Stump metal inlays. Inlay for a tooth under a crown. Why are stump inlays needed?

Sooner or later, human teeth begin to undergo destruction. Modern approaches dental care allow you to solve any problem that arises in your mouth. The resulting defect can be restored not only with filling material, but also with orthopedic construction. Indications for replacement are limited by IROPD (index of destruction of the occlusal surfaces of the tooth). Let's look at this type of intervention by an orthopedic dentist, such as a tooth tab, what is it and how is it used?

Inlays on teeth are used when IROPD is more than 55%. Using this orthopedic design, it is possible to recreate a severely damaged surface and restore functionality. What is a dental inlay? The orthopedic design looks like an inseparable microprosthesis, which was prepared in a dental laboratory. This microprosthesis fills a large cavity defect, its absence, or eliminates aesthetic dissatisfaction by installing it on the front teeth affected by the process. The structure is installed on the teeth or on the implant rod using special keys.

If tissue destruction is significant, it is impossible to install a filling, since it will inadequately transmit chewing pressure, which will subsequently lead to a crack and breakage of part of the crown. All this can complicate further treatment from an orthopedic surgeon and the only way out will perform extraction (removal from the socket) from this situation, with further correction of the stages of prosthetics. Accordingly, the choice of tactics in favor of a crown, inlay or filling will be based on the indications.

An inlay in a tooth is a copy of the lost integrity of the crown. It has the appropriate anatomical structure shapes, recesses. After manufacturing, at the fitting stage (preliminary fitting in the tooth cavity), it should fit evenly along the entire line with the edges. And also this design is in no way inferior in color characteristics physiological color of the tooth. The main indication for the diagnosis will be severe destruction from caries, when repeated filling measures do not give the desired results. They do not provide recommendations for installation if there is a cavity on the approximal edge or with bruxism (night grinding of teeth).

Installation steps

Let's take a closer look at installing a tab in a tooth, and what is it? At the first appointment, having chosen the tactics of prosthetics and heard about this design, the patient thinks about the aspects of prosthetics. The establishment process takes place in several stages. Initially, the mouth, dentition and mucous membranes and directly affected structures are examined. Then the doctor refers the patient for an X-ray diagnosis. After this, the therapist performs depulpation or repeated endodontic treatment of the canals; if there are periapical changes around the apex of the tooth, it is necessary to correct the therapy.

After carrying out the above procedures, the result of which is confirmed x-ray examination you need to come back for an appointment with an orthopedic doctor. An impression is taken (a reverse image of the dentition with the teeth in it). The impressions are sent to the dental laboratory. Further creation and modeling of the structure takes place there. This type of design takes 1-2 weeks to create. During the manufacturing period, the doctor makes a temporary microprosthesis so that the functions of the tooth perform their work fully.

Dental technician (specialist who specializes in orthopedic types works, with secondary specialized education) performs:

• recreating the lost part of the tooth with wax;
• replaces wax with the selected alloy or material;
• models the structure, taking into account the anatomical shape;
• sends for fitting (fitting) to an orthopedist.

The doctor tries on the finished structure in the patient’s mouth and notes any inaccuracies, if any. If everything suits both the doctor and the patient, then the temporarily inserted structure is removed and the permanent one is fixed with appropriate materials. The microprosthesis in color, shape and occlusion should not be inferior to either fillings or fillings.

Difference from a filling

What is an inlay installed in a tooth? What is better to install and what is the difference from a filling? This orthopedic design undoubtedly has a number of advantages:

• Wear resistance;
• Fortress;
• No change in color;
• Adequate transmission of masticatory tension while maintaining precise marginal fit;
• Reconstruction of a large part of the affected tooth structures.

An important nuance is that this design cannot be installed on children’s baby teeth, since the period of suitability of a microprosthesis is significantly longer than the lifespan of this type of teeth. The average lifespan of a microprosthesis is about 10 years.

There are two options for establishing the design:

1. With IROPZ 0.55_0.6, the design is used without additional installation of a crown. Since the tooth structures are preserved by almost half and will be able to directly continue to participate in the performance of their functions;
2. If the destruction of the tooth surface is more than 80%, then it is necessary to use a pin structure (KShV). After installation and fastening to the structure, a crown is put on, which must meet all the necessary requirements:

• Accuracy of fit;
• Color;
• Execution of a function.

Varieties

This representation of a dental inlay, what is it? A range of dental services represented by an orthopedic surgeon can offer various options replacement of an extensive defect in the patient’s dental tissues. The difference in designs is mainly based on the material and method of restoration.

The method of restoration is divided in correlation with the reconstruction of the crown part of the tooth.

The structures are divided into:

• Stumps;
• Restorative: provide color and shape to affected tissues.

