Porcelain Laminates (Laminate Veneer Crowns)
Porcelain laminate veneer crowns are very thin porcelain layers that are usually limited to the front face of the tooth. They are bonded with tooth-colored, transparent or opaque adhesives with high adhesion strength. They can be applied for fractures, excessive loss of material, discoloration or changing the position of the tooth, or they can be applied to as many teeth as the number of teeth visible when the patient smiles, aiming for a complete smile change. This procedure is now called Smile Design. When photoshop and cad / cam systems are included in the treatment plan in the smile design process, the process is called Digital Smile Design.
Generally, in preparation for porcelain lamina procedures, enamel material between 0.3 – 0.5 mm is removed from the front of the tooth. Care is taken to remain limited at the enamel level. When the positions of the teeth are very different from each other, in order to achieve the ideal smile line, it may be necessary to cut more than ideal in some teeth, sometimes even to prepare a full ceramic crown in the relevant tooth. In addition, in cases where there are gaps between the teeth (in cases of multiple diestama), in cases where the axis of the tooth allows, porcelain laminates can also be made without making any cuts on the tooth (uncut / prepless).
In general, this treatment method requires much less tooth structure removal than crowns where the entire tooth is covered, but the situation is irreversible when the enamel is eroded. In the presence of caries and fillings in the relevant tooth, it may be necessary to add these areas to the minimal tooth cutting performed. The treatment aims to correct and organize the aesthetics of the teeth, to protect the tooth structures by removing very little tooth tissue, and to obtain the closest appearance to the natural tooth with metal-free aesthetic materials (such as porcelain, zirconia). If the recommended treatment is not applied, crowns (veneers) that require the entire tooth to be cut may be necessary.
Inlays, Onlays, Overlays and Endochrones
Inlays, onlays, overlay fillings and endochrons can be made of porcelain or hybrid (composite porcelain) materials. They can be prepared in the dental office with the digital method, or they can be prepared by taking impressions with the classical method and sent to dental laboratories. They are generally preferred for molars and teeth with a lot of material loss. They are more resistant to chewing forces than composite fillings. Composite restorations can be preferred for inlay fillings. This is because the teeth have three or four side walls and therefore have less material loss.
With these treatment options, it is aimed to maintain the chewing function by avoiding new material loss that may occur with tooth cutting (minimally invasive method) in teeth that already have material loss and to design the restoration to be made in the most appropriate way to the original state of the tooth. After the relevant tooth is prepared for impression, it can be finished in a single session with digital dentistry, or it can be finished in 2-3 sessions by working with dental laboratories with the classical impression taking method. The prepared restoration is bonded to the tooth. The lifetime of the restorations varies according to the material used. In addition, as a result of continuing poor oral hygiene, new caries may develop on the existing tooth surfaces around the restorations.
Removable Partial Dentures
Removable complete (total) and partial (partial) dentures are the classical types of dentures used in tooth deficiencies. Complete dentures are made of acrylic or acrylic and metal parts, supported by soft tissues and the underlying bone structure, and can be inserted and removed by the patient. Partial dentures are prostheses that receive support from teeth in addition to the soft and bone support tissues mentioned above. The retention of partial dentures is provided by specially designed hooks (clasps) and/or precision retainers that are supported by the teeth present in the mouth. Prostheses are prepared by carrying out both clinical and laboratory procedures together. The teeth to be used in removable dentures can be either acrylic or porcelain.
Fixed Prostheses (Crowns and Bridge Prostheses)
Fixed prostheses are prostheses that are supported by the teeth, allow for the restoration of missing teeth and/or teeth with excessive loss of material, and help to regulate aesthetic, functional (elimination of chewing and bite disorders) and phonation (ensuring the proper production of sounds) needs.
Porcelains with metal substructure, porcelains with zirconia substructure, monolithic full zirconia crowns and bridges, full ceramic restorations, porcelains reinforced with zirconium are used in the construction of fixed prostheses. In addition to traditional methods in the construction of fixed prostheses, digital dentistry tools have brought a new dimension to the treatment. The materials used in the construction of fixed prostheses have differences determined by the literature in terms of aesthetics, durability, durability and healthy retention time in the patient’s mouth. The patient and the dentist should decide together on the choice of material and method according to the suitability of the teeth and the patient’s wishes.
