage process of replacing lost teeth or damaged tooth tissue with the help of dentures. So, after you have been consulted by a specialist, a diagnosis has been made, a treatment plan has been selected, a treatment agreement has been drawn up, and the treatment stages begin. Any dental prosthetics includes: 1. Preparation for prosthetics, if necessary.

2. Dental prosthetics itself, which includes clinical and laboratory stages.

Features of quota provision

If social security confirms the basis for dental prosthetics on preferential terms, you will be given a coupon for applying to a state or municipal medical institution. The coupon is valid from 2 weeks to six months

. If you do not use the ticket at the appointed time, the queue disappears. The beneficiary is not allowed to choose a clinic. The medical institution is designated according to the place of registration, the name of the clinic and address are noted on the coupon.

Free prosthetics for pensioners are provided in state and municipal dental clinics. According to the quota, they will only make and install dentures for you. Treatment is paid separately. Expensive materials are not used for prosthetics. Such as ceramics, metal ceramics and implant prosthetics. In some cases, for example, with allergies, the doctor may recommend more modern and expensive materials. When making such a decision, the patient will have to pay extra for consumables. Free prosthetics are done only once every 5 years

.

Where to start treatment

Dental prosthetics for pensioners has a number of features. In old age, this is a complex and delicate procedure. A careful and careful approach to treatment is required.

Start by visiting a dental clinic and get a consultation with a dentist. After the examination, the doctor will tell you whether prosthetics can be done and what preliminary treatment is necessary. Before installing dentures, undergo a medical examination. Older patients, as a rule, have a number of chronic diseases and weak immunity.

Please note the contraindications: allergic reactions to anesthesia and substances used in dental prosthetics. It is not recommended to carry out treatment during an exacerbation of diseases of the cardiovascular system and respiratory organs. It is necessary to eliminate inflammatory processes in the oral cavity (stomatitis, bleeding gums). In state or municipal dentistry you can receive treatment under the compulsory medical insurance policy. After treatment, contact your orthopedic dentist and discuss what type of prosthesis and what material will be suitable for your case.

Dental prosthetics cannot be done under the compulsory medical insurance policy.

.
But for pensioners, Russian citizens, social programs
under which prosthetics can be installed for free.

Prices for implantation using templates in Moscow