Everyone needs to know about metal-ceramic crowns. Which teeth are better

Metal ceramics occupies a special niche in dentistry due to the reasonable demand. Dentures made of this material are united by an acceptable cost, high strength and the fact that metal-ceramic crowns look as natural as possible- the photo is a direct confirmation of this.

Metal ceramic prosthesis: types, structure and manufacturing stages

The concept of "cermet" speaks for itself. This is a compound of metal (zirconium dioxide) and ceramics, which has high hypoallergenic properties.

The process of creating a structure begins with the manufacture of a frame base. According to the material of this part, they distinguish the following types metal-ceramic crowns:

Made of ultra-strong medical alloy: nickel and chromium, cobalt and chromium.
From elite alloys of non-ferrous metals: gold, palladium, platinum.

The use of noble materials enhances the strength and hypoallergenic properties. Gold alloys not only provide the strength of the metal frame, but also give natural look manufactured product. In its shade, such a crown accurately imitates a natural tooth, which is why cermets are so common in the prosthetics of anterior incisors and canines.

When the frame base is ready, a ceramic coating is created, this stage of manufacturing the cermet is the final one. The mass is applied to the frame base by casting or layer-by-layer spraying. Application is the task of the dental technician, performed according to the patient's individual impressions, which makes it possible to create a prosthesis of maximum accuracy, reliability and convenience.

After manufacturing, the crown is processed in a special oven: firing at temperatures up to 900 ° C. This ensures high adhesion and interaction of the elements of the product.

The methods of applying ceramics differ only in technology, the choice of method does not affect either the strength, or the quality, or the hypoallergenicity of the prosthesis.

In the photo, a crown on a tooth made of metal ceramics

Composite product, which has special strength and immunity to external factors, wear resistance and durability, is optimal way prosthetics. Metal-ceramic dental crowns have a natural and aesthetic appeal.

How to insert teeth from metal ceramics

The main stages of metal-ceramic prosthetics:

preparatory;
laboratory;
final.

Preparatory stage

At this stage, the oral cavity is prepared for the subsequent placement of prostheses. The beginning of prosthetics includes the following procedures:

With the help of X-ray, inflammatory processes, dental pathologies are revealed. Dentists determine the treatment regimen, carry out restorative measures oral cavity, abutment tooth, select a crown.
Preparation of a tooth (the place where the prosthesis is installed) or several. The procedure is mandatory in the presence of inflammatory processes in the root, damage to the tooth, which must be treated to the end. It is necessary to treat the tooth.
Installation of a pin or stump tab. The pin is installed in case of damage to half of the hard tissues of the tooth. The stump tab is necessary for its complete destruction.
After carrying out medical and restorative procedures, the abutment tooth is ground to prepare for taking an impression. The resulting impression is sent to the laboratory.

Laboratory stage

Combines the stages of manufacturing a metal-ceramic crown:

Getting started includes taking an impression from the base tooth. As well as the formation of a plaster model and a frame of the future prosthesis.
The frame is tried on on a plaster model or on the patient's abutment tooth.
If the fitting was successful, the dental technician begins to apply a ceramic mass layer by layer on the metal frame base, after which the finished crown is "baked".

The final stage

At this stage, temporary installation of a metal-ceramic prosthesis, which is possible in the absence of discomfort, the presence of minor defects in the crown. It is placed on a temporary retainer. The specialist determines the period of adaptation, getting used to the design. If rejection does not occur, the temporary fixing element is removed, the crown is placed on the tooth using a permanent one.

Prosthetics of cermets for anterior and chewing teeth

A combination of such positive qualities, as wear resistance, strength, durability, natural appearance, allows you to effectively use cermets for prosthetics different teeth, regardless of their function.

Advantages of metal-ceramic prosthetics on molars

Cermet crowns on chewing teeth are done most often. Molars are prosthetic with this material because of its high strength, immunity to external unfavorable factors, and wear resistance. These properties make it possible to insert a prosthesis while maintaining all the necessary physiological functions.

Despite the fact that molars are not as visible as anterior teeth, the installation of a metal-ceramic crown makes it possible not only to preserve the functional purpose of molars , but also creates an attractive appearance.

Crowns made of metal and ceramics have a wide shade palette that allows you to reproduce the naturalness of an artificial tooth as accurately as possible.

Advantages of metal-ceramic prosthetics for incisors and canines

In the presence of congenital pathologies leading to the destruction of the front teeth, wear and tear, thinning, strong curvature, crowding, they are prosthetic with cermet. By installing a metal-ceramic crown on one or several teeth, the doctor solves not only the problems of proper functioning.

The barely discernible border of contact between the crown and the gum, the natural color of the prosthesis, not damaged gum integrity, solve the aesthetic issue as efficiently as possible. After installation, the patient can fully smile, teeth with a metal-ceramic composite crown look natural and attractive.

