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Prosthodontics

Prosthodontics

Overview
Prosthodontics (also known as dental prosthetics or prosthetic dentistry) is one of nine dental specialties recognized by the American Dental Association
American Dental Association
The American Dental Association is an American professional association established in 1859 and has more than 152,000 members. Based in Chicago, the ADA is the world's largest and oldest national dental association and promotes good oral health to the public while representing the dental...

, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons
Royal Australasian College of Dental Surgeons
The Royal Australasian College of Dental Surgeons or RACDS is a professional college established in 1965 that administers Fellowship Exams for both general and specialist dental practitioners in the Australasian region...

. Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes http://www.ada.org/prof/ed/specialties/definitions.asp.

A prosthodontist is a dentist who specializes in prosthodontics, the specialty of implant, esthetic and reconstructive dentistry.
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Encyclopedia
Prosthodontics (also known as dental prosthetics or prosthetic dentistry) is one of nine dental specialties recognized by the American Dental Association
American Dental Association
The American Dental Association is an American professional association established in 1859 and has more than 152,000 members. Based in Chicago, the ADA is the world's largest and oldest national dental association and promotes good oral health to the public while representing the dental...

, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons
Royal Australasian College of Dental Surgeons
The Royal Australasian College of Dental Surgeons or RACDS is a professional college established in 1965 that administers Fellowship Exams for both general and specialist dental practitioners in the Australasian region...

. Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes http://www.ada.org/prof/ed/specialties/definitions.asp.

A prosthodontist is a dentist who specializes in prosthodontics, the specialty of implant, esthetic and reconstructive dentistry. Prosthodontists restore oral function through prostheses and restorations (i.e., complete dentures
Dentures
Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental...

, crowns
Crown (dentistry)
A Crown is a type of dental restoration which completely caps or encircles a tooth or dental implant and is typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which are usually fabricated using indirect methods...

, implant retained/supported restorations). Cosmetic dentistry, implants and temporomandibular joint disorder
Temporomandibular joint disorder
Temporomandibular joint disorder , or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporomandibular joint, which connects the mandible to the skull. The disorder and resultant dysfunction can result in significant pain and impairment...

 all fall under the field of prosthodontics.

Australia


Training in prosthodontics in Australia consists of a 3 year postgraduate specialty training program that culminates in a DClinDent (Doctor of Clinical Dentistry) degree and certification as a specalist prosthodontist. Fellowship status can then be obtained through the Royal Australasian College of Dental Surgeons
Royal Australasian College of Dental Surgeons
The Royal Australasian College of Dental Surgeons or RACDS is a professional college established in 1965 that administers Fellowship Exams for both general and specialist dental practitioners in the Australasian region...

 ( FRACDS (Pros) ) by completing the Final Fellowship examinations.

USA


The American College of Prosthodontists (ACP) http://www.prosthodontics.org/ ensures standards are maintained in the field. Becoming a prosthodontist requires an additional 3 years of postgraduate specialty training after obtaining a DDS (Doctor of Dental Surgery
Doctor of Dental Surgery
The Doctor of Dental Surgery is an academic degree awarded to dentists, along with the Doctor of Dental Medicine , Bachelor of Dentistry , Bachelor of Dental Surgery/Chirurgiae , Bachelor of Dental Science , Bachelor of Dental Medicine , Licentiate in Dental Surgery , Doctor of Dentistry ,...

) or DMD (Doctor of Dental Medicine) degree. Training consists of rigorous preparation in the basic sciences, head and neck anatomy
Head and neck anatomy
Head and neck anatomy focuses on the structures of the head and neck of the human body, including the brain, bones, muscles, blood vessels, nerves, glands, nose, mouth, teeth, tongue, and throat...

, esthetics, biomedical sciences, biomaterial sciences, function of occlusion (bite), TMD (Temporomandibular joint disorder
Temporomandibular joint disorder
Temporomandibular joint disorder , or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporomandibular joint, which connects the mandible to the skull. The disorder and resultant dysfunction can result in significant pain and impairment...

