Prosthetics using modern materials is a method of restoring chewing function and aesthetics of the dentition.
Often people are going to see a specialist for a long time, fearing pain and discomfort in the oral cavity, but in most cases, the fear is completely in vain.
Before going to the orthopedic dentist's office, it is important to learn how crowns are placed on the teeth in order to better understand the essence of the process.
The more information about the preparation for prosthetics and the stages of fixing durable pads, the easier it is to get rid of unreasonable fear.
In what cases is a crown placed on a tooth?
Prosthetics are carried out with significant tooth decay, when the usual filling does not give a result.
Other indications: decreased chewing function, deterioration in appearance. The uneven edges of problem units injure delicate mucous membranes, an inflammatory process develops.
The faster the restoration of the shape, strength, and chewing ability of the tooth takes place, the lower the risk of damage in the oral cavity.
It is important to know: poor-quality chewing of food leads to swallowing large pieces, excessive stress on the stomach and intestines. Uneven, dilapidated teeth are not only a repulsive appearance of the oral cavity, but also prerequisites for the development of pathological processes.
In large teeth, the distance from the enamel to the neurovascular bundle (pulp) is further, the risk of burning the sensitive fibers is lower. Smaller crowns are installed on single-rooted units (incisors).
Before prosthetics, the specialist must remove the nerve to reduce the risk of thermal burns in the pulp area.
How to put a crown on a tooth
The process of preparing for prosthetics, manufacturing, fitting, and final fixation of durable onlays takes several weeks. During this period, a person makes scheduled visits to the prosthetist.
Haste in such a responsible and delicate process as installing crowns is inappropriate: poor-quality treatment of units, poor turning of canines, incisors or molars reduces the service life of products, provokes discomfort and microtrauma of the mucous membrane in the oral cavity.
Photos before and after installing crowns
At the first appointment, the doctor:
- examines the oral cavity, identifies problem units;
- prescribes radiography to assess the condition of the roots, detect defects in dental tissue;
- talks with a person, learns wishes, briefly talks about the process of prosthetics.
After receiving X-rays, assessing the situation, the doctor develops a treatment plan. It is important to take into account the limitations: chronic diseases, pregnancy, nervous disorders, problems with blood clotting, the development of tumor processes in the oral cavity, and other factors. The dentist should know if a person is allergic to drugs and other irritants, what antibiotics and anti-inflammatory compounds cause side effects.
The future owner of ideal teeth should receive comprehensive information about suitable methods of prosthetics, taking into account the state of the units, the optimal type of crown prostheses. The doctor tells about the stages of work, indicates the approximate cost of products and additional services.
Crown installation scheme
It is important to focus on the average price threshold, to clarify what manipulations are included in the indicated cost. If a clinic offers the installation of quality products at a reduced price, then you should not immediately be tempted by a tempting offer: you will have to clarify whether all services are included in the announced figures.
Treatment plan:
- Removal of "dead" teeth (missing a nerve). The gradual destruction of problematic units provokes the development of negative processes in the oral cavity, reduces the service life of dentures.
- Preparation for attaching crowns. It is imperative to eliminate inflammation in the tissues of the periodontium and periodontium, to seal carious cavities.
- Coordination of the type of crown prostheses. The cost of products and aesthetics depends on the material. Experts offer several options. They are relatively cheap (from 7.5 thousand rubles): metal-plastic, metal, cermets with the use of non-precious metals. More expensive types of products made of zirconium dioxide, aluminum oxide (from 15-18 thousand rubles), metal-free ceramics (cost - 20 thousand rubles and more).
- Calculation of the approximate duration of prosthetics and the cost of all stages of work. It is important to clarify all the issues, eliminate disagreements, so that the process of prosthetics proceeds without conflicts and hitch.
The best option is to attach the product to a living tooth. This point is especially important when installing strong onlays on the canines and molars, which are actively involved in the process of chewing food.
Preparatory stage
Before prosthetics, it is important to complete the mandatory steps:- treat pulpitis, caries, eliminate the inflammatory process in the periodontium;
- if indicated, fill the root canals, remove nerve fibers;
- restore a tooth if the unit is dilapidated. The lack of strong tissues on which the crown can be fixed leads to early loss of the filling along with the prosthesis.
Coronal restoration methods
Each case is individual: the choice of method depends on the degree of destruction of the problem unit. After the installation of a stump tab or a solid base resembling a mini-reinforcement, the restored teeth practically do not differ from healthy ones in terms of their functional ability and appearance.
With a pin
A strong rod is screwed into the sealed root canal, creating the basis for attaching the filling material. The dentist builds up the tooth, then grinds it under the crown, and goes through the standard prosthetics process.
Using the pin
Using the stump tab
A more reliable and durable option for restoring destroyed areas. Dental laboratory specialists cast stump masonry from non-toxic, bioinert metal. The finished product is the root part for firm fixation in the canal and the coronal area, which exactly repeats the shape of a certain unit of the dentition.
Tooth preparation
A rather unpleasant stage of prosthetics, during which the dentist gives the problem unit an optimal shape.
To grind the teeth, use diamond burs and a conventional drill.
Most of the stories of discomfort are related to the handling of living units.
The use of local anesthesia makes the process painless, there is only psychological discomfort at the sight of dental instruments.
Dissection of units without nerves ("dead" teeth) requires the introduction of anesthetic compounds in isolated cases, for example, if necessary, to move the gingival tissue far away from a unit of the dentition.
