Dental prostheses

The outpatient unit of the Policlinic for Dental Prosthetics is the essential go-to point for all patients at their initial visit. Our seasoned dentists will perform an initial clinical exam and counsel you based on the findings. Depending on the complexity and extent of the expected treatment, this is followed by in-depth consultation and treatment by licensed dentists or – as part of their dentist training – by students.

Other tasks of the outpatient unit of the Policlinic for Dental Prosthetics include:

• Interdisciplinary consults and treatment of out-/inpatients of the university clinical centre Regensburg,
• Offering acute therapy for pain patients, and
• Repair of defective dental prostheses.

Please bring all documents which may be relevant to the diagnosis and treatment to your appointment (e.g., your latest x-rays, medication schedules or allergy pass cards).

Your oral health is at the heart of what we do. We deliver dental prostheses and preserve both your natural dentition and dentures. We provide prophylaxis and prevention to forestall the development and/or progress of illness. To achieve this, we offer a dental concept designed to support you from the start of the therapy up to long-term follow-up care.

Early detection: once a year!

A regular, thorough check-up helps detect diseases at an early stage and enables an early, targeted intervention. To enjoy the full benefits of this, at least one dental check-up per year is necessary, or more frequently if you're a high-risk patient. We will assess your teeth, periodontium, and oral mucosa as part of the preventive dental check-up. If necessary, we can take x-rays to allow a more in-depth diagnosis. The results and necessary treatment will then be discussed with you.

The most common dental diseases

The most common dental diseases are:

• Gingivitis (gum inflammation),
• Periodontitis (inflammation of the periodontium), and
• Caries (disease of the hard tooth tissue).

These conditions are caused by bacterial tooth deposits, also know as biofilm or plaque, which keep forming on the oral surfaces all the time. It must be removed at regular intervals to prevent these diseases and the resultant irreversible damage.

Core issues of dental prophylaxis

By engaging in personal oral hygiene at home, you're making a key contribution to dental prevention. This effort is rounded out by professional tooth cleaning which serves to remove all hard and soft deposits. Smooth tooth surfaces facilitate care at home.

In addition, you'll be given recommendations for your oral hygiene routine at home in the form of the so-called oral hygiene instruction, tailored specifically to you and your teeth.

This includes:

• An analysis of your oral hygiene as it is,
• Recommendations of appropriate tooth care aids,
• Learning how to brush your teeth and maintain your interdental spaces correctly,
• Beside the professional tooth cleaning, the professional cleaning of your dental prostheses and proper care instructions
• Plus many more useful tricks

Particular aspects

There are a few particular aspects that should be kept in mind if you are elderly, have a systemic illness or undergo hormonal changes. People with manual impairments, tumours or dry mouth, as well as the pregnant, must be particular careful about their oral hygiene. Athletes, too, may require special instructions or protection, for example to avoid or treat acid-induced tooth damage ("erosion") caused by nutrition and sport drinks.

Today, the steady advancements in the field of dental materials and processing techniques allow for highly aesthetic restorations consisting of tooth-coloured materials to be anchored to existing teeth in a minimally invasive and reliable manner.

Veneers, tabletops, and adhesive bridges

All restorations are glued to dental surfaces. They comprise so-called veneers, tabletops, and adhesive bridges.

• Veneers are thin, ceramic or plastic facings that are glued to the surface of frontal teeth to optimise aesthetics or achieve a functional improvement. As a general rule, veneers have a layer thickness of less than a millimetre meaning low invasiveness and, hence, a low risk of pathogens entering into the tissue.
• Crowns , too, can be kept thinner than in the past thanks to the utilisation of cutting-edge materials; they're called 360° veneers.
• Tabletops are the equivalent of veneers in the area of the posterior teeth. They are thin chewing surfaces consisting of ceramic or plastic which serve to adjust or optimise bite. They, too, belong to the minimally invasive therapeutic options.
• Adhesive bridges serve as replacements for undeveloped or lost teeth in the frontal and posterior areas. Unlike traditional bridges, they require very little in the way of preparing the anchor teeth. The surgical needs and sometimes long treatment times required by implant restorations are also eliminated. This makes adhesive bridges the therapy of choice especially in children and adolescents with anodontia. Modern adhesive bridges are manufactured from fully ceramic materials and, in many cases, are attached to just one anchor tooth. In addition, the oral mucosa may sometimes require dental interventions to optimise aesthetics. Despite their low invasiveness, adhesive bridges give excellent permanent results which is on par with classic restorations or implant restorations as regards both aesthetics and function.