According to the material:

1. Ceramic: made from porcelain mass. The model is cast at high temperature using the compression molding technique. high voltage. They have aesthetic properties and are quite durable. It is not recommended to install it on fangs, since chipping of the material is possible at the limit of the applied forces;
2. Composite: easy to manufacture, aesthetic, strong, good marginal fit to the tooth tissue;
3. Zirconium structures: the best aesthetic and adaptive properties. They are perfect for replenishing the front part of the jaw. The production of this design is carried out by a special apparatus, thereby ensuring maximum precision in the fit of the microprosthesis to the tooth tissues. Against this background, the price is significantly higher;
4. Metal: produced for a crown. I use alloys of homogeneous and dissimilar materials: medical steel alloys that do not give oxidation, gold-based alloys;
5. Metal-ceramic: often use a combination of metal inclusions in the porcelain mass.

KShV: application features

If the patient has significant losses of dense tooth structures and still wants to preserve, rather than perform extraction and place an implant, the orthopedic doctor suggests a stump structure. The peculiarities of the installation are that the pin device is attached not only to a special cement base material, but also that fixation is performed in the upper third of the length of the root canal. Due to this, the load is distributed evenly, microcracks and leaks are eliminated. A crown is subsequently placed on the stump structure.

Stump devices are:

• Cast: made under pressure and high temperature. The main part that fills the space of the tooth cavity is connected to the root canals using pins;
• All-prefabricated: installation is carried out in the presence of several channels. As a rule, I fix the main part connected to the pin in the main channel (leading, for transmitting the load).

Conclusion

I would like to note that only an orthopedic dentist can optimally select the necessary orthopedic design. He will take into account wishes, indications and contraindications, and give recommendations for use.

A dental inlay is an artificial miniature prosthesis installed in place of the removed affected tissues for reproduction anatomical shape each tooth.

In essence, such tabs are like a filling created in laboratory conditions according to a pre-made cast. This technology refers to one of the types of fixed prosthetics.
Aesthetic and visual characteristics significantly distinguish a dental inlay from an ordinary filling. Such a prosthesis resembles a particle of a molar with identical grooves and tubercles, has a similar color and shape. As a result of long-term manual work, a finished dental inlay is obtained that is ideally placed in a previously prepared cavity.
Most often, inlays are installed by dentists on back teeth. Such devices are often used in the process of prosthetics as supporting structures for bridges.

One of the ways to restore a damaged tooth is to install an inlay. The article describes the advantages and disadvantages of mini-prostheses, existing species and features of restoration work.

What is a tooth tab?

Dental tab- this is a kind of filling, but its production is carried out from other materials and not in the patient’s oral cavity, but in a special laboratory using modern equipment and computer program, which models the prosthesis. In essence, this is a restoration element of the coronal part. The parameters and all the curves exactly repeat the missing fragment of the tooth, which was lost due to injury or as a result of the development of caries.

Due to the use latest technologies the mini-prosthesis is obtained in the size it has reached carious cavity in the tooth, so the product fits tightly to the tissue during installation. This prevents food debris and microbes from entering the cavity.

The tab performs the following tasks:

• eliminates aesthetic problems;
• prevents further destruction of dental tissue;
• restores the chewing functions of the molar.

Indications for installation

• when dental tissue is destroyed by more than 1/3;
• if the patient has increased wear of molars;
• for the restoration of units that are planned to be used as a support for bridges;
• when the cavity is too large and filling is ineffective.

Kinds

There are several types of tabs, each of which has its own characteristics. Before choosing one or another option, you should consider the advantages and disadvantages to prevent unpleasant surprises while wearing a mini-prosthesis.

Kinds dental tabs
Name	Description
Ceramic	A popular material that has earned trust due to its high strength and reliability. The aesthetic factor is superior to other types of options; the inlay adheres well to the dental tissues, which eliminates re-development caries. The only drawback is the high price, but justified by the advantages.
Metal-ceramic	The material does not differ significantly from ceramic products in terms of price, but is inferior in strength and reliability. This is due to different coefficients of thermal expansion of ceramics and metal, as a result of which dentures often fall out.
Composite	The composite is inferior in strength to metal, ceramics and zirconium, but this option has its advantages. The material does not sag during wear, retains the shape of the bite, and does not interfere with the chewing functions of the tooth.
Zirconium	Zirconium dioxide is used to make a mini-prosthesis. Turning of the product is carried out on the basis plaster cast automatically using a computer. This technology is highly accurate, and the material itself is not inferior in properties to porcelain inlays.
Metal	Currently, this type is used as temporary structures. The decline in popularity of metal products is associated with galvanism, which is expressed in profuse salivation and the patient's response to the galvanic current generated in the oral cavity. In addition, metal does not provide a tight fit to the tooth tissue, with the exception of gold, which was often used previously in dentistry. Another disadvantage of metal is an allergic reaction.
Plastic	A modern type of plastic is used to make a mini-prosthesis. The products benefit in price, which is due to the simplicity of the technology and the availability of the material. Often such structures are installed when large defects on the front teeth. Disadvantages of plastic products: absorb odors, are subject to pigmentation, low mechanical strength.

How to make

The inlay is a worthy alternative to a filling, but the manufacturing process is quite complicated and relatively lengthy, including the use of the latest technologies.

After preparing the tooth cavity for prosthetics, the specialist makes an impression, after which the patient is asked to scan the causative tooth using special equipment to obtain a three-dimensional image. The next step is making a cast from plaster. The process is automated and occurs under computer control. The finished microprosthesis is fixed with dental cement.