The thickness of the surface that gets under grinding depends on the type of crown prosthesis, it is at the level of 1.5–2.5 mm. To install molded products, the doctor removes a smaller volume of hard tissue. After the preparation of the tooth, the base remains in the mouth - the "stump".
The dentist takes an impression to create an exact copy of the units. It remains to create plaster models, which fit the dentures.
When the patient chooses the type of crowns, it is necessary to know how long such a product will serve. and tips for care - this article is devoted to this.
What to do if teeth are crumbling? It will help you to understand the reasons for this phenomenon and choose methods of treatment.
Dental prosthetics is a common procedure in dental clinics. Sometimes patients have complaints that the tooth under the crown hurts. Why such symptoms appear, we will explain.
Laboratory stage: manufacturing of crowns
The process is quite lengthy, depending on the type of prosthetics, material, the number of ordered products. During the waiting period, a person cannot walk with "stumps" in the mouth: grinded teeth impair aesthetics, the risk of food and drinks being exposed to the base for attaching prostheses increases.
To restore the appearance of the dentition, temporary crowns made of sufficiently strong but inexpensive plastic are attached to the turned base.
Metal-ceramic crowns
A dental laboratory specialist forms the future tooth from the selected material on the basis of plaster casts.
Ceramic and metal-ceramic products require longer manufacturing times than cast metal crowns.
Fitting and fixing crowns
Before the end of the work on the manufacture of the prosthesis, the first fitting is carried out. It is important to evaluate how firmly and accurately the frame sits on the prepared "stump".
After quality control of the work, making adjustments (if necessary), the dental technician continues the formation of the crown prosthesis.
For example, when using cermets, a specialist applies a durable, aesthetic ceramic coating to the base.
At the end of the work, the dentist will temporarily fix the prosthesis. This step is mandatory, although some patients think differently.
Why does the specialist attach the crown with temporary cement? The method allows you to assess whether the restored unit interferes with the teeth from the lower or upper row, located opposite: "two" - "two", "four" - "four" and so on.
It is important to check how the teeth and surrounding tissues react to the new element in the oral cavity, whether there is any pronounced discomfort and allergic reactions. Sometimes there are defects in root canal filling, the development of an inflammatory process and severe pain.
Common defects: overestimation of the bite, the prosthesis does not sit tightly on the neck of the tooth, injures the gum, provokes bleeding of soft tissues. When complications arise, it is important to contact a prosthetist to discuss the issue of eliminating the shortcomings. In each case, the decision is made by a specialist, taking into account the identified deviations.
Temporary crowns are on the teeth for 14 to 28 days. In the absence of complaints, the dentist removes the prosthesis, removes the temporary material, cleans the unit, fixes the product using permanent cement.
Is it possible to remove the crown
There are two options:
- Planned replacement of products after 10-15 years of wearing prostheses.
- Urgent replacement, if a tooth hurts under the crown, after a while defects of the product are revealed that interfere with chewing food, creating discomfort.
The process is quite unpleasant even when removing prostheses from "dead" units of the dentition. To remove the crown, use strong burs and discs, saw the product. With two layers, for example, metal and ceramic, the task is not easy to cope with.
Local anesthesia is mandatory. When removing crowns, trauma to the gingival tissue near the problem tooth is possible.
To reduce the risk, it is important to consult an experienced prosthetist with a good reputation.
Many people during their life are faced with the need to restore dilapidated units of the dentition. Before installing crowns, it is important to know how the dentures are placed.
For more than 10 years they have been used for dental prosthetics. Are such crowns effective and how much will the treatment cost? About this on our website.
Many adults do not want to have braces, but teeth need to be straightened. Can teeth be straightened without braces? Read on.
Important points: find a good orthopedic dentist, choose the optimal type of products, follow all the doctor's recommendations during temporary and permanent wearing of crown-shaped prostheses. Only a balanced approach to prosthetics will save you from painful alterations and endless visits to the dentist.
Video on the topic
| Plastic crown (temporary) | PCS. | RUB 1000 |
| Solid crown | PCS. | 3600 RUB |
| Metal-ceramic crown | PCS. | RUB 6,000 |
| Metal-ceramic implant crown | PCS. | RUB 15,000 |
| Zirconium oxide crown for implant | PCS. | RUB 16,000 |
| Zirconium oxide crown | PCS. | RUB 13,000 |
| Endocrown | PCS. | RUB 12,000 |
| Pressed ceramic crown | PCS. | RUB 14,000 |
| Stump tab | PCS. | 3600 RUB |
Tooth crown
When the coronal part of the tooth is badly damaged and its restoration may be ineffective, even if a light-curing gel filling is used, it makes sense to place a crown on the tooth. This will help keep it from being removed, which is especially true when there are good, not decayed roots. Modern technologies of dental treatment allow you to get to the canals of a depulped tooth, completely disinfect and fill them so that inflammatory processes in the gums cannot develop in the future. This guarantees a long service life of the dental crown.
What is a crown on a tooth: a little history
Strengthening teeth with crowns has been known for a long time, only earlier they were performed exclusively from metals, which often caused allergies and could lead to ulceration of the gums. The situation was aggravated by the fact that at that time there were no gel fillings, which in most cases could replace the crown. Therefore, it was necessary to resort to orthodontic care even with relatively small chips on the teeth. A modern dental crown looks just like a real tooth, its color can be matched strictly to the shade of the patient's enamel. The indications for the installation of dental crowns have also been revised over time.
