Skeletal prostheses – Stable and comfortable solution for tooth loss

Skeletal dentures, also known as metal partial removable dentures, are an advanced type of dental prosthesis designed to replace several missing teeth in a situation where healthy teeth still remain in the jaw to serve as support. They are based on a strong but subtle metal structure (skeleton), usually made of a biocompatible chromium-cobalt alloy (Cr-Co). Artificial teeth (made of resin or ceramic) and, optionally, pink gum-imitating resin in places where it is aesthetically or functionally necessary, are precisely anchored to this structure.

The key element of skeletal dentures are retention elements that ensure their stability and hold in the mouth. Most often, these are metal cast clasps that precisely surround the remaining supporting teeth. An alternative that offers higher aesthetics (the clasps are not visible) are attachments. These sophisticated mechanisms consist of two parts – one is firmly integrated into the crown or bridge on the abutment tooth (patrician) and the other is part of the skeletal restoration (matrix). This solution provides excellent stability and is almost invisible.

Compared to classic resin partial restorations, skeletal restorations have a number of advantages. Thanks to the metal structure, they are significantly thinner, stronger and less bulky. Especially in the upper restorations, they do not cover the entire palate, which contributes to a better perception of taste, temperature and overall comfort of the patient. The transmission of chewing pressure is more physiological, distributed not only on the mucosa, but mainly on the remaining teeth via clasps or attachments.

Skeletal prostheses are indicated in the following situations:

• Partial tooth loss: Several teeth are missing, but there are still enough strong and strategically placed teeth in the jaw that can serve as a reliable support for the prosthesis.
• Unsuitability of fixed solutions: For various reasons (extent of the defect, condition of the remaining teeth, patient’s health, financial capabilities), a fixed bridge cannot be made or dental implants can be inserted.
• Need for stabilization of the remaining dentition: In some cases, skeletal prostheses can help stabilize the remaining teeth and prevent their further displacement or tilting.
• Long-term provisional solution: Sometimes they can serve as a high-quality temporary solution before planned implantation or other definitive treatment.

The essential prerequisite for The key to successful and long-term functioning of a skeletal prosthesis is the good condition of the remaining teeth and their supporting apparatus (periodontal system). That is why at Dobrý Dent we place great emphasis on a comprehensive initial examination. Using modern diagnostic methods such as digital X-ray and 3D CBCT (Cone Beam Computed Tomography), we can assess the condition of the bone and roots of the teeth in detail. Our experienced team of dentists, operating in Prague 5 since 2010, will carefully evaluate your individual situation and propose the most suitable treatment plan.

Skeletal dentures offer a number of significant benefits over other types of removable dentures:

• Excellent stability and retention: Thanks to the precisely designed metal structure and clasps (or attachments), the denture stays firmly in place while eating and speaking.
• High comfort: The subtle design and minimal coverage of the mucous membranes (especially the palate) ensure comfortable wear and quick adaptation. Patients often appreciate a better perception of the taste and temperature of food.
• Long life and durability: The metal structure is very strong and resistant to breakage. With proper care and regular check-ups, the prosthesis can last for many years.
• Better hygiene: The smaller size of the prosthesis and less contact with the mucous membranes makes it easier to clean both the prosthesis itself and the remaining natural teeth, which reduces the risk of cavities and gingivitis.
• Physiological transmission of chewing pressure: The pressure is transmitted primarily to the abutment teeth, which is gentler on the bone under the missing teeth than with prostheses that transmit pressure only through the mucous membrane.
• Good functionality: They allow for efficient chewing and contribute to clear pronunciation.
• Aesthetics: With careful planning and the use of modern materials, a very natural appearance can be achieved. Especially when using plug-in connections, the result is aesthetically excellent, as no metal elements are visible.

Although skeletal dentures have many advantages, it is fair to mention some potential disadvantages or aspects that need to be considered:

• Visibility of clasps: In dentures with classic cast clasps, these metal elements can be aesthetically disturbing in some cases (especially on the front teeth). This problem can be elegantly solved by using the aforementioned snap-in connections, which are, however, more expensive.
• Adaptation period: As with any new denture, a certain adaptation period must be taken into account before the mouth fully gets used to it. There may be temporary increased saliva production or a foreign body sensation in the mouth.
• Load on abutment teeth: The denture transfers part of the chewing forces to the teeth that hold it. Therefore, precise planning and fabrication of the prosthesis, as well as the perfect condition of the abutment teeth, are key. Regular check-ups at Dobrý Dent are essential to monitor the condition of these teeth.
• The need for perfect hygiene: Food debris and plaque can accumulate around the clasps and under the prosthesis. Consistent hygiene of both the prosthesis and the remaining teeth is absolutely essential for preventing tooth decay and gum disease.
• Price: The production of a skeletal prosthesis is technologically more demanding than simple resin prosthesis, which is reflected in the higher price. However, it is still a more affordable solution than extensive bridges or multiple implants.