Features of making inlays from different materials:

• ceramics– first, a porcelain frame is made, after which ceramic mass is applied successively in several layers;
• metal– the creation of a prosthesis is carried out using an alloy cast;
• zirconium dioxide– the mini-prosthesis is manufactured using digital modeling and milling;
• composite– a plaster model is taken as a basis, which undergoes polymerization using light radiation and heating.

How to install

The teeth are prepared for installation of inlays.

Installing a dental inlay involves a large amount of work, so the whole process is divided into stages:

1. The first priority is diagnosis. After a thorough examination of the patient, the doctor gives directions for x-rays and computed tomography so that the picture of the lesion is extremely clear.
2. Tooth preparation counts necessary procedure, after opening the tissues, hidden problems are often discovered. Grinding of dental tissue is carried out only to the required amount, which is determined by the extent of the affected area. At the same time, the specialist tries to preserve as much living tissue as possible so that the tooth remains functional.
3. After cleaning a carious cavity The doctor makes an impression from which the inlay is made. Together with the patient, the dentist chooses the material and shade.
4. After tooth treatment To install the tab, the operated area is scanned using special equipment, with the help of which a three-dimensional model of the future microprosthesis is compiled.
5. For making tabs it takes about a week, regardless of the type chosen.
6. Before installing a microprosthesis The tooth cavity is sandblasted. This increases adhesion when fixing the product.
7. Cavity installation The product is made using dental cement.

Is it possible to restore front teeth with inlays?

It is not possible to restore the front teeth with inlays; veneers or lumineers are more suitable for this.

As an option, in case of severe tooth decay, install a stump inlay, which is subsequently covered with a crown. Mini-prostheses, similar to a filling, are used for restoration bone tissue chewing teeth.

Further care and service life

Ready-made dental inlays.

Caring for teeth with dentures does not differ from the usual rules of oral hygiene. However, when performing procedures, it is important to adhere to regularity, thoroughness and technique of brushing your teeth. It is also worth paying attention to the choice of high-quality toothpaste, dental floss and brush.

The service life of the inlays is determined by the properties of the materials from which they were made:

• plastics– up to 5 years;
• metal– 10-20 years;
• ceramics– 8-15 years.

Advantages and disadvantages

Experts highlight the following advantages of dental inlays:

• strength and reliability of the material, ability to withstand loads when chewing food and the temperature factor;
• the causal tooth acquires good protection from further destruction;
• when installing a microprosthesis, the gap between the inlay and the soft tissues is minimal, which cannot be achieved with conventional filling;
• maintaining the functionality of the tooth;
• ceramic version resistant to pigmentation;
• with the help of microprostheses it is possible to seal quite large cavities in the causative tooth;
• long operational period (about 20 years);
• aesthetic factor.

To make the picture about the inlays more complete, it is recommended to take into account the disadvantages of the dental product:

• high price;
• treatment requires several visits to the doctor;
• the need for tooth preparation;
• presence of contraindications.

Possible complications

Casts for making inlays.

The process of tooth preparation is similar to surgery, so due to the doctor’s negligence or as a result of the body’s reaction, the following complications may occur:

• acute pulpitis;
• secondary caries;
• pain caused by infection.

Also, after installing the tab, you may experience a feeling of discomfort associated with large sizes prosthesis. In this case, you must contact your doctor to correct the product.

When choosing a clinic, you should pay attention to the qualifications of the dentists working in it. The quality of the work performed also determines the risk of complications.

As a result of a medical error, a cyst develops due to the pressure of the prosthesis on the periodontal tissue, or in the process medical manipulations the root is damaged (split).

What is a core inlay for a crown?

Sometimes a dental inlay is confused with a stump inlay. In fact, these are different things. A stump inlay is an orthopedic structure consisting of two parts: a pin, which is embedded in the root, and a supporting one for fixing the artificial crown.

This type of prosthesis can be solid or collapsible. They are often used as a base for a crown. The main indication is destruction of dental tissue of more than 70%.

Previously, pin structures were used, which took the entire load upon themselves when chewing food. Nowadays, a stump inlay is more often chosen, thanks to which the pressure is redistributed over the entire area of ​​​​the damaged tooth.

Contraindications

Restoration of a damaged tooth using a mini-prosthesis is contraindicated in the following cases:

• with the destruction of incisors and fangs;
• if the caries lesion is large and the disease is developing intensively;
• with insignificant cavity depth;
• if the slopes of the hillocks are steep;
• with bruxism;
• when the carious cavity deepens deeply into the dentin.

Experts do not recommend installing a restorative structure on a wisdom tooth due to the technical complexity of the work. If the bone tissue is severely destroyed, it is recommended to remove it; anyway, the molar does not carry the chewing load.

Price

The cost of dental inlays varies depending on the material used. The budget composite option will cost an average of 4,000-4,500 rubles, and the price of ceramic inlays starts from 8,000 rubles.

Pricing is also influenced by the following factors:

• regional location of the clinic;
• status of the dental center;
• qualifications of specialists.