For example, chips were previously masked with crowns. But if a metal crown is visible in the dentition, then the benefits of such "masking" seem to be relative. It is more convenient to chew with such a crown than with a chipped tooth; under it, the tooth is protected from caries formation, but in terms of aesthetic parameters, it does not stand up to criticism. Today, a small chip can be repaired with a filling, but the crown can now be installed on a post or stump, even when the upper part of the tooth is completely destroyed.
What is a dental crown for prosthetics? This is the part of the bridge or clasp prosthesis that is put on the abutment teeth. To such crowns, artificial teeth are attached by one method or another, filling the row. Many are afraid of bridge or clasp prosthetics, because they do not know which tooth can be crowned with and which not. At the same time, not everyone is shown implantation, therefore, it is necessary to clarify the possibilities of modern dentistry.
What teeth are crowned on during prosthetics?
Today the question “what teeth are crowned on” refers rather not to their location on the upper or lower jaw, but to the state of the teeth themselves. If you need to remove the defect of only one tooth, on which a crown is installed for this, then its condition can be initially any. But before it comes to making a crown, the tooth requires basic treatment. If a patient develops processes such as periodontitis, then first the doctor must go through all the canals, fill them using gutta-percha pins and filling material. The quality of root filling should be checked using an X-ray. If a cyst is found near the roots, then this is not always a reason for tooth extraction, however, it requires a longer treatment, the appointment of antibiotics and other drugs that contribute to the restoration of damaged soft tissues.
If the visible part of the tooth is completely destroyed, then the crown can be installed on the root using a dental inlay. If it comes down to the extraction of a tooth, and the person agrees to implantation, then in this case, too, a crown is used, which “crowns” the implant, imitating the visible part of the tooth. But where to put the crowns, on the upper and lower teeth, is all the same. Even if you need to qualitatively heal wisdom teeth, with which a person normally chews, the installation of dental crowns can be applied.
What materials are used to make modern crowns?
Today, most materials for crowns are the color of natural tooth enamel, and metal crowns can still be installed only in the depths of the mouth, since they are not visible there, but this allows, in general, to reduce the cost of prosthetics. At the same time, one more condition must be observed: the patient is not allergic to metal. Allergy sufferers are shown crowns without metal impurities:
- plastic;
- ceramic.
A new material is also used - zirconium dioxide, which is not a pure metal and takes root well in the oral cavity. If the patient is not constrained in funds, he can order zirconium dioxide crowns, excellent in appearance and strength.
Metal dental crowns
- They are made either from gold or from a special medical alloy. In the latter case, it is a silvery metal. It is believed that gold is best suited to the human body, it does not oxidize and does not form hazardous compounds when it comes into contact with saliva or food. However, gold looks beautiful as a piece of jewelry, and not when a tooth is made from it, which nature is destined to have a completely different color.
Sintered metal
- In terms of strength, it is worth stopping the choice on metal-ceramic dental crowns, especially since they practically do not differ in color from natural tooth enamel. However, the presence of a porcelain-fused-to-metal crown in the dentition may be indicated by its insufficient degree of transparency. The tooth turns out to be similar to a real one, but at the same time somehow "lifeless" in appearance. This is due to the fact that the inside of this crown is metal and the outside is ceramic. An opaque metal can slightly shine through the ceramics, becoming an absolute obstacle to light rays.
All-ceramic
- These crowns are more fragile, but they almost look like natural tooth enamel. The biocompatibility of the all-ceramic crown is the highest. Doctors prefer to put such dental crowns on the front teeth, because the aesthetic factor plays a key role here. However, the patient is not recommended to bite off even an apple with a tooth with such a crown, not to mention nuts or other solid foods. Doctors advise keeping a knife with you, which can be used to divide food into small pieces.
Zirconium dioxide
- A new and not cheap material that has almost all the aesthetic properties of ceramics and the strength characteristics of cermets is zirconium dioxide. This type of prosthesis is also called zirconium crowns. They can be used equally well both on the chewing teeth and on the front teeth - incisors and canines. So far, only one drawback of zirconium dioxide crowns has been identified - the high cost.
Plastic crowns
- Today, it is possible to create a plastic that would be similar to real tooth enamel and at the same time had good biological compatibility with the human body. Typically, a plastic dental crown is a temporary option. They do not last long, stain from food and can crack. This type of crowns is widely used during implantation - at the time of implant engraftment. Also, such a "cap" can be used to close the prepared tooth while a permanent crown is being made from a more expensive material.
Metal-plastic dental crowns
- The idea of a metal-plastic dental crown is the same as that of a metal-ceramic crown. Only this type is cheaper. If the task is to use such crowns on temporary structures or for a period of long-term treatment of the prepared tooth, then they fully justify themselves. But using such a product for more than three years would hardly be worth it. In addition to the disadvantages that metal-ceramic and plastic crowns have, one more flaw was found in metal-plastic structures - the lag of plastic from the metal base. But as temporary dental crowns, this is a more durable option than just plastic.
Features of crowns on implants
During implantation, the entire tooth is redone: both the part that replaces the root and the visible part. The types of crowns for implanted teeth are as follows:
- ceramic;
- zirconium.