), and full mouth treatment planning and reconstruction. Due to this extensive training, prosthodontists are frequently called upon to treat complex cosmetic cases, full mouth rehabilitation, TMJ related disorders, congenital disorder
Congenital disorder
Congenital disorder involves defects in or damage to a developing fetus. It may be the result of genetic abnormalities, the intrauterine environment, errors of morphogenesis, or a chromosomal abnormality. The outcome of the disorder will further depend on complex interactions between the pre-natal...

s, and sleep apnea
Sleep apnea
Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea , lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep...

 by planning and fabricating various prostheses. The ADA does not recognize any branch of dentistry called "cosmetic dentistry". Prosthodontics is the only dental speciality under which esthetic/cosmetic dentistry falls. Thus, prosthodontists are the only specialists who are trained as cosmetic dentists, as recognized by the ADA. It has also been argued that it is unethical for a general dentist to perform full mouth reconstruction type of treatment as they are not qualified specialists to perform these types of treatment.(Journal of Prosthodontics, Volume 18, Issue 4 (p 291-291)http://www3.interscience.wiley.com/cgi-bin/fulltext/122428818/PDFSTART. There is also a counter argument if prosthodontics need as much training as other areas of specialty dentistry at all - for example, studies have shown that general dentists can perform as good as prosthodontists http://linkinghub.elsevier.com/retrieve/pii/S0300571206000674. There is also an other group that argues that prosthodontics is small enough be combined with some other area of specialty training like Oral and Maxillofacial Surgery.

Board certification is awarded through the American Board of Prosthodontics (ABP) http://www.prosthodontics.org/abp/ and requires successful completion of the Part I written examination and Part 2, 3 and 4 oral examinations. This is a very rigorous process and so far there are no more than 800 diplomates, thus making diplomates exceptionally qualified http://www.prosthodontics.org/abp. The written and one oral examination may be taken during the 3rd year of speciality training and the remaining two oral examinations taken following completion of speciality training. Board eligibility starts when an application is approved by the ABP and lasts for six years http://www.prosthodontics.org/UserFiles/File/ABP%20Feb%2020%202008%20Guidelines%20for%20Certification.pdf. Diplomates of the ABP are ethically required to have a practice limited to prosthodontics. Fellows of the American College of Prosthodontists (FACP) are required to have a dental degree, have completed three years of prosthodontic speciality training, and be board certified by the ABP.

Maxillofacial Prosthodontics



Maxillofacial prosthodontics is a subspecialty of prosthodontics. Maxillofacial prosthodontists treat patients who have acquired and congenital defects of the head and neck (maxillofacial) region due to surgery, trauma, and/or birth defects. Artificial eyes (see Ocularist
Ocularist
An ocularist is someone who specializes in the fabrication and fitting of ocular prostheses for people who have lost an eye or eyes due to trauma or illness...

, Ocular prosthetic), ears, and maxillary obturators
Palatal obturator
A palatal obturator is a prosthesis that totally occludes an opening such as an oronasal fistula . They are similar to dental retainers, but without the front wire. Palatal obturators are typically short-term prosthetics used to close defects of the hard/soft palate that may affect speech...

 are commonly planned and fabricated by maxillofacial prosthodontists. Other less commonly employed prostheses include mouth devices used by amputees to aid in daily activities, tracheostomy obturators, and craniofacial prosthesis
Craniofacial prosthesis
Craniofacial prostheses are prostheses made by individuals trained in anaplastology or maxillofacial prosthodontics who medically help rehabilitate those suffering from facial defects caused by disease , trauma or birth defects...

.

Treatment is multidisciplinary involving oral and maxillofacial surgeons, plastic surgeons, ENT surgeons, oncologists, speech therapists, occupational therapists, physiotherapists, and other healthcare professionals.

To be qualified as a Maxillofacial Prosthodontist in the US, requires an additional year of training after completing a 3 year residency training in a Prosthodontics program. Due to their extensive training, breadth of knowledge and capabilities to handle any kind of a complex case, Maxillofacial Prosthodontists are often called as "Bullet-Proof" dentists.

Conditions and Treatment Modalities

  • Akers' Clasp
    Akers' clasp
    An Akers' clasp is the classic direct retainer for removable partial dentures. Named after its inventor, Polk E. Akers, this suprabulge clasp consists of a rest, a guide plate, a retentive arm and a reciprocal arm. Akers' clasps, as a rule, face away from an edentulous area. Should they face the...

  • Amalgam (dentistry)
    Amalgam (dentistry)
    Dental Amalgam is the most commonly used dental restorative material used for dental fillings. First introduced in France in the early 1800s, it contains a mixture of mercury with at least one other metal. Amalgam has been the restorative method of choice for many years due to its low cost, ease of...

  • Bisphosphonate-associated osteonecrosis of the jaws
    Bisphosphonate-associated osteonecrosis of the jaws
    Bisphosphonate-associated osteonecrosis of the jaw, often abbreviated as BON of the jaw or even BRONJ, is a recently discovered dental phenomenon that may lead to surgical complication in the form of impaired wound healing following oral or periodontal surgery or endodontic therapy.There is...

  • Bridge (dentistry)
    Bridge (dentistry)
    A bridge, also known as a fixed partial denture, is a dental restoration used to replace a missing tooth by joining permanently to adjacent teeth or dental implants....

