Saturday, August 8, 2009

Prosthodontics

Prosthodontics is one of nine dental specialties recognized by the American Dental Association, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons. 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.

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, crowns, implant retained/supported restorations). Cosmetic dentistry, implants and temporomandibular joint disorder all fall under the field of prosthodontics.


Training

The American College of Prosthodontists (ACP) 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) or DMD (Doctor of Dental Medicine) degree. Training consists of rigorous preparation in the basic sciences, head and neck anatomy, esthetics, biomedical sciences, biomaterial sciences, function of occlusion (bite), TMD (Temporomandibular joint disorder), 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 disorders, and sleep apnea 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, and often encounter clinical challenges to fix failed treatments rendered by nonqualified "cosmetic dentists". Specifically, these treatment plans include failed full mouth reconstructions performed by general dentists who underwent a weekend or a week-long course prior to treating patients. 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)


Board Certification

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. This is a very rigorous process and so far there are no more than 800 diplomates, thus making diplomates exceptionally qualified . 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.


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, Ocular prosthetic), ears, and maxillary obturators 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.

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
  • Amalgam (dentistry)
  • Bisphosphonate-associated osteonecrosis of the jaws
  • Bridge (dentistry)
  • Bruxism
  • Centric relation
  • Commonly used terms of relationship and comparison in dentistry
  • Crown (dentistry)
  • Crown lengthening
  • Crown-to-root ratio
  • Curve of spee
  • Dental implant
  • Dental Phobia
  • Dental Surgery
  • Dentures
  • Edentulism
  • Fixed prosthodontics
  • Head and neck anatomy
  • Inlays and onlays
  • Occlusal trauma
  • Occlusion
  • Temporomandibular joint disorder

2 comments:

  1. Most of the people suffer from the problem of yellow or brownish teeth called as stains. Many a times, improper brushing technique, lack of dental care and dental hygiene is responsible for this problem.


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