The abutment for ceramic crowns is often made of zirconium dioxide so that dark metal does not show through the ceramic. If a chewing tooth is implanted, the crown can be made of zirconium dioxide, and the abutment can be made of metal. However, such a design is also suitable for the smile zone, if the patient is not very moody or somewhat constrained in finances. Dental crowns on implants can be chosen not only in terms of aesthetics, but also in terms of cost. And since the price of dental crowns varies greatly, you can choose the option that will be quite "lifting" for you. It is not necessary to put dental crowns made of metal-free ceramics! It will be easier to determine which dental crowns are the best if you know what budget you will have to rely on. Therefore, you need to try to carry out a preliminary calculation with your doctor.
Color matching of dental crowns
If the crown is made of ceramic, plastic, cermet or metal-plastic, then it can be given the desired color. To do this, dentists use a special Vita scale, which contains almost all possible color options for tooth enamel. For cermets and metal-plastics, color selection is a more complicated matter, since the metal part is visible through the non-metal. If the frame does not consist of metal, but of zirconium dioxide, then it is easier not to be mistaken with the color.
How a crown is placed on a tooth
Installing a crown on a tooth requires several stages, and this task cannot always be solved in one day. Many therefore ask the question: where are dental crowns installed on the teeth - in the orthopedic department or the therapeutic department. Usually, if it is a large clinic, then the patients have to first communicate with the dentist-therapist, who conducts the diagnosis and the necessary treatment of the tooth. But preparation, making an impression, fitting and the actual installation - in the orthopedic department.
When a small clinic deals with the installation of dental crowns, then everything can be done by the same doctor. He tells the patient what dental crowns are, how much they cost by themselves, and how much the treatment will cost. Together with the patient, one or another option is accepted, after which a process begins, consisting of:
- diagnostics, at which a decision is made on the possibility of installing a crown of a certain type;
- preparation: most often the tooth has to be depulpated and the canals are filled; in rare cases, it is possible to place a crown on a living tooth - as a rule, if it is an integral part of a bridge prosthesis;
- turning teeth under a crown, if necessary - installing a dental inlay;
- taking an impression of the jaw;
- making either a crown - if the tooth is being repaired without an inlay, or an inlay - if there is a need for it.
Further, appropriate treatment is carried out. Either a dental inlay is placed under the crown, made from an impression, or a crown. If we are talking about installing the tab, then it is fixed with cement. The patient, as a rule, comes again to make an impression already with a tab and make a crown for it. On the next visit, the crown is fitted, and then, if the fitting showed that the crown is suitable, then the treatment can be considered complete after the final installation. If the crown does not fit, then you must first adjust it, and then proceed with the installation.
This is how a dental crown is placed on one tooth. If you need to restore several teeth at once, then you can deal with them simultaneously. In this case, you can save on the stage of taking the impression.
Can a crown be placed on a tooth with a living nerve?
It is possible to remove the nerve under the crown, but it will require a lot of trouble on the part of the dentist. It will be necessary to remove the dental crowns to heal the teeth that have begun to hurt, and this is associated with the risk of losing the orthopedic structure. After removal, the crown does not always need to be reinstalled. That is why they even try to remove a pulp with a nerve from a healthy tooth, and only then engage in the installation of crowns or bridges. Caries under the crown can also develop if the tooth is not properly healed. Based on this, dentists try to immediately place the prepared tooth under the crown or cover its surface with a temporary structure in order to limit contact of the enamelless surface with food.
When a dental crown is placed on a post or on an inlay, they try to protect the surface of the tooth with a temporary filling during the manufacture of the main structure. The production of dental crowns sometimes takes several weeks if the clinic is small and the dental technician is constantly busy with work.
If you still have to remove the crown ...
Sometimes you can hear very strange complaints from patients: "The dental crown hurts." In fact, it is the tooth under the crown that hurts, because it itself is not a living tissue. The question also arises: what is there to hurt if the tooth is devoid of a nerve? Inflammation can occur in the tissues of the gums, and it can already manifest itself as pain. Sometimes it happens that you just feel an unpleasant odor from under the crown, but there is no pain. But this is also a reason for removing dental crowns.
When dismantling such structures, it is important how dental crowns are glued. Knowing this, you can try to dissolve the material with such a substance that will not damage the tissues of the teeth and gums. It will then be much easier to remove the crown with the forceps. Often it is necessary to additionally break the cement with a drill with a special bur, so that the crown can be removed easily. Removal of the crown begins with the Kopp apparatus, a device that can perform a jogging motion, and ends with a forceps for removing crowns.
There are also devices that work with compressed air. This is, for example, kronaflex. The procedure is more expensive due to the high cost of the device, but the crown is not damaged and can be reused.
If you use other methods, for example, sawing, you will have to remove the dental crowns and put new ones after dental treatment. This will result in high costs on the part of the patient, moreover, it will take more time.
When it is known how the dental crowns are removed, it remains to be seen whether the patient is experiencing pain. If the reason for coming to dentistry is only the smell from under the dental crown, then when it is removed, there may not be any unpleasant sensations at all. After all, the smell can be the result of food and saliva getting under the crown, and not the development of caries under it. When a toothache brings a patient to the clinic, the dentist first has to do anesthesia, and only then get down to work. Pain clearly indicates inflammation.
Whether a tooth under the crown will ache or not depends not only on its quality, and not always on how well the dentist installed it. Often, even the best dental crowns can fly off or a tooth begins to ache under them. This is due to the poor condition of the gums, the slow inflammatory processes occurring in it. As soon as chronic inflammation worsens, pain symptoms can immediately appear.
This is why many doctors advocate long-term treatment before placing a crown on a tooth.
If the crown has come off the tooth ...