Photo: teeth before and after the installation of metal-ceramic crowns

Indications and contraindications for installation

Prosthetics with a metal-ceramic crown is indicated in the following cases:

missing one or more teeth;
the tooth is destroyed by more than 50%;
it is necessary to restore the jaw row completely;
odontological pathologies of a hereditary nature;
diseases that provoke accelerated abrasion, tooth decay;
restoration of the chewing function of molars;
restoration of the natural tooth shape with strong curvature, thinning;
periodontal disease of primary and secondary degree;
inability to carry out orthodontic treatment due to abnormal placement of teeth;
fixing movable teeth - splinting;
severe allergic reactions to metal-plastic crowns;
fluorosis in acute form when, due to an excess of fluoride, the enamel is destroyed;
when it is necessary to replace metal, plastic prostheses and put new ones.

A metal-ceramic crown is the most suitable solution for eliminating defects in the dentition.

Despite the complex of positive properties and qualities, the use of cermets and their prosthetics have a number of contraindications:

pregnancy;
severe periodontal disease;
foci of inflammation in the oral cavity;
psychopathology, psycho-emotional disorders;
malocclusion;
recovery period after a serious illness;
ARI, ARVI;
involuntary contraction chewing muscles- teeth grinding;
allergic reactions to metals used in the manufacture of crowns;
miniature teeth: it makes no sense to insert a denture, small size the tooth will not allow the crown to hold on.

The main pros and cons of cermets

Metal-ceramic prostheses have a number of advantages and disadvantages, including:

Dignity	disadvantages
Natural color, rich tint palette that allows you to naturally simulate the natural shade and texture of dental tissue.	Depulpation. Installation of a metal-ceramic crown most often requires nerve removal, cleaning and filling.
High functionality. Composite crowns, the way they do metal-ceramic teeth v special conditions, allows you to fully recreate the functional task of the prosthetic teeth. Molars retain chewing, frontal molars retain their biting and aesthetic function.	The need to grind the tooth, due to which up to 2 mm of its own tissue is lost.
Creation and maintenance of aesthetic appeal. Metal ceramics provides aesthetics of the dentition due to a wide shade-color palette, does not allow the absorption of dyes.	Chipping is possible, which occurs under excessive stress on the porcelain-fused-to-metal crowns.
Hypoallergenic. Development risk allergic reactions in the manufacture of cermet is minimal due to the use of non-toxic materials.	The strength and hardness of the prosthesis can lead to accelerated wear of the teeth of the opposite row.
High strength and resistance to external influences... The metal-ceramic composite crown withstands the required load. Firmly adhering to the hard tissue of the tooth, the material does not allow its further destruction due to its high resistance to external factors.	Available contraindications.
Long operational life. Proper care will ensure wearing metal-ceramic crowns for at least 15 years.	-
Biocompatibility. The risk of crown rejection is minimal.	-
Adequate price.	-

The choice of cermets, taking into account the characteristics of different manufacturers

In order to correctly understand what cermets are, to assess their relevance in dentistry, it is important to understand what technical and practical level this dental direction has reached. In the production of materials for metal-ceramic crowns, they use Newest technologies and scientific discoveries to improve your products:

Innovative developments allow the ceramic mass used by the brand to acquire special properties that prevent plaque from accumulating on the tooth surface. These qualities ensure the preservation of the original appearance several years after the prosthetics.
The ceramic mass contains the smallest crystals, which significantly increase its strength, wear resistance and service life. Advanced ceramics resist chipping and other imperfections.
Vita VM 13. Materials for the manufacture of prostheses are latest achievement German scientists in the field of cermets. Crowns have reflective, light-refractive properties that match those of natural enamel. This allows you to make the most natural prostheses.
Duceram prostheses with the highest esthetic properties. The dyes and ceramics used in the manufacture of these crowns reproduce the natural tooth enamel... This allows the manufacture of prostheses that are visually almost impossible to distinguish from natural teeth.

Metal-ceramic prosthetics is relevant not only in Moscow, but also in other Russian cities. In order not to be afraid of this procedure, it is necessary to understand what a metal and ceramic crown is, to know the pros and cons of a prosthesis, situations when metal-ceramic crowns are required, and when it is contraindicated. The necessary knowledge will allow you to select and install the optimal product, make your smile beautiful and healthy.

Tooth decay and loss are always associated with a variety of problems. An ugly smile becomes the cause of a bad mood, and digestive problems lead to a violation of the usual rhythm of life. Fortunately, modern dentistry has in its arsenal effective techniques restoration of teeth. And the materials used for are becoming more and more perfect every year.

Which teeth are better - cermets or metal-plastic?

For these purposes, ceramics, metal, plastic, as well as their compounds are now used. Consider the features of a particular material and try to answer the question of which of them should be preferred.

Sintered metal

In dental prosthetics, metal ceramics mean bridges or made of these materials. If only part of the tooth has undergone destruction, then crowns are installed. When one or more teeth are completely missing, a bridge is made. And if there is only a root of the tooth, it is possible to install a porcelain fused-to-metal crown on the pin.

The orthopedic construction is made of metal in the form of a tooth, which is covered with a ceramic layer. Ceramic is applied to a metal substrate in one of the following ways:

casting;
spraying.

In dentistry, when creating metal-ceramic prostheses, hypoallergenic materials are used that have good compatibility with the human body. And only in rare cases, individual intolerance can manifest itself.

