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UNSPECIFIED FIXED PROSTHODONTIC PROCEDURE

HCPCS code

Name of the Procedure:

Unspecified Fixed Prosthodontic Procedure (D6999)

Common Names: Fixed Dental Bridge, Fixed Partial Denture

Technical or Medical Terms: Prosthodontic Restoration, Fixed Prosthesis

Summary

An Unspecified Fixed Prosthodontic Procedure (D6999) involves creating a permanent dental appliance to replace missing teeth, often referred to as a fixed bridge or fixed partial denture. This procedure typically includes installing crowns or caps on adjacent teeth to support the artificial teeth, filling the gap left by the missing teeth.

Purpose

Medical Conditions: Tooth loss due to decay, injury, or congenital conditions.

Goals: To restore normal function (e.g., chewing, speaking), improve appearance, maintain proper alignment of adjacent teeth, and prevent bite issues.

Indications

  • Missing one or more teeth
  • Difficulty in chewing or speaking due to missing teeth
  • Facial structure changes resulting from tooth loss
  • Desire for a permanent solution to tooth loss
  • Inability to use removable dentures due to discomfort or other issues

Preparation

Pre-Procedure Instructions:

  • Maintain good oral hygiene
  • Avoid eating or drinking if sedation or anesthesia is planned
  • Follow specific instructions provided by your dental professional

Diagnostic Tests/Assessments:

  • Dental examination
  • X-rays or CT scans to assess bone structure and health of adjacent teeth
  • Impressions of teeth and gums for custom appliance creation

Procedure Description

  1. Consultation and Planning: Detailed discussion with the patient about desired outcomes and procedural plan.
  2. Teeth Preparation: Adjacent teeth are reshaped to fit crowns that will support the prosthesis.
  3. Impression: A mold of the teeth and gums is taken to create the custom prosthesis.
  4. Temporary Bridge: A temporary bridge may be placed to protect prepared teeth until the permanent appliance is ready.
  5. Fitting the Prosthesis: The final fixed prosthesis is adjusted for fit and comfort, then permanently cemented.

    Tools/Equipment:

    • Dental drills and files
    • Impression materials
    • Dental crowns and bridges
    • Dental cement

Anesthesia/Sedation: Local anesthesia is commonly used; sedation might be offered for anxious patients or complex cases.

Duration

Typically, each appointment lasts about 1-2 hours. The total process may require multiple visits over a few weeks.

Setting

A dental office or outpatient dental clinic.

Personnel

  • Prosthodontist or General Dentist
  • Dental Assistant
  • Dental Technician (if lab work is involved for creating the prosthesis)
  • Anesthesiologist (if sedation is used)

Risks and Complications

Common Risks:

  • Sensitivity in prepared teeth
  • Gum irritation
  • Temporary discomfort

Rare Risks:

  • Infection
  • Issues with bite alignment
  • Prosthesis becoming loose or damaged

Management: Antibiotics for infection, adjustments to the prosthesis, and follow-up visits for ongoing assessment and care.

Benefits

  • Restored ability to chew and speak
  • Improved appearance and self-esteem
  • Prevention of adjacent teeth shifting and bite issues
  • Permanent solution compared to removable dentures

Realization Time: Immediate functional improvement upon fitting; full adaptation may take a few weeks.

Recovery

Post-Procedure Care:

  • Maintain good oral hygiene
  • Avoid hard foods initially
  • Use prescribed anti-inflammatory or pain relief medication
  • Attend follow-up appointments for adjustments

Recovery Time: Few days to adjust to the new appliance; normal activities can generally be resumed within a week.

Alternatives

Other Treatment Options:

  • Removable partial dentures
  • Dental implants

Pros and Cons:

  • Removable Partials: Less expensive but less stable and comfortable.
  • Dental Implants: More stable and longer-lasting but require surgery and higher upfront costs.

Patient Experience

During Procedure: Minimal pain due to local anesthesia, potential pressure sensation during teeth preparation.

After Procedure: Mild discomfort or sensitivity in the treated area, manageable with over-the-counter pain relievers. Immediate improvement in function and appearance is noticeable. Comfort and normal function typically achieved within a few days to weeks.

Pain Management: Local anesthesia during procedure; pain relievers for post-procedure discomfort.

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