This also does not mean that the tooth will have to be removed. After all, even crowns with a zirconium frame - an expensive and high-quality material - can fall out. Parting with it is an unaffordable luxury if it is possible to install it again. By the way, if the crown fell out by itself, then this is a guarantee that it will not be sawed. Whatever materials are used for the manufacture of crowns, it is almost always possible to put them on the tooth again, only with new cement. The main thing is not to lose the crown and bring it to the doctor.
When a crown requires restoration
If you decide to install a crown on a tooth inexpensively, then over time it can deteriorate. In addition to losing color, the crowns may crack or even chunk off. Restoration of dental crowns is possible, only a highly qualified specialist should do it. You should not try to whiten the crown on your own if it has darkened, because you can completely spoil it. The cost of a dental crown per tooth will always be higher than going to a clinic for a restoration.
If the crown of the tooth is broken, then it is preferable to contact the same clinic where it was placed for you. It is better to do the same if the crown has fallen from the tooth. Here it is best to come to the dentist who was engaged in the installation. He remembers or has entries in the medical record, how he put, what substances he used, so when your crown fell off your tooth, he will know exactly what to do.
If you have neither pain nor suspicion that the structure may loosen or fall off, but just after installing the crown you feel discomfort, then this is also a reason to see a doctor. Sometimes a defect in the work of a dental technician can come to light. For example, the crown will be short or too protruding and interfere with the closing of the upper and lower teeth. All these shortcomings are eliminated at the expense of the clinic, not the patient.
How much will a dental crown cost per tooth?
Potential patients are interested in what are the prices for dental crowns. This information can be obtained from the website of a particular clinic. But the cost of preparing the tooth must also be taken into account. The doctor is also interested in the patient knowing which dental crowns are best, which one to choose, that is why he will be ready to calculate the cost of all stages of treatment.
If the patient was brought to the clinic by the restoration of dental crowns, then it is also advisable for him to consult a doctor who will deal with the treatment. It happens that a dental crown has fallen out after many years, and the clinic where it was placed is no longer there, and it is not known where to look for a doctor. This does not mean that you will have to re-manufacture the crown. It is possible that the doctor will find a way to use the old crown if it has not yet served its life. Then there is an opportunity to save on the crown itself, but you need to know how much it will cost to restore or reinstall the crown.
Any dentist's job costs a certain amount of money. If you independently calculate everything according to the price list, you can accidentally miss some mandatory operation and not include it in the total cost. Therefore, it is better to consult a doctor, and if this is not possible, then try to make a preliminary calculation with the registrar.
It is necessary to install these prostheses in the following cases:
- when most of the tooth is affected by caries;
- severe destruction of the dental organ (more than 70%);
- the tooth is destroyed after injury, while the root must be intact;
- external defects of the teeth (hereditary or acquired), a change in their color, when aesthetics suffers;
- predisposition of enamel to pathological abrasion;
- loosening of teeth, which is the cause of periodontal disease (temporary dentures will make them more stable);
- when the bridge is installed, thanks to the crowns, it is fixed on the supporting teeth;
- the presence of uneven edges on the tooth, which injure the mucous membrane.
Which material should you choose?
Thanks to new developments, in modern dentistry there are several types of materials from which crowns are made. Let's consider the main ones:
- Metal - classic prostheses that have been used for many years. Most often they are made of gold. The advantages of such products are strength, reliability and durability. They do not oxidize, have an abrasion coefficient almost like natural enamel, do not damage opposite teeth. The main disadvantage is minimal aesthetics, which is why they are placed on invisible areas of the jaw.
- Sintered metal, combining the advantages of metal and ceramics. They have durability, strength and high aesthetic performance. They are cheaper than all-ceramic ones. The disadvantage of these prostheses is the obligatory preparation of a large number of living tissues before their installation, as well as the possibility of abrasion of the enamel on opposite dental organs. You can also see a strip of ferrous metal at the gums if its edge is lowered or the product was not manufactured accurately.
- From ceramics or porcelain, crowns are made that have the most aesthetic appearance. They are as similar as possible to natural teeth and retain their properties for a long time. However, ceramics are significantly fragile and cannot always withstand the stress of chewing. For this reason, ceramic products are often placed on the front teeth. The main disadvantage of these crowns is the high price.
Manufacturing
Crowns are made according to the manufactured plaster models. Metal, cermets and ceramics can be used as the material to be produced.
Manufacturing is quite laborious and time-consuming, therefore, while the dental technician is working on their creation, the patient is put on temporary plastic products. This restores the aesthetic appearance of the grinded teeth, and they are protected from external influences and infection. These dentures, in addition to protecting the teeth, also allow them to be fully used when chewing.
Grinding teeth for installation on their crowns
Grinding teeth is called preparation. This procedure is performed using a drill, into which a diamond bur is inserted. This is how the tooth can be shaped.
When grinding living teeth, the procedure is painful, therefore, anesthesia is administered to the patient before it is performed. If you need to grind a pulped tooth, anesthesia is not always used, but if you need to move the gums, it is better to do it.
The orthodontist needs to grind the tissue of the dental organ, the layer of which will be equal to the thickness of the prosthesis. Depending on the crown used, 1.5-2.5 millimeters of dental tissue can be removed from all sides of the dental organ. When fastening cast structures, less turning will be required, and if ceramic or cermet products are installed, more.
A sharpened tooth is a stump, where a crown will subsequently be fixed.
How is the crown part of the tooth restored?