Metal-ceramic crowns - photo

On a note! Most often, metal-ceramic prostheses are installed in the area of chewing teeth, for which appearance is not particularly important, but it is imperative to restore the ability to chew food normally.

For the manufacture of a metal-ceramic prosthesis frame, dentists use the following types of metals:

precious;
semi-precious;
simple.

A layer of ceramics is applied to this base using one of the above methods. For the manufacture of crowns, a composition specially developed for dental purposes is used. It has hypoallergenic properties, does not fade over time and does not change color. This material imitates tooth enamel well, repeating its color and structure. If in any particular case it is impossible to install a fixed prosthesis, then a removable metal-ceramic construction is used. It consists of a metal arc with metal crowns fixed to it.

On a note! Despite the fact that the ceramic layer on dentures perfectly imitates tooth enamel, a metal base often shines through it.

If installed in place of the chewing teeth, this is not critical. But when prosthetics of the anterior teeth are carried out, it is necessary to resort to other materials in order to avoid this effect. In this case, as a rule, one-piece ceramics are used, but a base of zirconium dioxide or oxide can also be used.

Table. Metal-ceramic dentures - indications and contraindications.

Video - Metal-ceramic bridge prosthesis

Pros and cons of cermets

The following advantages of metal-ceramic prostheses are distinguished:

aesthetic appearance- they practically do not differ externally from real teeth (the selection of a suitable shade is carried out from a large palette of ceramic spraying colors);
biocompatibility with the tissues of the oral cavity, and hypoallergenic(in extremely rare cases, individual intolerance was observed);
complete restoration of chewing function: metal-ceramic prostheses practically do not differ from living teeth in functionality and do not cause discomfort;
reliability and durability: cermet withstands loads when chewing food, is not prone to cracking, chips and deformation, maybe more than 10 years;
hygiene: does not lead to the multiplication of bacteria in the oral cavity;
stain resistance under the influence food colors- no need to avoid eating any products;
preserving the tooth from further decay thanks to a snug fit.

Sintered metal - before and after

The disadvantages of metal-ceramic prostheses include:

turning- requires the removal of a significant part of the tooth tissue;
depulpation- the nerves of the tooth are also removed when installing cermets;
contact surface wear living teeth adjacent to the prosthesis.

Video - What is better ceramics or cermets

Metal-plastic

Like cermets, metal-plastic prostheses consist of a metal frame and a coating. The only difference is in the material from which the top layer is made. For this, a high-strength dental plastic is taken, which is non-toxic, strong adhesion to metal, and the ability to well imitate the surface of the tooth.

Such prostheses are installed in the following situations:

as temporary structures designed to replace missing teeth during the manufacture of metal-ceramic prostheses;
as an outer coating for implants with a metal base;
when combining several types of prosthetics to restore the dentition;
for prosthetics of individual anterior or posterior teeth.

Pros and cons of metal-plastic

The main advantages of metal plastic prostheses:

fast production time;
ease of repair if necessary;
relatively non-traumatic installation;
affordable price.

The disadvantages include:

short service life (maximum 3 years);
fragility, which leads to the formation of chips and deformation;
the porous composition of the material promotes staining under the influence of food dyes, which worsens the appearance of the teeth;
poor fit, resulting in a bad smell from food lodging under the denture.

What to give preference to?

Depending on the goals of prosthetics and the patient's financial capabilities, dentists can install manufactured according to various technologies and using a wide variety of materials. The most reliable, durable and aesthetic prostheses require expensive materials for their creation. Another factor influencing the choice of material is the location of the tooth that needs restoration.

The plastic used in dentistry is characterized by high quality, perfectly recreates the structure of tooth enamel and the shade of living teeth, and is hypoallergenic. Nevertheless, in terms of a number of characteristics, this material is much inferior to cermets. Therefore, when choosing from these two materials for dental prosthetics, it is recommended to give preference to cermets.

Metal-plastic prostheses are less reliable. They are incapable of imitating the surface of natural teeth as well as cermets. Metal-plastic prostheses are used mainly as a temporary measure for the period while the process of manufacturing metal-ceramic structures is in progress or if it takes time for the patient's body to get used to the implant. Installation of metal-plastic crowns for a long time is not justified also for the reason that plastic is destroyed much faster than metal.

The 3 best options for removable dentures with no teeth at all

Photo	Name	Description
	Acrylic denture	Affordable material cost, but due to its hardness, it is the hardest to get used to. Such prostheses are not recommended for people with traumatic work. In addition, acrylic can cause allergic reactions.
	Nylon prosthesis	Nylon, on the other hand, is hypoallergenic and soft. It's easier to get used to. In terms of aesthetic qualities, nylon is several times superior to acrylic: such a prosthesis cannot be visually distinguished from natural tissues
	Acre-free prosthesis	The acri-free structures are even thinner and lighter. They are somewhat stiffer than nylon, but unlike the latter, they can be adjusted in case of damage. But their cost is somewhat higher.

Video - What are the types of dental prosthetics?

Metal-ceramic prostheses are made using an alloy of chromium, cobalt and nickel. To put it simply, this is a metal structure, on top of which there is a special coating (ceramics). A special layer in the form of gold or platinum is possible. These materials make it possible to achieve a very similar result with your own teeth.