  • Bruxism
    Bruxism
    Bruxism is characterized by the grinding of the teeth and is typically accompanied by the clenching of the jaw. It is an oral parafunctional activity that occurs in most humans at some time in their lives. In most people, bruxism is mild enough not to be a health problem...

  • Centric relation
    Centric relation
    In dentistry, centric relation is the mandibular jaw position in which the head of the condyle is situated as far superior and anterior as it possibly can within the mandibular fossa....

  • Commonly used terms of relationship and comparison in dentistry
    Commonly used terms of relationship and comparison in dentistry
    There are numerous commonly used terms of relationship and comparison that refer to different aspects of teeth and are frequently utilized in articles about dentistry...

  • Crown (dentistry)
    Crown (dentistry)
    A Crown is a type of dental restoration which completely caps or encircles a tooth or dental implant and is typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which are usually fabricated using indirect methods...

  • Crown lengthening
    Crown lengthening
    Crown lengthening is a surgical procedure performed by a dentist to expose a greater height of tooth structure to properly restore the tooth prosthetically. This is done by incising the gingival tissue around a tooth and, after temporarily displacing the soft tissue, predictably removing a given...

  • Crown-to-root ratio
    Crown-to-root ratio
    Crown-to-root-ratio is an important consideration in the diagnosis, treatment planning and restoration of teeth, one that hopefully guides the plan of treatment to the proper end result.-Anatomical terms:...

  • Curve of spee
    Curve of spee
    In Anatomy, the Curve of Spee is defined as the curvature of the mandibular occlusal plane beginning at the tip of the lower cuspid and following the buccal cusps of the posterior teeth, continuing to the terminal molar. According an another definition c...

  • Dental implant
    Dental implant
    A dental implant is an artificial tooth root replacement and is used in prosthetic dentistry to support restorations that resemble a tooth or group of teeth. There are several types of dental implants. The major classifications are divided into osseointegrated implant and the fibrointegrated implant...

  • Dental Phobia
  • Dental Surgery
    Dental surgery
    Dental surgery is any of a number of medical procedures which involve artificially modifying the dentition.-Types:Some of the more common are:* Endodontic ** Root canal...

  • Dentures
    Dentures
    Dentures are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental...

  • Edentulism
    Edentulism
    Edentulism is the condition of being toothless to at least some degree; it is the result of tooth loss. Loss of some teeth results in partial edentulism, while loss of all teeth results in complete edentulism....

  • Fixed prosthodontics
    Fixed prosthodontics
    Fixed prosthodontics in dentistry is a technique used to restore teeth, using fixed restorations , which include crowns, bridges, inlays, onlays, and veneers. Prosthodontists are specialist dentists who have undertaken training recognized by academic institutions in this field...

  • Head and neck anatomy
    Head and neck anatomy
    Head and neck anatomy focuses on the structures of the head and neck of the human body, including the brain, bones, muscles, blood vessels, nerves, glands, nose, mouth, teeth, tongue, and throat...

  • Inlays and onlays
  • Occlusal trauma
    Occlusal trauma
    Occlusal trauma is a dental term that refers to the damage incurred when teeth are left in traumatic occlusion without proper treatment.When the maxillary and mandibular dental arches approach each together, as they do, for example, during chewing or at rest, the relationship between the opposing...

  • Occlusion
    Occlusion
    Occlusion is a term indicating that the state of something, which is normally open, is now totally closed.* In cardiology, the term is often used to refer to blood vessels, arteries or veins which have become totally blocked to any blood flow...

  • Temporomandibular joint disorder
    Temporomandibular joint disorder
    Temporomandibular joint disorder , or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporomandibular joint, which connects the mandible to the skull. The disorder and resultant dysfunction can result in significant pain and impairment...


External links


Societies and Organizations

Scientific Journals

See also

  • Fixed prosthodontics
    Fixed prosthodontics
    Fixed prosthodontics in dentistry is a technique used to restore teeth, using fixed restorations , which include crowns, bridges, inlays, onlays, and veneers. Prosthodontists are specialist dentists who have undertaken training recognized by academic institutions in this field...

  • Dental restoration
    Dental restoration
    A dental restoration or dental filling is a dental restorative material used to restore the function, integrity and morphology of missing tooth structure. The structural loss typically results from caries or external trauma. It is also lost intentionally during tooth preparation to improve the...

  • Ocularist
    Ocularist
    An ocularist is someone who specializes in the fabrication and fitting of ocular prostheses for people who have lost an eye or eyes due to trauma or illness...

  • Craniofacial prosthesis
    Craniofacial prosthesis
    Craniofacial prostheses are prostheses made by individuals trained in anaplastology or maxillofacial prosthodontics who medically help rehabilitate those suffering from facial defects caused by disease , trauma or birth defects...