Composite prosthesis

Composite prosthesis

The design of composite prostheses is based on a careful analysis of parasitic movements.

The various classic elements of the chassis, to which must be added the millings and the attachments, are used to neutralize these movements.

The composite prosthesis is characterized by being complex to produce and difficult to manage at the design stage and in mastering the therapeutic sequences.

Mixed prosthesis

Composite prosthesis treatment combines on the same arch, a prosthesis attached to a removable partial prosthesis (PAP)

The morphology of the joint elements is modified to promote the stabilization of the removable prosthesis (guide surfaces, milling) and can integrate various attachment systems, ensuring the connection with the latter (slides, clips, etc.).

The development of the fixed prosthesis always precedes that of the removable prosthesis, the design of which is dictated by the principles of balance.

This applies to the production of a single crown intended to receive a hook as well as to the production of large bridges in which milling will be provided to increase the friction of the PAP.

Indications

• in the case of crowns on teeth or implants to be developed when a PAP is planned,

In case of dental decay of the teeth bordering the edentulism .
In the presence of an aesthetic, mechanical requirement.

Benefits :

improved comfort thanks to better distribution and better quality of dental and mucosal support, by optimizing Housset’s triad (sustenance, stabilization, retention).
removal of unsightly hooks in favor of attachments
To meet the patient’s aesthetic requirements
ensure the retention of the future prosthesis
To satisfy the principle of prophylaxis, by solidifying the supporting teeth to better distribute the occlusal forces.

Composite prosthesis

Treatment plan

Develop a therapeutic protocol starting with a prospective assembly which will allow the provisionals to be carried out.

The sealed prosthesis steps will be carried out before those of the mobile prosthesis. This will allow the best use to be made of the different support surfaces.

Production of the joint prosthesis : highlights, for example, a possible project to produce coronal -radicular anchors .

The sequence of design steps is done by conventional technique, up to the production of bridge or crown frames, carrying an attachment ( male part) or a milling surface. Then the design of the superstructure.

The fixed prostheses are tried and validated in the mouth, then stabilized on the dental preparations by a material which temporarily seals them. They are driven into the recorded impression for the creation of the frame.

Production of the partial removable prosthesis :

The process begins with taking a precise impression, inside which the sealed prostheses are left.

Transferring the crowns to the laboratory via the impression will allow the prosthetist to make the frame without the risk of alteration that a plaster reproduction would present.

Design of a metal frame according to a conventional layout depending on the type of tooth to which the 2nd part of the attachment ( female part) is connected.

First, the crowns are sealed with a sealing cement and held in place during the setting time, then the removable partial prosthesis is inserted.

Delayed sealing of fixed prostheses, which is only done when the removable partial prosthesis is placed in the mouth, facilitates the laboratory steps and improves the final result of adaptation of the removable partial prosthesis.

Delayed sealing is essential if the fixed prosthesis has an attachment.

Conclusion

Composite prosthetics require a close relationship between the practitioner and the prosthetists intervening successively during the different stages:

Development of fixed elements
Development of the metal frame and assembly of the teeth.

In addition to the roles of practitioner and architect designing the prosthetic project, there is also that of coordinator between the different prosthetists.