Fixed prostheses are permanently attached to the remainder of the tooth. Neither the dentist nor patient can detach it. It serves to replace the lost hard tooth tissue, stabilise the remainder of the tooth, and restore function and aesthetics to the tooth or teeth. A minimum number of teeth and favourable distribution of remaining teeth is of the essence for a fixed prosthesis.

There are different types of fixes prostheses:

• Partial crown: only a part of the tooth is replaced; tooth walls are preserved.
• Crown: the natural tooth is fully enclosed and covered. As part of the preparations, the tooth is reduced on all sides and in the area of the chewing surface by the layer thickness of the crown material.
• Bridge: designed to replace lost or undeveloped teeth. In most cases, the teeth next to the gap are prepared in the same way as for a crown.

Fixed prostheses may come in the following materials:

• Ceramics,
• Plastics,
• Composites,
• Metals.

Materials are selected depending on functional, aesthetic, and financial aspects.

Implants may be eligible in a broad range of clinical situations. They're mostly made of titanium and less commonly of ceramic. They're directly implanted into toothless jaw segments to replace the root of one or more missing teeth.

The Policlinic for Dental Prosthetics delivers the full range of modern implant prostheses. We plan and treat many complex situations in close collaboration with the Clinic and Policlinic for Oral, Mandibular and Facial Surgery.

Healing over several weeks

As a rule, the implants will only be stressed after allowing several weeks for healing; it is only then that the dental prosthesis is installed. In many cases, implants help spare surrounding tissue structures and significantly improve the wearing comfort of the prosthesis. Fixed prostheses can thus be permanently anchored in the form of crowns and bridges. Implants may also be used to optimise the stability of removable dentures.

Implants or conventional prostheses?

Implantation is elective and should hence be weighed against treatment with conventional prostheses in view of the patient's general state of health. The individual anatomic make-up of a toothless jaw section, too, may complicate the treatment with implant prostheses. More often than not, it may be necessary to build up the jaw bone and surrounding soft tissues as part of the implant therapy.

Cost coverage

The statutory health funds will subsidise implant-borne prostheses under the fixed-subsidy system. The costs of the implantation itself, however, will only be borne in exceptional cases.

Removable dentures may present a high-quality and convenient solution especially when multiple or all teeth are missing. This applies in particular if the fixed prosthesis can no longer be anchored to the patient's own teeth due to an unfavourable prognosis and implants are ineligible for personal, financial or health reasons.

Benefits of removable dentures:

• Removable dentures are generally easy to maintain and clean. They can be removed from the mouth for cleaning, and the remaining teeth can be cleaned with a tooth brush, floss, and interdental brush.
• Depending on the design, removable dentures are easy to repair and extend at relatively low cost in many cases.
• Given appropriate care and regular dental checks, removable dentures will often last very long.
• As a rule, treatment with removable dentures is significantly less expensive and sometimes also less time-consuming than fixed alternatives and/or implants.

Removable dentures and especially the type of anchoring offer a host of options. The planning is always based on the individual clinical situation. The type, quality, and number of remaining teeth are essential to the planning of removable dentures. Individual desires and needs of the patient, too, can be accounted for in the design, such as aesthetic or material options or incompatibilities. Special requirements posed by patients with reduced agility and ability to pursue oral hygiene can also be incorporated in the design of a prosthesis.

Total prostheses

When all teeth in one or both jaws are lost, there are basically two treatment options:

• different implant-based fixed or removable prostheses can be provided.
• If implantation is not possible or desired, so-called total prostheses are available. These are custom-made in multiple steps and are fixed via exact fitting of the prosthesis base to the toothless jaw sections. This prosthesis type offers excellent repairability and, hence, durability.