When reading the price lists, it is worth considering that the range of services for installing inlays includes the cost of a microprosthesis, preparation and temporary reconstruction of a molar. But during examination and diagnostics, hidden problems may be discovered, the treatment of which will require additional expenses.

Popular questions

Veneers and crowns are preferable to conventional fillings, since the service life of mini-prostheses is longer than that of dental cement. The differences between restoration inlays and veneers are in the area of ​​application and functionality:

1. inlays are placed more often on chewing units, regardless of the side of the tooth surface, they restore natural shape teeth, which preserves their functionality;
2. veneers are used to improve aesthetic appearance, installation is limited outside tooth in the front of the jaw.

• Is tooth preparation necessary?

The process of installing a prosthesis involves preparing the tooth in order to clean the cavity from necrotic tissue and clarify the real situation with the tooth. Underneath the lesion there may be other problems that require urgent treatment.

• What to do if a tooth hurts under the tab?

The pain is most likely due to developing complications or failure to comply with precautions when using the prosthesis. To begin with, chewing loads should be eliminated, and the diet should consist of liquid and pureed foods. It is also worth excluding exposure to high temperatures (eating warm, not hot food). If the pain does not subside or is accompanied by other symptoms (chills, fever, headache, radiating into the ear), then you urgently need to contact the nearest clinic.

• The tooth under the tab hurts when pressed, what should I do?

This symptom may indicate the following problems:

1. for crack formation;
2. perforation;
3. exacerbation of chronic periodontitis.

In any case, you need to take a picture that reflects the real reason.

• Why does the tooth on the tab wobble and what should I do?

A tooth can become loose for several reasons, among the main ones: weakening of the periodontium and deformation of the inlay (if the product is made of low-quality material). In any case, you should see a doctor to prescribe soft tissue strengthening agents or to replace the inlay.

• How is a tooth with an inlay removed?

The tab is fixed with cement, this makes it possible to remove it if necessary. If a doctor orders tooth extraction, an analogue of the filling is first removed, after which the usual operation is performed.

• How and when is an inlay removed from a tooth?

For a number of reasons, it becomes necessary to delete a tab. This may be due to the need for periodontal treatment, elimination of carious dentin, an allergy to the material used for dentures, or a simple replacement of a mini-prosthesis. Extraction should only be performed in a clinical setting. To prevent deformation of tooth tissues, various means are used:

1. Kopp apparatus;
2. ultrasound;
3. special orthopedic instruments.

• What to do if it falls out?

A mini-prosthesis falls out more often due to improper fitting of the structure and other installation irregularities. To correct the situation, you must immediately contact the doctor who performed the work. If the reason for the tab falling out is medical error, the specialist will fix the problem at his own expense.

• Is it possible to put an inlay on a dead tooth?

Mostly the inlay is placed on a living tooth. If the nerve was removed, this indicates severe destruction of the molar. And in case of such damage, the installation of a crown is recommended. But the option with a tab is not excluded. The material retains the integrity and appearance of the tooth well without nerves.

• Is it possible for teeth abrasion?

It is possible to install inlays to restore a tooth even with increased abrasion.

From this article you will learn:

• what are dental inlays and what are they?
• their advantages compared to tooth filling,
• dental inlays – cost for 2020.

A dental inlay is a microprosthesis of a tooth that restores its missing part. There are several types of inlays in dentistry, each of which solves separate problems. To restore human teeth, the crown of which is only partially destroyed by caries, the so-called recovery tab. Such a tooth inlay can most often be made of either metal or highly aesthetic metal-free ceramics, and it is an alternative to traditional tooth filling.

The second option is the so-called, which are used to restore almost completely destroyed teeth. This inlay consists of two parts - 1) the lower part resembles a pin, which will subsequently be fixed in the root canal with cement, 2) top part looks like a tooth stump ground down for a crown. After fixing such a tab in the root canal, an artificial crown is fixed on top of it.

Restorative dental inlays: photo

In our article we will talk specifically about recovery tabs. The main difference between such tabs and artificial crowns is that they do not cover the entire tooth, but only 1-2 of its surfaces (Fig. 1-2). Most often, inlays are made for lateral chewing teeth, restoring completely or partially destroyed chewing surfaces. The production of inlays occurs mainly from pressed ceramics and metal alloys, and most often they are classified according to the material of manufacture.

Classification of recovery tabs –

1) Metal tabs –

Metal inlays are usually made of gold, silver-palladium or chromium-cobalt alloys. It would seem not entirely aesthetically pleasing, but... Since the inlays are located on the chewing teeth, they, as a rule, do not fall into the smile line. Metal inlays are much more reliable than composite fillings, and therefore in Europe and the USA such inlays are preferred over fillings.

2) All-ceramic inlay –

Ceramic inlays come in two types: zirconium dioxide or pressed ceramic.

