Dental prosthetics in Istanbul: types, choices and upkeep

A dental prosthesis replaces or restores one or more teeth, to improve chewing, speech, appearance and the stability of the bite. The word covers very different treatments: a crown, a bridge, a removable appliance, a full denture, or a restoration fixed onto implants. For a project in Istanbul, the choice rests neither on price alone nor on a photograph. It depends on the state of the remaining teeth, the gums, the bone, the bite, and on what you can realistically maintain over years.

What counts as a dental prosthesis

A prosthesis may cover an existing tooth, replace a missing one, or restore a whole arch. It is fixed when only a professional can remove it, removable when the patient takes it out to clean it. Some rest on natural teeth, some on the gum and bone, some on implants.

The main types

The crown

A crown covers a heavily restored, fractured or weakened tooth. It requires irreversible preparation of that tooth. Zirconia, all-ceramic and porcelain-fused-to-metal do not have the same properties. A full crown should not be chosen simply to change the colour or to line up a tooth that is still sound, where a more conservative option exists.

The bridge

A bridge replaces a missing tooth by resting on the neighbouring teeth, or on implants. A conventional bridge requires the abutment teeth to be prepared. A resin-bonded bridge is more conservative in certain situations, but it does not suit every sector of the mouth or every chewing load.

The partial denture

It replaces several teeth while keeping the ones that remain. Its base may be acrylic or carry a metal framework. It is generally less invasive than an extensive fixed restoration, but its comfort, stability, appearance and effect on the supporting teeth have to be assessed case by case.

The full denture

It replaces all the teeth in one arch. Its stability depends on the shape of the tissues, on saliva, on the bite and on how well the base fits. It needs adjustment after fitting, because gum and bone change over time. It is not a permanent device that needs no upkeep.

Implant-supported prosthetics

Implants can support a single crown, a bridge, or stabilise a removable denture. A fixed implant-supported restoration and a stabilised removable denture do not meet the same need and do not require the same maintenance. Having implants removes neither biological complications nor wear of the screws, abutments and prosthetic components.

Fixed or removable: how the choice is made

Fixed is not automatically better. The choice depends on the number and quality of the remaining teeth, on bone volume, on the space available, on cleaning habits, on grinding, on general health and on expectations. A solution that is technically possible can still be unreasonable if it means preparing several healthy teeth, or if the daily cleaning it demands is too complex.

- Keep restorable natural teeth for as long as their prognosis allows.

- Compare bridge, implant and removable denture for each gap separately.

- Judge how easy cleaning under bridges and around implants will really be.

- Account for the repairs, adjustments and replacements to come.

The assessment before treatment in Istanbul

A remote estimate helps to prepare the project, but it stays provisional. The final plan needs a clinical examination, an assessment of the gums, the bite and the supporting teeth, and whatever radiographs are indicated. A tooth that looks beyond saving on a photograph can sometimes be kept; conversely, a tooth planned as an abutment may be hiding a fracture, an infection or loss of support.

- Tooth by tooth: which are restorable, which are compromised, which are missing.

- Assessment of decay, old restorations, root canal treatments and fractures.

- Check of the gums, mobility, bone and hygiene.

- Analysis of the bite, the vertical dimension and any grinding.

Materials

Acrylic, metal, zirconia, ceramic, composite, or a combination. No material is best in every situation. Strength, weight, repairability, translucency, the thickness required and how it behaves against the opposing teeth all have to be weighed against each other.

How many appointments, and how many trips

There is no universal timetable. It depends on preliminary treatment, extractions, any healing period, the number of teeth, the impressions, the temporaries, the try-ins and the laboratory corrections. Implant treatment runs in phases separated by months.

As a guide, at Nobel Dent: crowns on prepared natural teeth need a stay of seven to eight days. On implants, the crowns are fitted during a second stay of nine to ten days, three to four months after the surgery — five to seven months where a bone graft was needed. Keep some margin on the return flight for check-ups and adjustments.

Risks, adjustments and repairs

- Sensitivity, pain or complications in the supporting tooth after preparation.

- Gum irritation, areas that are hard to clean, inflammation around implants.

- Bite interference, difficulty chewing or speaking, requiring adjustment.

- Debonding, cracking, fracture, wear or loosening of a component.

- The need to reline, repair or replace a prosthesis over time.

Upkeep

A prosthesis does not remove the need for hygiene. Crowns and bridges can develop decay at their margins if the supporting tooth stays exposed to plaque. Tissues around implants can become inflamed. Removable appliances come out and are cleaned as instructed — and so are the remaining teeth, the gums and the tongue.

- Daily brushing and interdental cleaning suited to crowns and bridges.

- Cleaning underneath pontics and around implants.

- Separate cleaning of removable appliances, with a compatible product.

- Regular checks of the bite, the gums and the supporting teeth.

What the estimate has to specify

An estimate separates clinical procedures, prosthetic components and travel services. A general heading such as "full denture" or "implant bridge" makes two proposals impossible to compare. Ask for the number of teeth replaced, the supporting teeth, the materials, the temporaries, the stages, the check-ups, the exclusions and the warranty conditions.

Questions to ask before you agree

- Why this solution rather than the alternatives, in my case?

- Which teeth will be prepared, and how much tissue will be removed?

- Will it be fixed or removable, screwed or cemented?

- How is it cleaned, repaired and replaced?

- Who handles adjustments and emergencies once I am home?

Sources

The NHS describes what crowns, bridges and dentures are for, the materials used, and how each is made and cleaned. Guy's and St Thomas' NHS Foundation Trust notes that long-term care of an implant-supported restoration is the patient's own responsibility, and that components can loosen or wear with time.

Further reading

Our page on dental prostheses for bone loss covers the cases where bone is missing. See also dental crowns, dental implants and dental implants and E.max crowns. Our article on what a dental implant is explains the healing period the timetable depends on. The free quote page lists the documents to send.

This article is general information and does not replace an examination. Only a dentist can make a diagnosis and propose a treatment plan suited to you. Results vary from one person to another.