FIXED AND REMOVABLE PROSTHETICS

Prosthetic dentistry is the branch of dentistry that deals with restoring and maintaining chewing function through the restoration of natural teeth and/or the replacement of missing teeth and adjacent oral tissues using artificial devices. Fixed prosthetics involves the restoration and/or replacement of teeth using structures that cannot be removed from the mouth. With this type of prosthesis, in the form of single crowns or bridges, it is possible to reconstruct and/or improve the shape, functionality, and aesthetics of severely compromised teeth in all those cases where it is not possible to apply simpler forms of restoration (see dedicated section on direct and indirect restorative dentistry).

Removable prosthetics allow for the replacement of teeth and adjacent structures in patients who are totally or partially edentulous using artificial structures that can be removed from the mouth. In the case of partial prostheses, the choice (in contrast to a fixed solution) depends on the number, position, and conditions of the supporting structures of the existing abutment teeth.

Total prosthetics are necessary to compensate for the complete loss of the dentition in one or both arches; it is essential that their fabrication accurately respects the remaining oral structures in order to ensure their long-term maintenance.

Customised implant abutment made of zirconia oxide (Mignani Laboratory)
Final rehabilitation achieved with ceramic crown on zirconia oxide (Mignani Laboratory)
Lower left first molar prepared to a prosthetic stump state
Final crown on the element made of zirconia oxide and ceramic (Mignani Laboratory)
In this case, it is necessary to replace the existing prosthetic crowns due to cavities affecting the natural elements and for the rehabilitation of the recently extracted upper right first molar due to severe endodontic pathology. View of the prosthetic stumps upon removal of the existing prostheses.
View of the prosthetic stumps upon removal of the existing prostheses
Zirconium oxide implant pillars (Mignani Laboratory)
Definitive prosthetic crowns in zirconium oxide and ceramic (Mignani Laboratory)
Deep inflammation around crowns with completely incongruous margins 
The stumps will need to be completely rebuilt and reprepared
The reconstructed pillars with completely healed gingival tissues
Single crowns cemented permanently
First premolar and second molar "prepared" to serve as bridge pillars
The final bridge after cementation
The tooth will be extracted and replaced with a single insertion and immediate load implant
The first premolar was extracted and immediately an implant with a resin element screwed in was placed: healing after 4 months
A customised zirconium pillar with a titanium base was applied to the implant
The correct morphology of the pillar is checked
The final result respects the morphology of the adjacent teeth tissues
The entry hole for the implant-crown connection screw is filled with composite material, making it invisible but still inspectable for any needs
Patient affected by widespread chronic periodontitis with total absence of molar support
Bone resorption was such that extraction of all present elements was necessary, leaving only the canines at the root level
In the lower arch, the 4 premolars are retained, prepared as pillar elements
Plaster models corresponding to the situation after complete arch debridement are analysed in a semi-individual values articulator to establish the most appropriate treatment and rehabilitation plan
The retained lower elements are protected by metal structures built to provide retention for a complete prosthesis
The lower prosthesis is constructed with metal elements corresponding to the telescopic elements of the previous image
The upper total prosthesis is constructed with the palatal part in transparent resin for easier control
The patient with definitive upper and lower total prostheses
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