Prosthodontics, also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses. It is one of 12 dental specialties recognized by the American Dental Association (ADA),

Royal College of Surgeons of England The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgical care for patients, and regulates surgery and dentistry in England and Wales. T ...

Royal College of Surgeons of Edinburgh The Royal College of Surgeons of Edinburgh (RCSEd) is a professional organisation of surgeons. The College has seven active faculties, covering a broad spectrum of surgical, dental, and other medical practices. Its main campus is located o ...

Royal College of Surgeons of Ireland The Royal College of Surgeons in Ireland (RCSI) is a medical professional and educational institution, which is also known as RCSI University of Medicine and Health Sciences, Ireland's first private university. It was established in 1784 ...

, Royal College of Surgeons of Glasgow,

Royal College of Dentists of Canada The Royal College of Dentists of Canada (RCDC; french: Collège royal des chirurgiens dentistes du Canada) is a regulatory college which administers examinations for qualified dental specialists as part of the dentistry profession in Canada. Its h ...

, and

Royal Australasian College of Dental Surgeons The Royal Australasian College of Dental Surgeons (RACDS) is a postgraduate professional education body established in 1965 to provide a broad range of activities to enhance the professional development of both general and specialist dentists thr ...

. The ADA defines it as "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 or oral and maxillofacial tissues using

biocompatible Biocompatibility is related to the behavior of biomaterials in various contexts. The term refers to the ability of a material to perform with an appropriate host response in a specific situation. The ambiguity of the term reflects the ongoing de ...

substitutes."

History

Dental prostheory was pioneered by French surgeon

Pierre Fauchard Pierre Fauchard (January 2, 1679 – March 21, 1761) was a French physician, credited as being the "father of modern dentistry". He is widely known for writing the first complete scientific description of dentistry, ''Le Chirurgien Dentiste'' (''" ...

during the late 17th and early 18th century. Despite the limitations of the primitive surgical instruments, Fauchard discovered many methods to replace lost teeth using substitutes made from carved blocks of

ivory Ivory is a hard, white material from the tusks (traditionally from elephants) and teeth of animals, that consists mainly of dentine, one of the physical structures of teeth and tusks. The chemical structure of the teeth and tusks of mammals i ...

bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...

. He also introduced

dental braces Dental braces (also known as braces, orthodontic cases, or cases) are devices used in orthodontics that align and straighten teeth and help position them with regard to a person's bite, while also aiming to improve dental health. They are often ...

to correct the position of teeth using gold wires and silk threads.

Training

According to the American College of Prosthodontists, a prosthodontist is a dentist who: # Specializes in the aesthetic (cosmetic) restoration and replacement of teeth. # Receives three to four years of additional training after dental school. # Restores optimal appearance and function to your smile. The planning, surgical placement (subcrestal prosthodontics) and restoration of implants and rehabilitation of

occlusion Occlusion may refer to: Health and fitness * Occlusion (dentistry), the manner in which the upper and lower teeth come together when the mouth is closed * Occlusion miliaria, a skin condition * Occlusive dressing, an air- and water-tight trauma ...

with prostheses all fall under the field of prosthodontics. The American College of Prosthodontists (ACP) ensures standards are maintained in the field. Becoming a prosthodontist requires an additional three years of postgraduate specialty training after obtaining a dental degree. Recently, the ADA's Commission on Dental Accreditation (CODA) passed the updated educational standards for all prosthodontics programs in the United States that now mandates surgical placement of dental implants (subcrestal prosthodontics) at an in-depth competency level (on par with other surgical dental specialties) Training consists of rigorous clinical and didactic preparation in the basic sciences,

head and neck anatomy This article describes the anatomy of the head and neck of the human body, including the brain, bones, muscles, blood vessels, nerves, glands, nose, mouth, teeth, tongue, and throat. Structure Bones The head rests on the top part of the vertebra ...

, biomedical sciences, biomaterial sciences, implant surgery, function of occlusion (bite), TMJ, and treatment planning and experience treating full-mouth reconstruction cases, and esthetics. Due to this extensive training, prosthodontists are required to treat complex cases, full-mouth rehabilitation, TMJ-related disorders,

congenital disorders A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...

, and

sleep apnea Sleep apnea, also spelled sleep apnoea, is a sleep disorder in which pauses in breathing or periods of shallow breathing during sleep occur more often than normal. Each pause can last for a few seconds to a few minutes and they happen many tim ...

by planning and fabricating various prostheses. There are only 3,200 prosthodontists in comparison to 170,000 general dentists in the United States. Prosthodontists have been consistently ranked at 6th or 7th positions by Forbes among America's most competitive and highest salaried jobs. Board certification is awarded through the American Board of Prosthodontics (ABP) and requires successful completion of the Part I written examination and Part 2, 3 and 4 oral examinations. 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. 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. According to the ADA, specialties are recognized in those areas where advanced knowledge and skills are essential to maintain or restore oral health (Principles of Ethics and Code of Professional Conduct). Not all areas in dentistry will satisfy the requirements for specialty recognition. Acknowledged by the profession, the contributions of such and their endeavors are encouraged. The American Dental Association does not recognize

cosmetic dentistry Cosmetic dentistry is generally used to refer to any dental work that improves the appearance (though not necessarily the functionality) of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, ...

as a speciality. Prosthodontics is the only dental speciality under which the concentration of cosmetic/esthetic dentistry falls. General dentists may perform some simple cosmetic procedures. Consequently, there are questions regarding whether it is ethical for general dentists to treat "smile makeovers" or complex cosmetic and full-mouth reconstruction cases, as they are not qualified to address the complex needs of the patient. Likewise, there is no specialty recognized by the ADA for dental implants.