How are cermet prostheses made?

Cermet crowns made according to the following scheme:

The dentist takes an impression of the upcoming design.
Gives this impression to the dental technician.
The technician makes a model of the future prostheses.
The dentist tries on the design on the patient's teeth.
When flaws are found, the design is sent back to the technician for revision. When everything fits well, then a layer of ceramics is applied on top of the structure.
On the last stage the dentures are covered with a layer of glaze.

Indications for metal-ceramic prosthetics

Metal-ceramic crowns are attached to real teeth or, in their absence, to implants. Anyway, there are certain indications:

Metal-ceramic prostheses have a large list of advantages:

But at the same time, metal-ceramic prostheses have a number of disadvantages:

Probable complications of cermets

Prosthetics may have side effects... This can occur both from the inserted material and from the actions of the dentist. Typically, factors are technical and human. Side effects can appear in the form of gum inflammation and gingivitis. Diseases of the soft tissues can be caused directly by the inserted prosthesis. Most often, the focus of infection begins in the area where the crown is in contact with the tissues. Most likely, during the installation, the technology was not followed, plus the person did not provide proper hygiene. Thus, the described factors of the procedure created an undesirable effect. V this case the dentist will be required to remove the tooth.

It so happens that the patient feels pain under the prosthesis itself. Most likely, periodontitis develops. This often happens when the prosthesis is placed on a living tooth.

Also cyanosis of the gums appears, this reaction is caused by metal crown... Apart from the unnatural color, the person does not feel any discomfort. This complication only causes an aesthetic problem.

In some cases, a metal base can be observed under the metal-ceramic layer of the prosthesis. This can often be seen in people who have had a single tooth replacement. When the restoration of a number of teeth was carried out, this unaesthetic moment is imperceptible.

Preparatory process

Before inserting the prostheses, an X-ray examination is certainly performed. With the help of his, the doctor will be able to see the foci of inflammation and other negative processes. Found diseases are bound to be cured.

If necessary, then non-viable teeth are removed... Then the remaining dentition and gums are treated. The research carried out on the person and the budget drawn up completely leads to the prosthetics procedure.

When the tooth has left roots behind, the missing structure is restored with a pin or inlay. The stump tab makes it possible to restore teeth even with very strong destruction. About its establishment, the doctor is determined at the stage of preparation. The post is installed before building up in almost half of the cases.

Before installing the prostheses, depulpation is performed. This procedure is very controversial. The professionalism, qualifications, experience of the dentist and the modernity of the equipment are paramount in this case.

Turning or preparation

it mandatory procedure... The preparation process itself is carried out so that the tooth got a conical shape.

While the impression and the final prosthesis are being performed, the person walks with a temporary one. The crown protects the tooth from stress, food ingress and infection. Typically, this crown is made of plastic.

The finished crown is attached using a special adhesive material, it adheres perfectly to the surface, and also provides additional strength.

It is possible to install a porcelain-fused-to-metal prosthesis without pulping. This is required for such moments when a living tooth with nerves is much better quality, more durable and better than the one where the nerves were removed. A pulped tooth becomes quite fragile over time. After a while, it can chip off under the influence of the cermet structure. It is for this reason that dentists tend to place pins. The only exceptions are molars, which have the required amount bone tissue, which makes it possible to securely fix the structure.

Nerve tooth tolerates negative influences much easier. It is these teeth that are least affected by caries. By eliminating depulpation, you can significantly reduce the cost of prosthetics.

It is undesirable to use metal-ceramic prosthetics, if:

Prosthetics price

Metal-ceramic crowns can be installed at different prices... A cheap analogue costs about 4 thousand rubles. This is the simplest stamped design. A German and Japanese manufacturer produces prostheses for 7 thousand rubles. for a unit. Belarusian and Russian manufacturers produce cermets for 5 thousand rubles. When cermet is coated with gold and palladium or platinum and gold, then its price will be about 10 thousand rubles. If the crown is coated with pure gold, then 18 thousand rubles.

The cost of prosthetics can be reduced by using certain tricks. For example, on the back and lateral teeth put plastic crowns, and on the front - metal-ceramic.

Denture care

It is no secret that clean and well-groomed teeth retain their health for quite a long time. The same applies to artificial teeth... With them, you must perform the same activities as with your own teeth. Everything We have known these procedures since childhood:

Between brushing your teeth, rinse them with plain water or a pharmacy solution. This should be done after any snack.
V mandatory clean dentures with your own teeth in the morning and before bedtime.
If, while wearing prostheses, complications in the form of swelling of the gums begin to be felt, then you need to visit a doctor. He will determine the cause of the development of the pathology and perform the necessary treatment. Much attention must be paid to serious foci of inflammation, the slightest bleeding and severe edema. These symptoms of infection are the most dangerous.
It is necessary to clean teeth and dentures with powder or paste. In some cases, thread can be used.
You need to take preventive measures... For which the funds purchased at the pharmacy are quite suitable.

Cermet or ceramics

Each of these materials has advantages and disadvantages. For example, metal-ceramic prostheses optimal in terms of price and quality... Durability, aesthetics, strength of these crowns are at their best. But, in case of allergy to metal products, these prostheses are undesirable to use.