1. Zirconium dioxide inlay –
   are made by milling from zirconium dioxide blanks according to. The process of making such a tab is simplified as follows:
   • First, all tissues affected by caries are removed from the chewing surface of the tooth with a drill and thus a cavity is formed for an inlay of a certain shape.
   • Then they take an impression of the teeth and send it to a dental laboratory, where a plaster model of the patient’s teeth is cast using this impression. This model reflects with the highest accuracy what the patient has in the oral cavity.
   • After this, the section of the model with the tooth prepared for the inlay is scanned using a special scanner, and the computer uses these data to build a three-dimensional model of the future inlay.
   • After this, the computer transfers the three-dimensional model to a milling machine, which, without human intervention, “cuts out” this tab from a zirconium dioxide workpiece.
   • After this, the finished workpiece is fired and the porcelain mass is fused onto it.
   • the last stage: fixing the inlay to the patient’s tooth.

   Inlays made of zirconium dioxide are similar in aesthetics to inlays made of pressed ceramics, and due to the zirconium frame (stump) they are not inferior in strength to metal inlays. In addition, the process is fully automated, so below the notorious human factor, which can affect the quality of work; in addition, the size of the gap between the zirconium inlay and the tooth tissue is the smallest of all types of inlays (accordingly, the risk of secondary caries with adequate hygiene is minimal).

2. Pressed ceramic inlays –
   are made by injection molding porcelain under pressure and high temperature. They allow you to achieve ideal aesthetics, if this is so important to you on your chewing teeth. The pressed one behaves best here, from which veneers and ceramic crowns are also made.

Rarely, but you can still find inlays made of metal ceramics. They are no different in cost from ceramic ones, but their quality is much worse. The fact is that such tabs often fall out. This is due to the fact that the coefficient of thermal expansion of ceramics and metal is different, and given that the inlay (unlike the crown) occupies only a small part tooth, then the difference in the coefficients of thermal expansion of metal and ceramics leads to the loss of such inlays.

4) Composite tab –

Previously, this type of tabs was widely used. Such inlays are made from ordinary filling composite materials, but not in a person’s mouth (like dental fillings), but in a dental laboratory. In cost, they are 30% more expensive than fillings made from the same materials, and in quality they practically do not differ from ordinary fillings; for example, they also darken and fade over time. Therefore, there is basically no point in making such inlays.

Advantages of inlays over fillings –

• Highest aesthetics of ceramic inlays, high stability of aesthetic properties–

  Ceramics most closely matches the color and structure of tooth enamel. Due to this, teeth, the chewing surface of which is covered with an inlay, are absolutely indistinguishable from real tooth tissue. Plus, ceramic is a timeless material and its aesthetics are guaranteed for life. In turn, fillings made of composite materials darken and fade after 2-4 years, losing their shine.

• Quality, reliability of inlays made of ceramics and metal alloys–

  The size of the gap between the natural hard tissues of the tooth and the artificial structure (inlay, filling) has a great influence on the service life. Connection boundary artificial material and dental tissues – is the most vulnerable place where secondary caries most often occurs.

  Prosthetics with inlays makes it possible to ensure that the gap between the tooth tissue and the inlay is measured in microns - this is how accurately modern technologies make it possible to manufacture an inlay to the size of the tooth defect. In turn, fillings have similar indicators that are hundreds of times worse, and that is why caries so often occurs at the filling/tooth/border.

  Therefore, with satisfactory hygiene, the service life of inlays is more than 10 years, and polymer fillings - on average only 3-4 years.

Lack of inlays before fillings –

• The cost of inlays, due to the high cost, complexity of manufacturing, as well as their higher quality, significantly exceeds the cost of traditional fillings made from light-polymer filling materials.

Dental inlays: price 2020

1) Ceramic inlay: price

• from pressed ceramics: 12,000 – 15,000 rubles,
• from zirconium dioxide: 18,000 – 25,000 rubles.

2) Metal tooth tab: cost

• inlay made of chrome-cobalt alloy – from 3500 rubles
• The cost of a gold tab will depend on the weight of the tab + the cost of the work itself. Typically, a gold tab can weigh from 1 to 3 grams, depending on the size of the tab. The cost of 900-carat gold leaf for such inlays is about 60 Euros per gram. Approximately 10% of gold (by weight of the insert) goes to irreparable losses during production (evaporation, losses during abrasive preparation), which will also be taken into account in the cost.

3) Composite inlay dentistry: price
the cost of composite inlays is usually approximately 30% higher than the cost of light-polymer fillings. Composite inlays are practically not used today due to the backwardness of the technology and its low “usefulness”. We hope that our article on the topic: Tabs in dentistry was useful to you!

Sources:

1. Personal experience as a dentist,
2. National Library of Medicine (USA),
3. American Academy of Cosmetic Dentistry (USA),
4. " Orthopedic dentistry. Textbook" (Trezubov V.N.),
5. " Orthopedic treatment fixed prostheses” (Rozenshtil S.F.).

Photo: Stump metal tooth inlay

A stump inlay is a specially made one from a cast dental design, onto which an artificial crown is subsequently fixed. Used to restore severely damaged teeth.

The stump pin tab consists of coronal and root parts. Its root part is fixed in the dental root canal, the coronal part is similar to the stump of the tooth and is already prepared for the crown.

The stump insert, unlike the pin, is installed in several steps, but its use guarantees that the tooth will definitely not break and will no longer be destroyed.