Maxillofacial prosthodontics/prosthetics

Maxillofacial prosthetics (Oral and Maxillofacial Prosthodontics) is a sub-specialty (or super-specialty) of prosthodontics. All maxillofacial prosthodontists first specialize in prosthodontics and then super-specialize with a one year fellowship exclusively in maxillofacial prosthetics. A fellowship provides intensive clinical, hospital and laboratory training. Maxillofacial prosthodontists treat patients who have acquired and congenital defects of the

head and neck This article describes the anatomy of the head and neck of the human body, including the brain, bones, muscles, blood vessels, nerves, glands, nose, mouth, teeth, tongue, and throat. Structure Bones The head rests on the top part of the vertebra ...

and maxillofacial region due to cancer, surgery, trauma, or birth defects. Maxillary obturators, speech-aid prosthesis (formerly called as pharyngeal/soft palate obturators) and mandibular-resection prostheses are the most common intra-oral prostheses planned and fabricated by Maxillofacial prosthodontists. Facial prostheses include artificial eyes, nose, ears and other facial prostheses fabricated by the clinician or in conjunction with an

anaplastologist Anaplastology (''Gk. ''ana''-again, anew, upon ''plastos''-something made, formed, molded ''logy''-the study of'') is a branch of medicine dealing with the prosthetic rehabilitation of an absent, disfigured or malformed anatomically critical locati ...

. Treatment is multidisciplinary, involving oral and maxillofacial surgeons, plastic surgeons, head and neck surgeons, ENT doctors, medical oncologists, radiation oncologists, hospital dentists, speech pathologies (speech therapists), clinical psychologist, occupational therapists, physiotherapists, and other healthcare professionals. The

American Academy of Maxillofacial Prosthetics American(s) may refer to: * American, something of, from, or related to the United States of America, commonly known as the "United States" or "America" ** Americans, citizens and nationals of the United States of America ** American ancestry, pe ...

is the academy of this discipline: https://www.maxillofacialprosthetics.org.

Conditions

All-on-4 The term All-on-4, also known as All‐on‐Four and All‐in‐Four, refers to 'all' teeth being supported 'on four' dental implants, a prosthodontics procedure for total rehabilitation of the edentulous (toothless) patient, or for patients wi ...

Bisphosphonate-associated osteonecrosis of the jaw Medication-related osteonecrosis of the jaw (MON, MRONJ) is progressive death of the jawbone in a person exposed to a medication known to increase the risk of disease, in the absence of a previous radiation treatment. It may lead to surgical compl ...

* Bruxism *

Edentulism Toothlessness, or edentulism, is the condition of having no teeth. In organisms that naturally have teeth, it is the result of tooth loss. Organisms that never possessed teeth can also be described as edentulous. Examples are the members of th ...

Occlusal trauma Occlusal trauma is the damage to teeth when an excessive force is acted upon them and they do not align properly.Bibb, CA: Occlusal Evaluation and Therapy in the Management of Periodontal Disease. In Newman, MG; Takei, HH; Carranza, FA; editors: ...

Temporomandibular joint disorder Temporomandibular joint dysfunction (TMD, TMJD) is an umbrella term covering pain and dysfunction of the muscles of mastication (the muscles that move the jaw) and the temporomandibular joints (the joints which connect the mandible to the skull ...

Treatment modalities

Bridge A bridge is a structure built to span a physical obstacle (such as a body of water, valley, road, or rail) without blocking the way underneath. It is constructed for the purpose of providing passage over the obstacle, which is usually somethi ...

Centric relation In dentistry, centric relation is the mandibular jaw position in which the head of the condyle is situated as far anterior and superior as it possibly can within the mandibular fossa/glenoid fossa. It is defined as, ''"The maxillo-mandibular rel ...

Crown A crown is a traditional form of head adornment, or hat, worn by monarchs as a symbol of their power and dignity. A crown is often, by extension, a symbol of the monarch's government or items endorsed by it. The word itself is used, partic ...

* Veneer *

Dental surgery Dental surgery is any of a number of medical procedures that involve artificially modifying dentition; in other words, surgery of the teeth, gums and jaw bones. Types Some of the more common are: * Endodontic (surgery involving the pulp or r ...

* Complete dentures *

Fixed prosthodontics Fixed prosthodontics is the area of prosthodontics focused on permanently attached (fixed) dental prostheses. Such dental restorations, also referred to as indirect restorations, include crowns, bridges (fixed dentures), inlays, onlays, and ve ...

Inlays and onlays In dentistry, inlays and onlays are used to fill cavities, and then cemented in place in the tooth. This is an alternative to a direct restoration, made out of composite, amalgam or glass ionomer, that is built up within the mouth.Inlays and onl ...

Removable partial denture A removable partial denture (RPD) is a denture for a partially edentulous patient who desires to have replacement teeth for functional or aesthetic reasons and who cannot have a bridge (a fixed partial denture) for any reason, such as a lack of ...

* SMK- Composite Bridge System * Implant dentistry * Full mouth rehabilitation

References