Partial prostheses

Partial prostheses are provided if sufficient remaining dentition is available for anchoring which, however, cannot handle the stress imposed by fixed prostheses. Depending on the condition, number and distribution of the remaining teeth, different anchoring and design options are available for the prosthesis.

Most commonly used partial prostheses:

• Clamp/model casting prostheses
• Double-crown prostheses
• Attachment prostheses

If you'd like to be treated by students of dentistry, please turn to the outpatient unit of the Policlinic for Dental Prosthetics. Since not all cases are eligible for treatment by students, experienced dentists will decide during the initial presentation whether treatment by students is possible, subject to the complexity of your specific case.

Under guidance and supervision by experienced dentists 

The advanced students are in the last semesters of their clinical training and perform treatments at their level of training under the guidance and supervision by tutoring dentists. The treatment is performed in so-called treatment boxes which are designed like a regular dentist's room. It is assigned to a student who will then carry out the full treatment from beginning to end under supervision.

Demand is high so you may be put on a waiting list. In most cases, a morning or afternoon should be allowed for the treatment. Two students, one of whom is in charge and the other providing assistance, work in each treatment box. Every single work step will be checked by a dentist. Specific work steps are additionally presented to the course instructor.

Treatment and cost schedule

Just like in a dentist's practice, the initial assessment is followed by the preparation of a treatment and cost schedule, which will be executed after the health fund has given its consent. In this context, treatment by students is cheaper than by licensed dentists.

We offer a broad range of prosthetic treatment options within the framework of the student courses of the university clinical centre Regensburg. 

This includes:

• Check-ups,
• Relining and repair,
• Functional analytical and therapeutic measures,
• Fabrication of fixed prostheses in the form of crowns and bridges from various tooth-coloured and metal materials,
• Removable dentures in the form of temporary prostheses, partial prostheses, and total prostheses,
• Combined fixed-removable prostheses in the form of telescope or attachment prostheses.

Many of our patients suffer from various conditions, have a complex history or take specific drugs. To account for these different aspects, the Policlinic for Dental Prosthetics works in close collaboration with other disciplines. 

Treatment of dental accidents

The tooth trauma unit of the university clinical centre Regensburg is open 24/7 to patients with tooth accidents resulting in tooth trauma, where they receive the optimal interdisciplinary treatment.

Diagnostic assessment of craniomandibular dysfunctions

We offer the diagnostic assessment of craniomandibular dysfunctions in a specialised clinic of the Policlinic for Dental Prosthetics. The subsequent multimodal therapy takes place in collaboration with other disciplines including oral, mandibular and facial surgery, physiotherapy, and radiology. Our research topics include the therapy of degenerative diseases of the mandibular joints such as osteoarthritis, which are often painful. As part of a scientific study, we address the question in cooperation with the clinic and policlinic for radiation therapy how the irradiation of the mandibular joint may help reduce the painfulness and improve function. The Policlinic for Dental Prosthetics is a member of the interdisciplinary tinnitus centre of the university of Regensburg.

Dysgnathia, tooth anomalies, and anodontia

The therapy of innate or acquired severe dysgnathia, tooth anomalies or innate hypodontia / anodontia may require a coordinated interdisciplinary treatment approach. In such cases, diagnostics and therapy are carried out by professionals in the field of orthodontics, oral, mandibular and facial surgery as well as dental prosthetics.

Oncology clinic: dental prostheses and covering of defects

The Clinic and Policlinic for Oral, Mandibular and Facial Surgery, together with the Policlinic for Dental Prosthetics, offers an oncology clinic to coordinate the therapy of patients with benign or malign tumours. Here the Policlinic for Dental Prosthetics provides dental prostheses and the so-called intraoral defect covering with obturators. An obturator is a prosthesis or palatal closing plate covering a defect to improve food intake and speech in cases in which surgical intervention is impractical. 