The pin stump insert distributes the load on the tooth evenly, this is its main difference from the pin.

Fastening the inlay to a special cement composition ensures a tight fit of the structure to the remains of the tooth and prevents the formation of cracks.

Kinds

According to the manufacturing method, dental stump inlays are either cast or collapsible.

Cast stump inlay

Manufactured at high temperature and under pressure. It consists of the main part, which restores the tooth, and fixing pins, with the help of which the tab is secured in the dental canals.

Collapsible stump tab

It is made if the tooth root has three or four canals. Some pins are made removable because they cannot freely enter the root canal. This tab is almost no different from a cast one. The collapsible inlay fits perfectly to the shape of the tooth. After its installation, removal of the stump tab is unrealistic. In this regard, a lifetime warranty is established on collapsible stump inlays.

Depending on the material from which the stump inlay for the crown is made, there are the following types designs:

• Metal stump inlay .

It can be made from chrome-cobalt alloy, from precious metals and their alloys. Such inlays are more reliable than structures made from composite materials, but are not aesthetically pleasing. Therefore, they are often placed on chewing teeth and do not fall into the smile line. Gold inlays - best option for restoration of chewing teeth.

• All-ceramic inlay.

The structures are made of pressed ceramics and zirconium dioxide. Stump inlays made of zirconium dioxide are not inferior in strength to metal inlays, and inlays made from pressed ceramics are identical in aesthetics to porcelain inlays. The manufacturing process of all-ceramic structures is fully automated, which completely eliminates the formation of secondary caries. For the restoration of anterior teeth, a stump inlay is used on the anterior teeth.

• Stump metal-ceramic inlay.

The quality of such tabs is worse, because they often fall out. This is explained by the difference in thermal expansion of metal and ceramics.

• Inlay made of composite materials.

Nowadays such inlays are used very rarely, because their quality is no different from a regular filling, although their cost is higher.

Stages of manufacturing a stump tab

• Preparing the tooth for making an impression. Preparation for the stump inlay is carried out using a drill. To do this, remove all dental tissue affected by caries and create a cavity for the inlay. It is given a certain shape.
• Taking an impression of teeth. In the laboratory, based on the impression, the dental technician casts a plaster model of the teeth.
• Scanning a section of the model with a prepared tooth.
• Computer modeling of the stump tab.
• The computer transfers a three-dimensional model to a milling machine, where the ceramic inlay is cut out.
• Firing the workpiece in special furnaces.
• Fixation of the core inlay on the tooth.

Indications for installation

A stump inlay is only possible if the tooth root has survived.

Indications for the use of stump inlays:

Photo: Destruction of dental crowns

• Destruction of the crown of the tooth.
• Defects in the shape and position of teeth.
• Defects of the supragingival area of ​​the tooth, having different origins.
• The inability to restore dental crowns using filling materials or other methods.
• As a support for the installation of a bridge prosthesis.
• For periodontal diseases, as a splinting structure.

Contraindications

The stump tab has some contraindications for use:

• Gum disease at the site of installation of the stump tab.
• Damage to the tooth root.
• The presence of pathological mobility of teeth.
• Poorly treated root canals.
• Allergic reaction to the alloys from which the structure is made.

How does the installation work?

• Preparing the tooth for installation of a core inlay. For this purpose, endodontic therapy is performed. The root of the tooth is carefully filled to the very top, which is confirmed with an x-ray.
• Unsealing the roots to one third or half the length of the root. The channel is given a taper and width.
• Taking impressions from both jaws so that the future inlay is made taking into account the relationship of the antagonist teeth.
• In the laboratory, a plaster model of the teeth is made and a wax core insert is modeled.
• The core is cast and sent to the dentist's office.
• Fixation of the finished stump structure using cement. Immediately before installation, the tab is thoroughly degreased. The tooth is treated with alcohol and thoroughly dried. Using a canal filler, the root canals are filled with cement. The inlay with the pin is coated with cement mortar and installed in place. Then, if the structure is collapsible, then additional pins are coated with cement and placed in the desired root canals. At the end, the entire tab is carefully pressed down.

Recovery and rehabilitation

• Since teeth are prepared before prosthetics with a dental core insert, complications such as secondary caries or pulpitis may develop after installation of the structure.
• In some cases, pain is noted.
• To prevent such complications, you must strictly follow your dentist's recommendations.

Video: “Removing the core inlay from a tooth”

FAQ

It is often difficult for patients to decide on the choice of material for installing stump inlays.

When choosing, it is necessary to take into account the condition of the patient’s oral cavity, the aesthetics of the structures, and the compatibility of the materials from which the core inlay and dental crown are made.

Do right choice Experts' answers to frequently asked questions from patients will help.

• Question: What material is best to make a stump insert from? Everyone recommends gold, is this correct?

Answer: Gold inlays are biocompatible and transfer uniform load to the root.

• Question: How durable are the inlays? They say that their service life is from 5 to 10 years, is this true?

Answer: Tabs can last a very long time when proper care. The most durable are gold and zirconium stump inlays.

• Question: What material is best for a crown to be placed on a core inlay?