At our clinic Dobrý Dent in Prague 5, we approach each patient individually and with the utmost care. The process of making a skeletal prosthesis usually involves several visits:

1. Introductory consultation and examination: We start with a thorough conversation about your needs and expectations. We will perform a comprehensive dental examination, including an assessment of the condition of the remaining teeth, gums and bone. To do this, we use modern diagnostic tools such as digital X-rays and, if necessary, 3D CBCT for a detailed view of anatomical structures. Based on this information, we will discuss all treatment options together and propose the optimal solution.
2. Treatment planning and preparation: If you decide on a skeletal prosthesis, we will draw up a detailed treatment plan. This may also include any preparatory phase, such as treatment of caries, endodontic treatment (root canal treatment) or professional dental hygiene. The health of the remaining teeth is crucial for the success of the restoration.
3. Impression: To make a perfectly fitting restoration, we need precise impressions of your jaws. In addition to classic impression materials, at Dobrý Dent we also use a top-notch 3D intraoral scanner. This digital impression is much more comfortable for the patient (without the unpleasant gag reflex), faster and, above all, extremely accurate, which is the basis for a perfect result.
4. Metal structure test: A metal framework for the restoration is made in the dental laboratory based on the digital model or classic impression. During the next visit, we will carefully test its accuracy and fit in the mouth.
5. Test with a wax model of teeth: A metal framework is built in wax on top of the artificial teeth. During this test, we verify the correct bite, position of the teeth, their shape, color and overall aesthetics. Together with you, we will fine-tune the final appearance of your new smile.
6. Delivery of the finished restoration: After you approve the wax model, the restoration is completed in the laboratory. During the final visit, we will hand over the restoration to you, check its function and comfort when wearing it. We will make any minor adjustments to ensure maximum comfort. All procedures that could be potentially uncomfortable are performed using modern and gentle computer-controlled STA anesthesia, which ensures painless treatment.
7. Instruction and aftercare: We will provide you with detailed information on how to properly care for your new restoration and how to maintain the hygiene of your remaining teeth. We will also schedule regular check-ups, which are important for long-term monitoring of the condition of the restoration and your teeth.

The Dobrý Dent Clinic is committed to using the most modern technologies that increase the quality of treatment, the accuracy of results and the comfort of patients. When making skeletal restorations, we are helped by:

• 3D intraoral scanner: For fast, convenient and highly accurate digital impressions without the use of traditional materials.
• 3D CBCT X-ray: Provides a detailed three-dimensional image of the teeth, jaws and surrounding structures, which is invaluable for accurate planning and diagnosis.
• Operating microscope: Enables our doctors to work with maximum precision when preparing teeth (e.g. for attachments) or when checking the details of the restoration. Magnification ensures perfection at every step.
• Computer-controlled STA (Single Tooth Anesthesia): Ensures painless application of anesthetic with minimal discomfort and without unnecessary numbing of surrounding tissues.

Thanks to these technologies and the experience of our team, we can offer you skeletal restorations that are not only functional and durable, but also highly aesthetic and comfortable.

Proper care is key to the longevity of your dentures and the health of your remaining teeth. We recommend the following:

• Cleaning your dentures: Remove your dentures after each meal and rinse them under running water. Clean them thoroughly at least twice a day with a soft toothbrush and a special denture cleaner or non-abrasive soap (do not use regular toothpaste, as it may be too abrasive). Pay special attention to the clasp area and the inner surfaces of the denture.
• Cleaning your own teeth: Don’t forget to thoroughly clean the remaining teeth with a regular toothbrush and toothpaste, use interdental brushes and dental floss, especially around the abutment teeth that the clasps rest on.
• Night mode: Unless your doctor recommends otherwise, it is advisable to remove the denture at night and store it in a humid environment (e.g. in a box with water or a special solution) to prevent its deformation.
• Regular check-ups: Have regular preventive check-ups at Dobrý Dent (usually every 6 months). The doctor will check the condition of the denture, its fit, the condition of the abutment teeth and mucous membranes. If necessary, he will make adjustments or recommend professional cleaning of the denture.

Choosing a dental clinic is an important decision. At Dobrý Dent we offer you:

• Experience and expertise: We have been providing comprehensive dental care in Prague 5 since 2010. Our team has extensive experience in the field of prosthetics, including the manufacture of skeletal restorations.
• Leading technologies: We invest in modern equipment (3D scanner, CBCT, microscope, STA anesthesia), which allows us to work more precisely, efficiently and with greater comfort for you.
• Individual approach: Each patient is unique to us. We dedicate time to thorough diagnosis, consultation and treatment planning tailored to your needs and wishes.
• Quality materials: We use only certified and biocompatible materials from renowned manufacturers, which guarantee the safety and long life of the restoration.
• Comprehensive care under one roof: We offer a wide range of dental services from dental hygiene to restorative dentistry to implantology and prosthetics.
• Pleasant environment and patient care: We want you to feel good with us. Our modern clinic in Anděl is designed for your maximum comfort and our staff is always ready to assist you.
• Transparency: We will always provide you with a detailed treatment plan and price calculation before starting treatment.

If you are considering a solution to tooth loss with a skeletal prosthesis, or have any questions regarding your dental health, do not hesitate to contact us. We are here to help you regain a functional and beautiful smile.