Ceramic implants have better aesthetics. These prostheses have almost no contraindications. Also, in this case, depulpation is very rarely necessary. Turning occurs to a lesser extent than for a sintered structure. But this type of prosthetics is more expensive.

If it is necessary to restore several teeth in the foreground, then it is advisable to choose a ceramic structure made by pressing. The front of the teeth is least exposed to stress during chewing. Therefore, the installed ceramic crowns will last quite a long time.

These two types of prostheses are often combined. This is especially useful during the restoration of the entire row of teeth. That is, the front teeth are made of ceramics, and the back ones are made of cermets.

The dentists in the clinic will be able to suggest the right choice. They will correctly and competently determine the situation, as well as suggest methods of treatment.

Metal-ceramic dentures are a fairly reliable and popular restoration of lost teeth. For the price they are quite affordable, and at the same time they attract with aesthetics and please with quality. Therefore, you can not doubt the correctness of the decision and the perfect choice.

Recover lost or destroyed software different reasons teeth on this moment is, perhaps, the most widespread service provided by dental clinics and centers in Moscow. There are many types of this kind of restorations, including metal-ceramic prosthetics.

Cermet are called crowns or bridges made of metal and covered with a thin layer of ceramic spray or made by casting. The entire structure itself is absolutely hypoallergenic. The metal base as closely as possible follows the contours of the tooth itself, and the outer layer makes it possible to make a crown that looks very similar to the natural row of teeth.

At the expense of increased strength Basically, this type of prosthetics is very common for the restoration of those teeth that are called chewing. However, cermets are also often installed on the front teeth, since the aesthetic qualities significantly depend on the materials used. For example, the use of some special technologies and precious non-ferrous metals makes it possible to approximate the appearance of the crown as closely as possible to the original.

How is the cost of metal-ceramic crowns formed and what does it include?

There are many logical factors that can significantly affect the cost metal-ceramic crowns. It's just that the price range for this type of prosthetics is quite large. If, in general, we consider the cost in the dentistry market, then the approximate cost will vary approximately 21-24 thousand rubles. But there are quite a few variations here.

The minimum cost of cermets in Moscow starts from 3-5 thousand, and can even reach more than 50 thousand rubles. The cost consists of factors that are different in each specific case. Some of them are considered mandatory, some are not.

Therapeutic phase: preparatory

Consultation

In most dental clinics, especially with very high level service delivery, this service: either is completely free, or its price will be added to the invoice upon completion of all the work done. The approximate cost is 400-700 rubles.

Research

First of all, it is X-ray. Taking into account the resulting x-ray a decision is made on the subsequent actions of the dentist. The cost starts from 200 rubles and can increase almost to 1000, taking into account the equipment used and the required quality X-rays, print them out and save them for later use.

Pre-filling of teeth

When during the examination old fillings were revealed, then it is necessary to determine their quality. If it is rather bad, then new seals will need to be installed. The cost of this procedure is 1500-7000 rubles. In this case, the cost will depend on the material used and the complexity of the work.

Probably, pulping will be necessary, which needs subsequent filling of the canals. This is done if a lesion is identified. inflammatory process or in some other situations.

Also in the presence of such dental diseases as periodontitis or pulpitis, their treatment is required. The cost of all work, as a rule, reaches 7-11 thousand rubles.

Stump tab

When the tooth is destroyed no more than 50%, the metal-ceramic crown will be placed on the post. It is both cheaper and easier in cost. When if the damage is significant, that is, there is no tooth almost to the root or there are only walls, then it will be necessary to make and fasten a special stump tab. This design, by and large, is a support for the crown, the inlay increases the reliability and strength of the overall structure. Their price will depend on the materials for the manufacture and the level of tooth decay. Here is the approximate cost per tooth with installation:

Preparation for prosthetics and prosthetics itself

These two stages are combined into one, since it makes no sense to share the cost of work directly with the orthopedist ( is engaged in the manufacture of crowns), dentist and cermet fixation. As well as it is pointless to purchase a metal-ceramic crown separately without installing it. In almost every dental clinic, the cost is the same. This means that material and labor costs during metal-ceramic prosthetics are in the same general category.

There is only one small step, it is necessary most often, which is paid for a separate cost. This is the manufacture and fastening of temporary plastic dentures for teeth that have already been ground and prepared. These structures are required to protect the already ground and prepared teeth, as well as the aesthetic appearance. The price of each such one crown varies approximately 160–220 rubles.

Subjective components

To begin with, what needs to be said is assembly material manufacturer, which is used during prosthetics. This factor purely subjective, since, in addition to the fact that any manufacturing company has its own technological and specific developments and sets its own pricing policy, there are also objective market reasons for the rise in prices for foreign materials.

It is also necessary to say more about the fact that choice of dental clinic also important. Completely similar metal-ceramic dental crowns can have different prices even in the same polyclinic network. This is due to the specific location and popularity. The more popular it has dental clinic, the higher the cost will be. The region where the service of prosthetics of metal-ceramic prostheses is provided is also of great importance when determining the total cost. If the cost in Moscow, St. Petersburg and other megacities is still relatively comparable, then in small settlements you can get the same services much cheaper.