Answer: If the stump inlay is made of ceramic, then the crown should be made of the same material. If the inlay is metal, then the crown should also be made of metal. Ideally, the materials should be identical.

Pros and cons of stump inlays

Stump inlays have some advantages over other designs:

• Strength and reliability of fixation.
• Large selection of artificial crowns.
• Possibility of giving the correct shape to the tooth.
• In some cases, it is possible to correct the position of some teeth.
• The installation of bridge structures is simplified.
• They are used for the destruction of any teeth.
• There is no access for bacteria, which prevents development inflammatory processes in the gums and destruction of tooth tissue.
• The artificial crown can be easily removed and another one installed in its place.
• Excellent aesthetics when using ceramic inlays. A zirconium oxide core inlay can be used to restore anterior teeth.
• Long service life.

Disadvantages of stump inlays:

• High cost of structures.
• The need to remove a large part of the living tooth tissue to ensure a perfect fit of the inlay.

Care of stump inlays

• After installing the stump tab, it is necessary to maintain hygienic oral care. You should brush your teeth at least twice a day using toothbrush with pasta.
• To clean the surface of the dental structure and adjacent gums, it is better to use a toothbrush with soft bristles. Using a brush-brush and floss you can clean the interdental spaces.
• After each meal, your mouth should be rinsed with warm water or a special solution that has an anti-inflammatory effect and freshens breath.
• At least twice a year, you must visit the dentist’s office for a preventive examination.

Prices for stump inlays

Dental inlays are a fairly expensive method of prosthetics.

A cobalt-chrome stump inlay is more affordable in price, which is lower than those made from precious metals and ceramics.

Life time

With the right hygiene care behind the stump tab the service life is 10 years or more.

A gold stump inlay has a service life of more than 15-20 years.

The topic of our review today is dental inlays. What they are, what they are used for, how effective and durable - we will discuss all these topics in new article. Different kinds inlays are used in dentistry as a prosthetic element. They can partially restore the shape and function of a damaged tooth. There is also the concept of stump tabs. They are used to restore the tooth stump prepared in advance for the inlay.

What is the difference between such prostheses and standard crowns?

1. First of all, in size and purpose. imitates the entire tooth, the inlay imitates part of it.
2. In purpose, inlays are usually used for teeth located behind the canine teeth - premolars and molars.

Types of restoration inlays depending on material

IN modern dentistry Many different materials are used to restore the shape and functionality of teeth. If we are talking about chewing tooth, which traditionally bears the greatest load, the material must have maximum strength. Metals and alloys, ceramics, metal-ceramics, and composite materials are used.

First, we will discuss metal dental inlays. For their manufacture, various alloys are used, including the use of precious metals - silver and gold. Interesting fact– in the EU countries and the USA, people often choose not composite and photopolymer fillings, but more reliable metal inlays. If we are talking about molars that do not fall into the smile zone, there is no point in spending money on a filling that may break or simply fall out.

There are three popular materials:

• gold;
• palladium and silver alloy;
• an alloy of cobalt and chromium.

Features of gold and alloys in the manufacture of inlays

Gold is a high-quality and durable material. It is often used for prosthetics. But we are not talking about the 585 standard used in the production of jewelry, but about 900 and higher. This material is quite soft and pliable. It's not difficult to process at all. This makes it possible to avoid the appearance of large gaps between the metal and the surface of the tooth prepared for prosthetics. The result is long service life and reliability.

In addition, gold is a hygienic and chemically neutral material. When interacting with the moist environment in the mouth, it does not create toxic oxidation products

Cobalt chrome inlays. Of course, they do not last as long as gold ones and are noticeably inferior in appearance, but they are pleasing with their low cost. Their metal surface is polished to a mirror finish. If you compare them even with the most expensive fillings, the choice is obvious.

Manufacturing of dental inlays from ceramics and zirconium

The next item in our review is ceramic teeth. These include two materials - pressed ceramics and zirconium dioxide. When making inlays from pressed ceramics, the method of pressing cast porcelain is used. Modern technologies treatments make it possible to achieve excellent aesthetic parameters. The finished product will match the appearance of the surrounding teeth.

The product with a zirconium frame is not inferior in appearance to porcelain dental inlays. At the same time, they are much stronger, which means they will last longer. Manufacturing is fully automated, eliminating errors and poor fit. This reduces the risk of secondary dental caries. The procedure consists of several stages.

1. Preparing the tooth surface. Enamel and dentin affected by caries must be removed. To avoid missing the affected area, you can use caries markers. These substances stain all tissues that require removal. The cavities are given the desired shape.
2. The dentist makes an impression of the tooth, from which a plaster model is cast in the laboratory.
3. Based on the existing impression, a highly accurate 3D computer model is created using a special scanner.
4. Once your tooth is digitized, the process moves into auto mode. A special computerized machine creates the inlay exactly according to the shape of the cavity.
5. The workpiece undergoes heat treatment.
6. A procedure is carried out to fuse a porcelain coating onto a zirconium base.