The coronal part of the tooth in different cases can be destroyed in different ways, therefore, it is restored in different ways. To do this, either a stump tab is placed in the tooth, or a pin is placed, and this does not in any way affect the appearance of the tooth.
The post is a highly durable rod that is screwed into the root canal after filling. It plays the role of a base for attaching the filling material. Then the tooth is built up and ground under the denture.
With the help of the stump tab, you can make a very reliable restoration of a dental organ that will last a long time. It is made in a laboratory from a special metal that is not toxic. The inlay consists of a crown and a root part. The root one is fixed in the root canal of the tooth, and the crown one has a look ready for attaching the crown to it.
The first stage of the installation is preparatory
Before installing the crown, the dentist should carefully examine the patient's oral cavity, if necessary, an x-ray can be taken. Based on the results of the examination, a treatment plan is drawn up and the necessary procedures are recommended. It is also important to examine the patient for contraindications and allergies to any material.
The doctor, together with the patient, selects the most suitable type of crown. Specify the time when the prostheses will be made and installed, as well as the cost of treatment.
In the presence of diseases of the gums and teeth in the oral cavity - they are cured.
- Removes a nerve from a tooth and grinds it. It is important to grind a layer of the tooth that matches the thickness of the denture. When attaching the crown to the anterior units with one root, the removal of the nerve is mandatory, because during grinding, a pulp burn may occur. Depulpation of a multi-rooted tooth is not necessary, because the risk of burns in such a situation is minimal.
- Heals teeth that are affected by caries. Seals canals. Cleans teeth from calculus and plaque.
- If the dental organ is severely destroyed, it is depulpated, the canals are filled and the coronal part is recreated with a filling compound.
- When attaching a crown to a living tooth, anesthesia must be used.
- If there is a filling on the abutment tooth, it is changed to a new one.
After preparing the teeth for fixing the prosthesis, impressions are taken from them, according to which crowns will be made in the laboratory.
Laboratory (second) stage of installation
According to the casts taken from the prepared dental units, models of dental organs are made from plaster in the laboratory. So the dental technician gets an exact plaster copy of the patient's teeth, maximally reflecting all their features. With the help of these models, further production is carried out.
Fitting and fastening - the third stage of installation
Before the crown is installed and even before the end of the manufacturing work, the first fitting of the prosthesis is performed. Check that it fits accurately and firmly on the stump.
Further, if necessary, adjustments are made to the product and continue to form it in the laboratory. If cermet is used as the material to be produced, the metal frame must be covered with an aesthetically pleasing ceramic compound.
After completion, the prosthesis is fixed with a temporary composition, which makes it possible to assess the comfort when wearing the prosthesis, the possibility of allergic reactions, eliminate the possibility that it will interfere with the connection with the opposite teeth. The reaction of dental units and adjacent tissues is checked for the presence of a new element in the oral cavity.
At this time, defects in the filling of the root canals, inflammation or severe pain may appear.
The most common defect is: overestimation of the bite, which is why it turns out that the prosthesis on the neck of the tooth sits loosely, injuring the gum and causing it to bleed.
If there are such complications, measures should be taken to eliminate them.
Temporary dentures are worn from two weeks to a month. If the patient does not have complaints, they are removed, the dental unit is cleaned and the permanent product is fixed with permanent cement. Then the crown is irradiated with a special lamp, which helps to harden the cement. All excess cement is carefully removed.
On a note: You can chew on the tooth where the crown was placed after a couple of hours, and the maximum load can be given to it after one day.
Cases in which it is necessary to remove crowns
The need to remove the crown may be due to the following reasons:
- The tooth was poorly prepared for the installation of the prosthesis. Statistics show that 60% of root canal fillings are performed with errors. This is a prerequisite for the development of inflammation, and the treatment of the tooth leads to the need to remove the structure.
- An error in the manufacture of the structure. If the product distorts the bite, does not fit the neck tightly, or causes physical or aesthetic problems, it is removed.
- Planned replacement. At the end of the service life (usually 10-15 years), the prosthesis is changed.
- Damage to the structure, the appearance of cracks or holes on it from washed out cement, requires an urgent replacement of the product.
- The emergence of complications.
Withdrawal methods
Removing the product is quite difficult, especially if you need to keep it intact in order to reinstall it.
If the removal is made due to a breakdown of the structure, it is better to saw it with special tools.
If it is necessary to preserve the prosthesis, to remove it, use:
- Crown hooks (the most common are Kopp hooks) are special flat-hook tools that can be automatic or manual. With their help, the prosthesis is removed in the part of its connection with the tooth.
- The forceps securely grip the denture with the jaws and remove it from the base.
- Ultrasonic installations. Ultrasound waves can destroy the adhesive cement, after which the denture can be easily removed.
- Pneumatic tools, the use of which, also contributes to the destruction of cement and facilitates the removal of the crown.
What are the complications?
Consider the complications that may appear after the installation of crowns:
- The strong pressure of the product on the soft tissues disrupts blood circulation, contributes to the formation of pressure ulcers. In this case, the soft mucous membrane can die off at the point of contact between the gums and the crown. So prosthetic stomatitis can develop.
- The defeat of the supporting dental units by caries. Poor cleaning of the oral cavity or poor preparation of the dental organs for the installation of a prosthesis leads to the accumulation of food particles under the crown, where bacteria that cause disease develop.
- Allergy to the metals that make up the prosthesis may not appear immediately after the installation of the structure, but after a while. There is a burning sensation in the mouth, dryness, inflammation forms.