In this case relative cheapness of cermets is not a criterion for poor quality. Naturally, large dental clinics, where doctors have a large practical experience, most likely give guarantees for their services. However, this does not mean that in small clinics they will perform this work worse.

How to save money on cermets?

We have already partly talked about how to save without damage the quality of the installed metal-ceramic crowns. Some factors are not so obvious, however, they will also be indicated:

The cost of cermets

To begin with, it must be said about the fact that there are many manufacturers of metal-ceramic crowns for teeth. Their price is also partially influenced by... Including prices differ significantly directly for ceramic material, which is separately applied to a metal frame, then firing is performed in a special furnace.

Varieties of metal - approximate cost

In this case, we mean dental clinic with a relatively average cost at a decent level, but without pathos. All prices that will be quoted relate only directly to the crowns, in this case the work of the dentist, dental technician and other cost components are not taken into account.

The cost of anterior teeth prosthetics

This is prosthetics best done at the same time for the entire visible dentition. This significantly improves the aesthetic appearance. If only one prosthesis is installed, then almost always in appearance it will differ from the adjacent teeth. This service can be provided if there is no opportunity for restoration or restoration of the tooth, that is, during its almost complete destruction.

The cost of prostheses using a frame made of non-ferrous metals in this case will already start from about 21-23 thousand rubles, since a lot of skill is needed, both for a dental technician and a dentist, for a more accurate color selection and work performance.

For chewing teeth to install metal-ceramic prostheses the cost can sometimes be even more expensive. In this case, it is necessary to take into account the quantity necessary materials one crown for a tooth. But in this case, you can not use temporary crowns and non-ferrous metals. This will be a very significant savings.

It should also be added that the cost of a metal-ceramic crown that is installed on a bone implant will be much larger. This is due to the expensive cost of the implants themselves. The same crown, but with the addition of zirconium dioxide, will cost more than 19-20 thousand rubles, and this is equivalent to expensive precious structures.

Thus, the total cost metal-ceramic crowns will depend on the materials used, the degree of tooth decay, its location in the dentition, additional work that the dentist will need to carry out before installing the crown, etc.

Metal ceramics is a combined, fixed denture (crown or bridge), consisting of two layers:

The inner layer of cermet is a metal frame (cap), made by casting on a plaster model, ideally matching the ground abutment tooth on which it is put on.
The outer layer of cermet is a ceramic veneering mass (dental ceramics), which is baked on a metal frame at a temperature of about 960 degrees Celsius, matching in color and shape with natural human teeth.

Finished cermet dental construction(crown or dental bridge) is durable and hygienic. In dentistry, this type of dental prosthetics has been used for over 35 years.

Photo: metal-ceramic bridge frame

Prosthetics with cermet

A patient: Bushuev Alexey Valerievich, 44 years old

Complaints: On worn out front teeth

Treatment: Wax modeling of anterior teeth, preparation for metal-ceramic crowns 8 anterior upper teeth, German metal-ceramic crowns for teeth No. 14, 13, 12, 11, 21, 22, 23, 24

A patient: Malinina Tatiana Nikolaevna, 34 years old

Complaints: For wedge-shaped defects, cracks in the enamel of the teeth, gum recession

Treatment: Wax modeling of future dental constructions, on teeth 11, 21, 22, 12 pressed veneers made of glass ceramics, on teeth 13, 14, 23, 24 are crowns made of German cermet with veneer from Ivoklyar, Germany.

Number of clinic visits: 8

A patient: Gladkikh Sergey Vladimirovich, 38 years old

Complaints: Absence of upper lateral teeth, abrasion of upper incisors and canines

Treatment: Preparation of teeth for metal-ceramic crowns, installation of 10 German metal-ceramic crowns for the patient according to the action

Number of clinic visits: 11

A patient: Makarova Elena, 41 years old

Complaints: Decay of the front teeth in the upper jaw

Treatment: Preparation of 6 upper teeth for crowns, installation of upper anterior teeth from Japanese metal-ceramic "Naritaki"

Number of clinic visits: 12

A patient: Novak Yuri Leonidovich, 52

Complaints: Destruction of old metal-ceramic crowns, decreased occlusion, gaps between teeth, pain in the chewing joints

Treatment: Gnathological treatment of TMJ and chewing muscles, determination of the correct central ratio and occlusion by Dmitry Salatsky, installation of 17 metal-ceramic crowns on upper jaw and 13 metal-ceramic crowns on the lower jaw

Number of clinic visits: 19

A patient: Klyapin Alexander, 32 years old

Complaints: Bruxism, gritting teeth, worn teeth

Treatment: Treatment of bruxism and the mandibular joint with restoration of the bite height on splints by Dr. Salatsky, wax modeling and installation of Japanese metal-ceramic crowns on the upper and lower jaw by Dr. Evgeniy Kurakulov

Number of clinic visits: 21

A patient: Suladze Georgy, 34 years old

Complaints: Abraded teeth, aesthetic appearance of the upper teeth, bruxism

Treatment: Gnathological treatment of temporomandibular joint and masticatory muscles, restoration of the bite height with splint systems was done by Dr. Salatsky. Installation and fixation of German metal-ceramic crowns on the upper and lower jaw made by Dr. Shirinyan Sarkis Kimovich