Metal-ceramic dental inlays

This popular material is used not only in manufacturing. Nowadays dental inlays are also made from it. Unfortunately, they cannot boast of quality. What is the problem? The fact is that ceramic and metal parts have different physical and mechanical properties. In particular, the coefficient of thermal expansion. This causes the inlay to simply fall out of the tooth.

IN in this case it doesn't make much difference how much the workpiece cost. Cheap and expensive, they have the same disadvantages.

Composite inlays

This guy was popular for a long time, but is now used quite rarely. In essence, these are the same photopolymer fillings, but made from an impression in advance and then installed in the prepared cavity. This method of dental prosthetics costs a third more than filling, but there is not much benefit from it. Composites lose their aesthetics very quickly.

Over time, the restored tooth will darken and stand out unattractively from the rest. So there is no point in spending money on these tabs.

Advantages and disadvantages of tabs

We'll start with aesthetic parameters. Most people who go to the dentist to have a tooth restored want it to look exactly like the rest in the row. That is, it did not differ in color from natural enamel. Using ceramics, a specialist can easily imitate a tooth area using a dental inlay. The service life of the ceramic product is long. Some dental laboratories offer a lifetime warranty on their products. That is, if you do not open bottles with your teeth every day, the tab will last a long time without darkening or changing its properties.

Comparing porcelain with composite is pointless. After all, photopolymers are relevant only as a budget solution. Their service life is limited to 2-4 years. Strength, reliability and durability - no less important parameters. It is important that the product is made with maximum precision. This will avoid the appearance of large gaps between the surfaces of the inlay and the dentin. Consequently, foci of secondary caries will not appear at this border.

1. In the manufacture of metal and ceramic inlays, the gap is measured in microns, which is unattainable for fillings.
2. The service life of alloy/porcelain inlays is from 10 years.

A natural question arises: where is the fly in the ointment in this beautiful story? As you may have guessed, it is related to price. There is a big difference between photopolymerizing the material in the tooth itself and making a 3D model, cast, etc.

About stump tabs

Stump inlay for crown – effective solution to restore damaged teeth. It consists of two parts - crown and root. The crown is prepared for tooth restoration using a crown (most often), the root is installed in the root canal like a pin.

When does it make sense to install this type of tab? If the walls of the tooth are strong enough or at least part of them is preserved, installing a pin is usually sufficient. In cases where only the root remains, it is necessary to make a stump tab, otherwise there is a risk of root fracture due to high load. The manufacturing procedure is simple. First, the tooth is prepared. Root canals are treated and filled. Next, the orthopedist performs secondary preparation. To do this, he needs to partially unseal the canal to the required length. Once the hole is ready, an impression can be made. The future tab is made based on the physical model. It is not made on site, but in special conditions dental laboratory. This allows you to achieve high precision at work.

The tab is fixed inside the canal using special cement. It holds it securely inside the root, preventing it from moving and falling out. This material hardens in about 15 minutes.

If a molar is being restored, an inlay should be placed on all root canals. This makes it much more reliable. It is often necessary to make a collapsible structure in order to easily install it in channels that do not run parallel. Such a dental inlay will be more reliable and more effective than any standard pin structures and fillings. The service life of structures consisting of them and crowns is much longer.

Materials used in the manufacture of stump inlays

Inlays made from zirconium dioxide are considered to be of the highest quality. They are good because they allow you to restore teeth from the so-called smile zone. Unlike metal, zirconium ceramics do not show through the crown. Therefore, it looks natural.

There is no point in putting a porcelain crown on a metal inlay. The alloy glows blue. If it is planned to restore the coronal part using metal or metal-ceramics, solid dental inlays made of an alloy of chromium and cobalt are used.

Alloys for casting stump inlays

Name	Description	Photo
Gold with platinum	Alloy 750 with a content of 10% is the most optimal in terms of its characteristics
Silver	Pigmentation is often observed after the use of silver core pins surrounding the tooth gums
Silver-palladium alloy	Has bactericidal properties
Chrome-nickel alloy	The alloy has a high shrinkage and, in addition, nickel has a cytotoxic effect
Chromium-cobalt alloy	The alloy has high hardness, low shrinkage, but is difficult to process
Titanium	From the point of view of bioinertness, titanium is preferable, but, having great hardness, it has some fragility
Steel	For the manufacture of composite inlays, a light-polymer material is used, which is used for the manufacture of corresponding fillings

Cost of different types of tabs

The most pressing question when choosing tabs is prices. We present the average cost of stump and restoration inlays made from different materials. Prices for stump inlays:

• metal, 1-root tooth – from 2000 rub. ($34);
• metal, 2-root tooth – from 3000 rub. ($51);
• metal, 3-root tooth – from 4000 rub. ($68);
• zirconium oxide – from 8000 rub. ($136).

Recovery tabs:

• zirconium - about 17,000 rubles. ($288);
• pressed ceramics – 14,000 rubles. ($237);
• alloy of chromium and cobalt - from 3500 ($59);
• gold - by weight. On average, the weight of the tab is 3 grams. The cost of a gram is 60 €. That is, only 180 euros worth of material is required;
• composite materials are approximately 30% more expensive than a conventional filling.

Choose the option that suits you in terms of finances and quality.