Gnashing, pressing, and chattering of teeth are summed up under the term bruxism. Bruxism belongs to the group of parafunctions – an umbrella term for a non-natural use of the chewing apparatus. It is amenable to a broad variety of therapies. Facial pain, mandibular joint noises or reduced mobility of the lower jar are all symptoms of a craniomandibular dysfunction (CMD). In many cases, parafunctions and dysfunctions in the facial area are multifactorial, meaning they are determined by a number of factors: strong masticatory muscles, changes in the mandibular joint cartilage as well as psychosocial factors such as stress or hormones may have a significant influence on the clinical picture.
Details of the mandibular joint clinic

Dental guard therapy

The Policlinic for Dental Prosthetics offers a wide range of dental guards, including acute guards, biofeedback guards, tooth-coloured guards, and adjusted guards which are highly customised based on a measurement of your mandibular joints. Snorer guards or tooth correctors, too, are available in cooperation with the Policlinic for Orthodontics.

Training

The Policlinic for Dental Prosthetics has partnered with the certified DC/TMD Training Centre at the University of Leipzig. Please write an e-mail to prothetik@ukr.de if you're interested in the training. We'll be happy to send you our course information material.

The Policlinic for Dental Prosthetics provides rehabilitation services for special-needs patients in close coordination with other participating specialist departments, including but not limited to the Clinic and Policlinic for Oral, Mandibular and Facial Surgery. We use both conventional and implant-bearing dental prostheses in this context.

The rehabilitation of special-needs patients is necessary in the following situations:

• Post reconstructive surgery defects in connection with tumour diseases,
• Inflammations of the jaw bone,
• Accidents,
• Impact/gunshot/horse kick injuries, and
• Anodontia and tooth malformations.

The Policlinic for Dental Prosthetics, in close coordination with the Policlinic for Orthodontics and the Clinic and Policlinic for Oral, Mandibular and Facial Surgery also treats patients with:

• Multiple anodontia,
• Tooth and jaw bone malformations,
• Cleft lip, cleft jaw, and cleft palate.

Digitisation has been gaining importance in dentistry for years, letting dentists, dental technicians, and patients benefit from a plethora of innovations.

In dentistry, it involves digitising the workflow in the field of dental medicine and dental technology. It is gradually supplanting all or some of the traditional procedures and methods.  This is exemplified by the digital-optical scanning of teeth with a so-called intraoral scanner that may often replace the impression taking process with tray and impression compound which many patients are uncomfortable with.

Computer-assisted dental prosthesis design

Depending on the individual clinical picture, many of the steps required to produce a dental prosthesis are translatable to digital processes. In this context, the computer-assisted design of dental prostheses and the computer-assisted production based on subtractive and additive processes (milling and grinding, 3D print) have taken root in the field of dental technology. Today, these methods are known as CAD/CAM technologies and have become essential to modern dental technology. In CAD/CAM technology, restorations are designed with the help of a specific software. In the next step, the structure is milled, ground or printed from the specified material. CAD/CAM-designed dental prostheses have the benefit over traditional processes that the underlying materials are standardised industrial products. This improves mechanical properties, homogeneity, and chemical stability and reduces the number of gaps. This, in turn, benefits the patient because it helps prolong the life cycle of the prosthesis thanks to the optimised and consistent properties.

The Policlinic for Dental Prosthetics uses these modern procedures to produce dental prostheses, including digital-optical tooth scanning with intraoral scanners and reliance on CAD/CAM technologies in our own dental laboratory.

Every dental prosthesis is unique. Delivering the best functional and aesthetic result possible takes years of experience as well as teamwork and know-how. Another key factor is the close communication between dentist and dental technician. This is why all dental prostheses delivered by the Policlinic for Dental Prosthetics are made in our internal dental laboratory or in select dental laboratories in and near Regensburg.

The internal dental lab of the Policlinic for Dental Prosthetics has both cutting-edge technical equipment and dental technicians who use their long-standing experience to produce highly aesthetic fixed prostheses to high levels of precision. The short distances involved are also advantageous in various dental treatment steps such as the selection of tooth colour or joint counselling and repair of dental prostheses. Dental technicians also benefit from the close coordination with representatives of the dental material sciences.