Number of clinic visits: 22

A patient: Vladimirov Gennady Andreevich, 54 years old

Complaints: Decay of upper and lower teeth

Treatment: Gnathological treatment of temporomandibular joint and masticatory muscles on splint systems, determination of the correct central ratio of the jaws with temporary prosthetics on acrylic crowns was done by Dr. Dmitry Nikolaevich Salatsky. Prosthetics of all upper teeth with German metal ceramics was made by Dr. Shirinyan Sarkis Kimovich. The patient continues metal-ceramic prosthetics of lower teeth in Partner-Med dentistry

Number of clinic visits: 16

A patient: Cohen David Iosifovich, 36 years old

Complaints: Bruxism, destruction of old metal-ceramic crowns, abrasion of lower teeth

Treatment: Gnathological treatment of hypertonicity of the masticatory muscles and bruxism on the system of uncoupling splints, determination of the correct bite height was done by Dr. Dmitry Salatsky, prosthetics and installation of 27 metal-ceramic crowns on the upper and lower jaw were made by Dr. Sergey Evgenievich Brodsky

Number of clinic visits: 28

A patient: Yurkina Maria, 36 years old

Complaints: On crooked worn teeth

Treatment: Preparation and prosthetics of all upper and lower jaw aesthetic crowns made of Japanese metal ceramics

Number of clinic visits: 14

Pros and cons of cermets

To answer the question: "Why is cermet dangerous and harmful?" let's analyze the pros and cons of cermets.

Pros of cermets:

Hygienic
Lightweight, does not overload the abutment teeth
Perfectly withstands the chewing load of antagonist teeth
Long lasting (average shelf life 10-12 years)
Moderately aesthetic and natural
Affordable.

Cons of cermets:

In rare cases (less than 5%), an allergy to the metal alloy of the metal-ceramic crown frame is possible.
Very rarely (less than 0.1%), oxidation of the framework of a metal-ceramic bridge or crown is possible
Not quite perfect color match with natural human teeth
If, over time, a recession (loss) of the gums has appeared, in the region of the neck of the abutment tooth, in the absence of a shoulder ceramic mass on the metal-ceramic crowns, the end metal edge of the crown can shine through.
Regular (every 12 months) grinding of the chewing surface of the metal-ceramic crowns is required along the bite, otherwise the ceramic veneer of the metal-ceramic bridges and crowns may chip off.

As they say, the game is worth it, today, metal-ceramic structures (crowns and bridges) are leaders in dental prosthetics and this is unlikely to change in the near future.

The strength of cermet

The strength of metal-ceramic crowns and bridges is still unsurpassed due to the extremely successful combination of two layers in the composition of metal-ceramic, namely: the inner layer- metal frame + outer layer - aesthetic veneering ceramic mass. If any analogy can be drawn, then only with zirconium dioxide dental structures, which also have two layers, the inner layer is a zirconium dioxide frame, which has the same fracture strength as the metal frame (about 1200 mPa) and the outer layer is veneering ceramic mass for zirconium dioxide.

Therefore, metal-ceramic crowns and bridges are the ideal choice for the prosthetics of posterior chewing teeth and dentition defects. It must be remembered that, in contrast to the enamel of one's own teeth, ceramic veneering with cermet does not grind off, therefore, it is necessary to regularly grind metal-ceramic structures along the bite, once a year.

Allergy to cermets

Allergic reactions to metal-ceramic crowns and bridges are rare. As a rule, people with a history of allergies to many factors, including metals, are prone to this. If you suspect an allergy to metal-ceramic dentures, you need to donate blood to check the allergic status to the metals that are part of the metal-ceramic dental structures. The veneering ceramic mass used to create the cermets is hypoallergenic, as long as there are no cases of allergy to dental ceramic mass.

If a patient who is going to have teeth prosthetics with metal-ceramic crowns knows about his increased allergy, then it is necessary to warn his orthopedic dentist about this, in order to carry out preliminary allergic tests for denture materials, including metals for cermets.

Service life of cermets

The durability of all metal-ceramic dentures depends on a number of factors. With their successful coincidence and compliance with the dentist's recommendations, the average shelf life of metal-ceramic dental structures is from 10 to 20 years.

Here's what it depends on:

Correct calculation by an orthopedic dentist of occlusal (chewing) loads in the diagnosis and planning of metal-ceramic prosthetic structures.
Application by a prosthetist and a dental technician, for dental prosthetics with metal-ceramic prostheses, an articulator and a facial arch.
Thorough preparation, and, if necessary, strengthening of the abutment teeth with stump metal inlays.
Grinding of abutment teeth with a ledge by the dentist.
Production by a dental technician of metal-ceramic bridges and crowns with a ceramic shoulder mass, precise fixation of metal-ceramic crowns on a ledge, without overhanging the edges of the crowns in the gums.
Regular (once a year) grinding of the chewing (occlusal) surface of metal-ceramic crowns and bridges in accordance with the bite.
Observance and conduct of home hygiene measures for brushing teeth, and periodic removal of dental plaque (once every 6 months) in a dental clinic.