- Galvanic syndrome can be caused by the presence of various metals in the mouth. The result is the formation of an electric current, which intensifies oxidative reactions. At the same time, the patient feels a metallic taste in his mouth, general malaise may occur, headache, the structure and adjacent dental organs may change color.
Each of the listed complications requires a quick reaction and a visit to the attending physician, otherwise you can lose the abutment tooth. The doctor will most likely remove the crown, treat it, and place a new one.
The most interesting questions for patients
Question
Is it painful to install a crown?
Answer
Placing a denture can be as uncomfortable as any other dental procedure. The greatest number of unpleasant sensations falls on the preparation stage, which includes drilling, turning the dental organs, cleaning and filling the canals. But the fact that the crown is mainly attached to the pulped teeth minimizes the likelihood of pain. If living teeth are sharpened, anesthesia is used. And the very attachment of the crown to the stump takes place completely without pain.
Question
How long is the procedure?
Answer
Installation has several stages. To prepare your teeth, you need to visit the dentist from one to two times, and sometimes more. The duration of each visit depends on which teeth are to be attached to the crown and their condition. It can take several weeks to make a crown. The prosthesis is placed on temporary cement for a period of 2 to 4 weeks. Then it is fixed completely. In this case, the total time spent on installing the crown can be from 1 to 2 months, and sometimes even more.
Question
Are crowns placed on living teeth?
Answer
For living multi-rooted teeth, the condition of which does not require depulpation, a crown is allowed to be placed. They can also be placed during the installation of the bridge, when the crowns are attached to the grinded healthy teeth.
A crown on a tooth is a non-removable structure that allows you to eliminate a tooth defect. The anatomical crown of a tooth can be destroyed.
In such situations, dental crowns are used to restore the shape, size of the tooth, give the tooth strength, as well as resistance to chewing loads.
They protect the teeth from further decay.
Abutment crowns can be used to place bridges.
Indications
- Restoration of the crown of the tooth with its strong destruction (more than 50%).
- Increased abrasion of hard fabrics.
- To restore a lost tooth.
- Defects of dental crowns.
- Restoration of the anatomical shape and functionality of the tooth.
- Fluorosis.
- Anomalies of the teeth, manifested by the size or incorrect position of the teeth.
- Restoration of tooth aesthetics.
- A crown on a crooked tooth will help align it.
Contraindications
- Insufficient height of the preserved crown part of the tooth.
- Looseness of the tooth.
- Allergy to dental crowns.
- Malocclusion.
- Periodontal disease.
- Thinning of the walls of the lower anterior teeth.
- Age under 16.
Advantages and disadvantages
Pros of dental crowns:
- Aesthetics.
- Durability and strength depend on the material and manufacturing method of the crown.
- Affordability.
- Cast crowns do not require strong teeth turning.
- White ceramic crowns are ideal for anterior prosthetics.
- Ceramic crowns are biocompatible with tooth and gum tissue.
- The installed crown on the dead tooth prolongs its functionality.
Cons of dental crowns:
- Injury to healthy teeth if they are used for supporting teeth.
- Depulpation under the crowns on the teeth can cause complications in the form of an inflammatory process.
- Ceramic dental crowns are not strong enough.
- Unaesthetic metal crowns.
Materials for making
- Modern dentistry offers a wide variety of materials for the manufacture of dental crowns.
- For the manufacture of crowns, metal ceramics, zirconium oxide, metal alloys, ceramics and other modern durable and hypoallergenic materials are used.
- Cobalt - chrome and cobalt - nickel alloys, as well as alloys of precious metals: platinum, palladium, gold, are used in the manufacture of metal-ceramic crowns.
Types of dental crowns
The types of dental crowns are subdivided according to the material used:
- Metal-ceramic dental crowns. The inner part of the crown consists of a metal frame, which is veneered with ceramics on the outside. As a result, the structure is highly durable and aesthetically pleasing.
- Dental constructions made of metal-free ceramics. These crowns are made entirely of ceramic. The absence of metal improves the aesthetics of dental crowns. Crowns can be made of porcelain or zirconia. Constructions made of metal-free ceramics are very durable, reliable in use and have a long service life.
- All-metal dental crowns. They can be solid, stamped, gold. The molar crowns can be made of metal, because they still do not fall into the smile line. It is not necessary to sharpen the tooth under such crowns.
- Metal-composite crowns are combined. They are made from cobalt-chrome alloy, and the outer surface is lined with plastic. Such crowns are also called metal-plastic.
- Dental crowns for implants.
Which dental crown is better
- When choosing the type of dental crown, it is necessary to proceed from the indications for the installation of the structure, the wishes and choice of the patient, as well as from his financial capacity.
- Metal dental crowns are made from alloys of metals, precious metals, or only with their sputtering. Metal cast crowns on teeth restore the chewing function of the tooth. But in terms of external indicators, these crowns are the most unaesthetic.
- Metal-ceramic dental crowns are characterized by strength and naturalness. Moreover, this type of dental constructions is inferior to ceramic crowns. On the positive side, metal-ceramic crowns can be placed on teeth with nerves not removed. The disadvantage of the metal-ceramic design is that with the slightest decrease in the gums, a gap is formed between the crown and the tooth, and the metal rim of the dental crown becomes noticeable.
- All-ceramic dental crowns are the closest option to natural teeth. Differ in functional endurance. Ceramics from all of the above materials are highly biocompatible.
