Prosthodontics at Collins Street Specialist Centre

Prosthodontics is the dental specialty that restores and replaces teeth with crowns, bridges, veneers, dentures and implant-supported teeth, from a single tooth to a full upper or lower arch. At Collins Street Specialist Centre, our specialist prosthodontists, Dr Fotios Angelis, Prof Vasileios Chronopoulos, Dr Jamie Foong and Dr Simon Hinckfuss, working with Dr Gaurika Sud, plan and carry out this work, including complex cases that involve several teeth or a change to the bite. They see patients on Level 8 of the Manchester Unity Building, 220 Collins Street, Melbourne. Call (03) 9650 2726 to book.

When might you see a prosthodontist?

The word prosthodontics comes from the idea of replacing teeth. A prosthodontist is often involved when the problem is bigger than a single filling, or when the look, comfort and function of the teeth all need to be considered together. People come to us for:

• teeth that are broken, heavily filled or worn down, for example from grinding
• one or more missing teeth
• loose or uncomfortable dentures
• teeth whose shape, size or colour they would like changed
• a plan to replace most or all of the teeth in one or both jaws
• crowns or bridges that have failed and need to be redone
• a bite that has collapsed or changed after teeth were lost

What treatments do our prosthodontists provide?

• Crowns. A crown covers and protects a weakened tooth, such as one that is cracked, heavily filled or root-treated. Some crowns, inlays and onlays can be designed and milled chairside with our CEREC system, which may allow them to be fitted at one appointment.
• Bridges. A bridge fills a gap by joining a replacement tooth to crowns on the teeth or implants either side.
• Veneers. Thin porcelain facings bonded to the front of the teeth can change their shape or colour where that is appropriate for the teeth involved.
• Implant crowns and bridges. After an implant has been placed and has joined to the bone, the prosthodontist designs and fits the tooth or teeth it supports.
• Dentures. Partial dentures replace some teeth and can be made in acrylic, metal or flexible resin. Full dentures replace all the teeth in a jaw. Overdentures sit over retained teeth or implants for extra stability, and immediate dentures are fitted on the day teeth are removed.
• Full arch treatment. When most or all teeth in a jaw need replacing, a fixed bridge can be attached to a small number of implants, for example with the All-on-4® approach.

Implants: conventional, immediate and full arch

A dental implant has three parts: a titanium screw that sits in the jawbone, a connector called an abutment, and the crown on top, which may be all ceramic or porcelain bonded to metal. With a conventional implant, the screw is left to bond with the bone for some months before the final tooth is added. In suitable cases, an immediate implant allows the implant and a replacement tooth to be placed at the same visit, for example when a tooth has broken and cannot be kept. If there is not enough bone, a bone graft or sinus lift may be needed first.

Implant treatment is usually a team effort in our practice. The implant is placed by one of our periodontists or oral and maxillofacial surgeons, while the prosthodontist leads the design of the final teeth. Implant positions can be planned in advance on three-dimensional scans with coDiagnostiX planning software.

How does a prosthodontist train?

A specialist prosthodontist first holds the same dental degree as a general dentist, then completes a further three years of full-time university training in prosthodontics, usually a master's or clinical doctorate. They can then apply to the Dental Board of Australia for registration as a specialist. Many dentists provide crowns, bridges and dentures, but not all of them hold specialist registration, so you can confirm a practitioner's registration on the AHPRA register at ahpra.gov.au.

Which of our specialists provide prosthodontics?

What happens at your first prosthodontic consultation?

Your prosthodontist will ask what you would like to change and why, and review your medical and dental history. They examine the teeth, gums, jaw joints and bite, and check any existing crowns, bridges or dentures. Records such as photographs, X-rays, a three-dimensional scan or a digital scan of the teeth may be taken. For larger cases, a mock-up or trial teeth may be suggested so you can see and test the proposed result before committing. You will receive an explanation of the options, the stages involved, the expected timeline and a written estimate, and you are welcome to take time to decide.

Risks, recovery and looking after your new teeth

Preparing a tooth for a crown or veneer removes some tooth structure, and occasionally the nerve becomes inflamed and needs root canal treatment. Porcelain can chip, crowns and veneers can come loose, and new dentures need a settling-in period with some adjustments. Implant treatment carries surgical risks, and implants can develop gum and bone problems around them if they are not cleaned well. Restorations do not last forever, and how long they last depends on your bite, habits such as grinding, cleaning at home and regular check-ups. Your prosthodontist will explain the risks that apply to your treatment.

Working with our other specialists

Prosthodontic plans often draw on other specialties. Our endodontists may first treat a tooth that is to be crowned, our orthodontists can move teeth to create space before crowns or implants, and our periodontists treat any gum disease before new teeth are made. Because these specialists practise together, they can review the same records and agree on the order of treatment, and with your consent we keep your general dentist informed.

Cost and payment

Fees depend on the number of teeth involved, the materials, any implants or laboratory work and the number of stages, so your prosthodontist will give you a written estimate before treatment begins. Larger plans can be staged. Private health insurance may cover part of the cost, depending on your level of cover. Payment plans through Payright and TLC, and early release of superannuation through Supercare, are available subject to each provider's eligibility criteria. See our payment plans page.

Frequently asked questions

Which suits a missing tooth: a bridge, an implant or a denture?

Each has advantages. A bridge relies on the neighbouring teeth, which are shaped to hold it. An implant stands on its own but needs enough healthy bone and a surgical step. A partial denture is removable and usually costs less. Your prosthodontist will weigh up your teeth, gums, bone and preferences before recommending an option.

Can loose dentures be made more secure?

Often, yes. A new denture made to fit well can help, and in many cases two or more implants can be placed so the denture clips onto them. Your prosthodontist will check the bone and gums and explain whether implant support is possible for you.

How long does treatment take?

A single crown may take one or two visits. Implant treatment often runs over several months while the bone heals, and full arch work can take longer, with temporary teeth used in between. Your prosthodontist will set out the stages and timing at the consultation.

How should I look after crowns, veneers or implants?

Clean them as you would your natural teeth, with careful brushing and cleaning between the teeth, and keep up regular check-ups. If you grind your teeth, a night guard may be advised to protect the porcelain.

Related pages

• Our services
• Periodontics
• Endodontics
• Orthodontics
• Oral and maxillofacial surgery
• Our technology
• Payment plans
• Contact us

Collins Street Specialist Centre at a glance

• Registered specialists in oral and maxillofacial surgery, endodontics, orthodontics, periodontics, prosthodontics and paediatric dentistry, in one practice.
• Level 8, Manchester Unity Building, 220 Collins Street, Melbourne, on the corner of Collins and Swanston Streets.
• No referral needed to book.
• Payment plans through Payright, TLC and Supercare, subject to eligibility.
• Call (03) 9650 2726 or email theteam@collinsstreetspecialistcentre.com.au.

Contact Collins Street Specialist Centre

Every patient is different, so results, recovery times and potential risks vary from person to person. This information is general in nature and is not a substitute for a consultation. Seek advice from an appropriately qualified, AHPRA-registered practitioner before proceeding with treatment.