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Doctor Roy B. Judge
Prosthodontics

 

Prosthodontics


 

 

 

Crown

A crown is a dental device that replaces the outside structures of the tooth. A crown can be made out of gold, porcelain or a combination of both gold and porcelain.

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Before
Before
After
After

A crown is used mainly to strengthen the outside of the tooth to increase its use in the mouth and is also very useful in making the tooth look aesthetically pleasing. A crown is attached to the tooth with dental cement and has a life span in the order of 15-20 years.

 

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Bridges

A bridge (see Diagram 1) is often used to replace missing teeth. This can be done by placing a crown onto adjacent teeth on either side of the gap and then joined together by a false tooth.

Diagram 1
Diagram 1: This shows a bridge being placed upon the prepared natural teeth.

A bridge is most useful when a tooth that needs to be replaced is adjacent to teeth that also are in need of extensive reconstruction. Bridges can be made of gold, porcelain or a combination of gold and porcelain depending on the aesthetic requirements and or functional requirements.

Bridges can also be constructed using a minimalistic approach (see Diagram 2). Rather than a crown being placed on the adjacent tooth a thin shaving is taken from the back of the tooth to allow a wing to be bonded to the back of this tooth. From this wing, again a false tooth can be attached to replace the missing tooth. These minimal preparation bridges rely on the cement to keep them in place. They are less destructive than a conventional bridge however their longevity is not as good.

Diagram 2
Diagram 2: This shows a minimal preparation bridge being inserted. The metal wing is bonded to the back of the adjacent natural tooth.

 

 

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Porcelain Veneers

Porcelain Veneers are restorations that can be bonded to the front or the back of a tooth to reconstitute the shape. They are very aesthetic restorations used mainly at the front of the mouth to enhance the aesthetic appeal of the tooth. They are bonded to the tooth and are useful when small spaces need to be closed to restore broken down or fractured teeth, sometimes to cover up unsightly blemishes in the tooth and corrections of small or crooked teeth.

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Before
Before Treatment
After
After teeth are bleached and veneer is placed on the upper left lateral incisor tooth.

For veneers to be placed on the teeth a small preparation is required on the outside of the tooth removing some of the enamel. The longevity of these restorations is good however they do need to be maintained and cleaned.

 

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Bleaching

Patients often want to have their teeth colour lightened. In the past we had few treatment options and the treatment options often were aggressive removal of large amounts of tooth structure requiring long term care of the teeth.

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Before
Before Bleaching
After
After Bleaching

Today we have a simple cost effective and highly conservative method of bleaching teeth. We are able to lighten teeth in most cases using organic bleaches held over the teeth for a period of a time. We have several ways of bleaching teeth however since 1989 we have a predictable manner in which teeth can be bleached.

 

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Partial Dentures

What is a partial denture? (See Diagram 3)
A removable partial denture is a casting made of cobalt chromium metal which attaches to the outside of the teeth. This in turn holds in place acrylic (plastic) teeth replacing missing teeth both in the upper and lower jaw. This is a predictable and safe way of replacing several missing teeth.

Diagram 3
Diagram 3: This shows a missing tooth being replaced by a removable partial denture.

The dentures can be removed at night for cleaning and to allow the gums to recover. In some instances the use of the removable partial denture is the treatment of choice. It allows the replacement of missing teeth and sometimes gums and bone depending on the levels of the tissue.

Before

Before removable partial denture
After

After removable partial denture



Full Dentures
When all the teeth are missing, they can be replaced with acrylic dentures. The upper denture is held in place by suction. The lower denture is held in place by the actions of the lips and tongue.

 

 

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Treatment of Worn Teeth

People are keeping their teeth longer these days. The upper anterior (front) teeth come into the mouth at 6 years of age. By the time people are 50 or 60 years old there is often a degree of wear and tear on the teeth. In some cases the wear can be quiet severe. We specialise in the treatment of this type of situation.

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Before
Before Treatment
After
After Treatment

There are a variety of ways to replenish the worn teeth, often involving a combination of direct filling materials, crowns, bridges and partial dentures. The aim is to try and maintain the teeth in the mouth for as long as possible and to enhance the aesthetic and functional value of remaining teeth. We can also protect remaining teeth by provision of a splint (bite plate). These are used extensively in the treatment of patients with severely worn teeth or in the treatment of pain associated with the jaw joints.


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