Hi, I'm Berna Saglik. I'm a Clinical Associate Professor in the Department of Biological Material Sciences, Division of Prosthodontics, here at the University of Michigan School of Dentistry. Today, I'll be sharing with you what our specialty is about, and how we utilize that to help our patients. So, what is prosthodontics? Prosthodontics is one of the nine dental specialties recognized by the American Dental Association, it pertains to treat the patients that present with missing teeth or deficiency of tooth structure, missing or deficiency of oral and maxillofacial structures, by using biocompatible substitutes. We do that through the diagnosis, treatment, planning, rehabilitation, and maintenance of these patients by providing them with the comfort, appearance, oral function, and health that you're looking for. So, how do you become a prosthodontist? A prosthodontist is a dentist that has completed Dental School, plus an additional three years of advanced specialty training and education in an ADA-accredited prosthodontic graduate program. We specialize in treating and handling dental and facial problems that involve restoring missing tooth or jaw structures. A prosthodontist is highly trained in dental cosmetics, dental implants, crowns, veneers, bridges, full dentures, partial dentures, temporomandibular disorders, and many more. So, as prosthodontists, what can we do for patients? Well, we can help them to restore their smile and their function. As you can see on the slide, the patient presented with two of their front teeth broken down. We can help them restore that smile by placing caps on the teeth, or crowns on the teeth, so that they can go back to where they were before they lost the teeth. Sometimes our patients present with more complex needs, such as missing teeth. We help them to restore that by making bridges to restore the missing tooth structure, as well as replacing the missing teeth with bridges. As you can see in this picture the patient received two bridges to restore their missing teeth in the front area. Prosthodontists can also handle very complex cases where the patient presents with multiple missing teeth and sometimes all of their teeth. In those cases, we can provide complete dentures to help them gain the function and the comfort and aesthetics that they lost with the loss of these teeth. Some of our patients sometimes present with some of their teeth still remaining and some of them are missing. We can fabricate removable partial dentures for these patients so that we can restore the missing teeth, while we keep their remaining teeth in a healthy condition. Prosthodontists can also treat very complex cases, where a patient can be presenting with missing tooth structures as well as oral and maxillofacial structures, due to oral cancer, traumatic injuries, birth defects, and many more. The slide that I'm sharing right now shows a patient that had lost part of their upper jaw due to oral cancer, and an obturator was fabricated and delivered to the patient to restore the missing tooth structures as well as the jaw structures. Prosthodontists use extensive state-of-the-art technology while we render these services. The slide I'm sharing shows an example of a CT scan of a patient where dental implants were planned in such a way that it will not damage the patient's oral structures, anatomical landmarks, nerves, adjacent teeth. This is all planned on software and transferred to a guide, and so that the final plan can be delivered with high precision and accuracy as well as safety to the patients. Prosthodontists can place and restore dental implants. Dental implant placement can also be sometimes referred to other specialties, but prosthodontists can also place and restore dental implants. It could be as simple as a dental implant restoration on a single tooth all the way to restoring the full dentition with dental implants. Overall, through all these complex cases, advanced procedures, we try to provide the patients with the best, beautiful smiles that they’re looking for, making a dramatic effect on their lives by providing the smiles and the comfort that they are longing for. It’s a dramatic experience for the patient, and a very satisfying experience for the provider to see the look on these patients when the treatment is rendered, in terms of to see the excitement on their faces on how they feel, how they look, how they function. So, it's a very satisfying experience for both the patient and the provider. What is new in prosthodontics? Prosthodontics traditionally uses what we call the “analog” methods. A lot of those impressions are made using traditional trays and materials set in the mouth, and all that information from the mouth is transferred to the casts, where the final restorations are fabricated. These restorations are going to be fabricated on stone models, mounted on these special instruments, called articulators, to simulate the jaw movements, which sometimes take all these procedures, from an impression all the way to the final fabrication, could take weeks in the dental laboratories in a very technical, sensitive manner. With the digital advances, most of these procedures now can be done in a significantly reduced time by using state-of-the-art technologies, such as digital impressions, where scans of the patient's teeth are taken using special tools connected to computers. Images and scans are taken, sent to the dental laboratories, and the final prosthetic work is designed on software, able to provide the patient the best outcome. Computer-aided design and computer-aided manufacturing has a huge role now in prosthodontics in terms of providing the patients with digitally designed restorations, as well as computer-aided manufacturing, as incorporated using 3-D printing, 3-D milling. So, all the examples that I showed earlier, partial dentures, full dentures, bridges, crowns, can be fabricated through the process of using these computer-aided design and computer-aided manufacturings. So, as a University of Michigan faculty member I'm mostly interested in the accuracy of these techniques and materials, how these prostheses fit to the teeth, and how they withhold all the pressure that are going to be subjected to the patient's function in the mouth. So, we want to make sure that we can provide the patients with the best materials and best-fitting materials so that they can last a long time. As an dental educator, I'm also interested in incorporating these three-dimensional software into the classroom teaching. Traditionally, most of the dental concepts are taught using two-dimensional images and pictures, whereas the dental students have a better experience with the incorporation of these 3-D software, and we can utilize the 3-D objects images for the students to learn these concepts in a more efficient way. And it also helps them better prepare for the future; as they step out in the real world, they most likely are going to be using one of these software or the programs, so they'll get a better experience while they're still in dental school so that they are better prepared for the real world. So, what is in the future for prosthodontics? I think prosthodontics is still going to be at the forefront of this technology, making sure that we provide the best service to our patients and helping them to achieve that beautiful, healthy, comfortable smile that they're looking for, while significantly reducing the treatment time and making it available to the public. The future of prosthodontics is very exciting, and lots more to come. Thank you for listening.