How is it made
After preparing the teeth for prosthetics, the following is performed:
- Taking casts from both jaws. The impression is made in order to be able to accurately make a crown, taking into account both the adjacent teeth and the antagonist teeth. For the production of casts, a special impression mass is used.
- In the dental laboratory, a model of teeth from plaster is cast from an impression, which is an exact copy of the patient's teeth. On it, a sample of the future dental crown is modeled from wax.
- At the time of making permanent crowns, temporary ones are made. They are fixed on the tooth with a special cement, which allows them to be removed before the permanent crowns are installed.
- A metal frame of the crown is made, which, after trying on and clarifying the color of the teeth, is covered with ceramics.
Installation steps
To install the structure, it is supposed to prepare a tooth for a crown:
- Visual examination of the tooth with the obligatory direction for an X-ray. If necessary, the required treatment and filling of the canals is carried out.
- To prepare the tooth for placing a crown on it, the tooth is prepared under anesthesia. Grinding teeth for crowns is carried out taking into account the thickness of the walls of the structure. The walls of the prepared tooth should converge upward so that the crown can be easily put on the tooth. At the same time, ledges are made in the cervical area of the tooth.
- Dental pulp if necessary. The specialist decides whether to place crowns on live or dead teeth.
- If the upper part of the tooth is missing, then the doctor installs a stump metal inlay. It will help to securely fix the crown on the tooth.
- If there is no anatomical crown of the tooth, a pin is placed in the root of the tooth.
- Taking casts, which are then sent by the doctor to the dental laboratory.
- Fitting the finished structure. Color selection.
- Fixation of the crown on the tooth using permanent or temporary cement (at the discretion of the doctor).
How does a dental crown differ from a filling
A dental crown and filling are used to restore the shape and appearance of the tooth.
Their difference:
- Tooth filling takes place directly in the patient's mouth. The filling is attached to the walls of the tooth. She acts as a wedge. When pressure is applied to the filling, it puts pressure on the walls of the tooth and can cause it to fracture. A large filling volume increases the likelihood of a tooth fracture.
- A dental crown covers the tooth from above, so the tooth under the crown remains intact, even with strong pressure on it. The crown is made in the laboratory.
Video: "Restoration of the tooth crown with a filling"
The advantages of a dental crown:
- The material from which the crown is made is much stronger than the material from which the fillings are made.
- The crown breaks less often. If the crown is uncemented or broken, then the repair of the dental crowns or the replacement of the crown of the tooth is possible. When filling, this option is not possible.
- The crown transmits the chewing pressure to the root. And the filling - on the remaining areas of the tooth, which can provoke a fracture.
For a high-quality tooth restoration, you must follow the following rule:
To restore a tooth with a filling, the defect should be no more than 1/3 of the volume of the remaining tooth. If the defect is 1/2 - 1/3, then the restoration is carried out with an inlay or veneer. With the destruction of a dental crown by more than 50%, the most effective way to restore a tooth is a crown.
Service life of dental crowns
The service life of dental crowns depends on factors: the material from which the crown is made, the quality of the construction, the care of the prosthesis, the condition of the gums.
- Metal crowns have a service life of 25 years or more.
- Cermet crowns - 10-12 years.
- Metal-free structures have less use - from 5 to 10 years.
Often the crown has to be removed not because of wear, but because of problems with the tooth under the crown. The reason may be poor preparation of the tooth for prosthetics.
A year and a half after prosthetics, when the warranty for dental crowns ends, chronic inflammation in the area of the dental root often appears, which is characterized by swelling and soreness of the gums, an unpleasant odor may appear from under the crown of the tooth.
The service life of crowns is influenced by oral care.
Care
- The same as for real teeth. It is advisable to visit the dentist at least once every six months to check the condition of the structure and surrounding tissues.
- If single crowns are installed in the mouth, then they can be cleaned with a toothbrush with paste and floss.
- If there is a bridge in the oral cavity, irrigators are recommended for irrigating the structure. This removes food debris and soft plaque from hard-to-reach places.
FAQ
- Question: The doctor suggests placing crowns on the teeth. Is it bad for a tooth to grind?
Answer: Grinding is a traumatic procedure for a tooth. It is a necessary stage in the preparation of a tooth for a crown.
- Question: How much does a metal-ceramic crown cost?
Answer: The cost depends on how much and what kind of metal will be used. Depending on this, such a crown will cost from 3 to 40 thousand rubles.
Answer: A ceramic crown looks no different from a real tooth. It is better to put a metal-ceramic or metal crown on the chewing teeth, because they are more durable.
- Question: How are dental crowns glued to the tooth?
Answer: To glue the crowns, use dental cement or special glue for dental crowns.
- Question: Do teeth deteriorate under the crown?
Answer: If the preparation for the installation of the crown is carried out efficiently, then the teeth under the crown cannot deteriorate. After all, the crown is put on the tooth in order to preserve it.
- Question: How to clean dental crowns?
Answer: Crowns should be cleaned in the same way as all other teeth using a toothbrush with toothpaste and floss.
- Question: Can there be any complications after installing the crown on the teeth?
Answer: If a high-quality preparation of the tooth was carried out before installing the crown, then there should be no complications.
Dental crown prices
The cost of a crown per tooth depends on the material and method of its manufacture.
More expensive ceramic crowns are usually recommended for use only on the front teeth, therefore, in order to save money, cheaper crowns, for example, from cermets, can be placed on the chewing teeth.
Photos before and after the installation of dental crowns
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Video: “Metal-ceramic crowns. Some features "
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