It is fundamentally important to understand the more careful operation and hygienic care for cermet structures, the longer they will last.

Sintered metal color

The veneering ceramics used for metal-ceramic crowns can simulate the full range of shades of natural, living human teeth. Also, the individuality of artificial teeth is given by internal intensities (dyes), emphasizing the half-tones inherent in natural dentin of living human teeth. With a competent selection of dental opaques, dentins, intensives, enamels and glazes, a dental technician can create a beautiful and natural-looking metal-ceramic crown, indistinguishable from their own teeth.

Over time, the color of the cermet does not change, but it is not removable for a long time; from cermet dentures, plaque and calculus can create a false appearance of a change in the color of cermet.

Metal ceramics or frameless ceramics, which is better?

This question can be raised mainly from an aesthetic point of view. Considering that cermets are stronger and more durable, but less aesthetic than frameless ceramics, it is possible to recommend the use of cermets for long, extended (missing more than one tooth) bridges, especially in the lateral parts of the dentition, and frameless ceramic crowns are best done on the front teeth, if possible, it is better to avoid even small bridges made of frameless pressed ceramic masses altogether, there is a high risk of fracture of such ceramic dental bridges. From a financial point of view, ceramic crowns are more expensive than metal-ceramic crowns.

Cermet or zirconium (dioxide), which is better?

Single or bonded together, ceramic-veneered zirconia frameworks are superior to single-metal ceramic crowns. However, in the case of long (more than 1 missing tooth) dental bridges that are fixed on their own teeth, in terms of strength and durability, metal-ceramic dental bridges are better. This is due to the fact that the elasticity and endurance to bending and deforming loads, especially at an angle (angular), are better for metal than for zirconium dioxide. If the financial situation allows, then the ideal replacement for a long dental bridge based on zirconium dioxide is a long gold-ceramic bridge (gold-ceramic).

Metal ceramics on gold (gold ceramics)

If the framework of a dental bridge or crown is made of a gold-platinum dental alloy with palladium additions, then such a crown is called gold-ceramic. Dental crowns and bridges made of gold ceramics have features that improve their properties. Ceramic veneering mass for a gold frame is baked at a lower temperature than that of cermets, which makes gold-ceramic dental constructions more plastic and durable than cermets. Taking into account that the frame of gold-ceramic has a golden hue, the final color of gold-ceramic crowns is smoother and more natural, especially in section "A" of the "Vita" color scale than for cermet. The gold alloy itself is absolutely biocompatible with both teeth and gums. Gold-ceramic dental crowns and bridges are the best choice in terms of aesthetics and strength, surpassing dioxide in some parameters (strength) zirconia crowns... At the moment, these are the most expensive dental crowns used in dentistry.

How to put the cermet correctly?

The most important thing when installing metal-ceramic crowns and bridges is:

correct calculation by the dentist orthopedist of occlusal (chewing) loads from the teeth of antagonists and
correct turning (preparation) of abutment teeth

Let's take a look at these important nuances.

Durability of metal-ceramic crowns

(the preservation of the ceramic veneer and the metal frame) is ensured by the ability of fixed dentures to resist chewing pressure when eating and when involuntarily clenching the jaws during sleep. To do this, the orthopedist dentist must calculate the required number of supporting teeth, assess their stability and the state of the bone tissue surrounding these teeth, especially the occlusion, the state of the masticatory muscles (is there muscle hypertonicity or vice versa atony), and also take into account the condition of the mandibular joint (TMJ).

Correct turning of the abutment with the formation of a circular cervical shoulder

is necessary so that the end edges of the crown sit clearly on the ledge, and do not hang down in the surrounding gum. This ensures the hygienic processing of the metal-ceramic crown and the absence of bleeding and blue discoloration of the gums around the tooth on which the dental crown is located.

With good work of the dental technician, the metal-ceramic crown with the shoulder ceramic mass sits clearly and is hermetically fixed with cement on the cervical dental ledge, which provides prophylaxis against secondary caries under the metal-ceramic crown.

How to care for cermets?

When caring for metal-ceramic crowns and bridges, it is necessary to clean them like your own teeth, twice a day, with a toothbrush with soft bristles and toothpaste, it is highly desirable to use an oral irrigator to wash the interstices under the metal-ceramic bridges, as well as for hydromassage of the gums, which improves microcirculation of gingival capillaries. To prevent the formation of subgingival plaque and calculus around metal-ceramic crowns, it is necessary to visit dental center or a clinic for professional removal of dental plaque and other preventive dental measures.

How to fix cermets?

One of the relatively common problems with metal-ceramic crowns is the chipping of veneering ceramics. To prevent them, it is necessary to regularly visit preventive examinations, at least twice a year, and carry out selective grinding of the occlusal surface of metal-ceramic crowns in accordance with changes in the occlusion. The fact is that at the time of delivery and fixation of metal-ceramic crowns on the abutment teeth, the crowns clearly correspond to the occlusion. But after 6-12 months, due to the fact that the teeth are suspended in the alveolar holes on the fibers of the periodontal (periodontal ligaments), to cushion the masticatory pressure, they (teeth) have a mobility in the range of 0.1 mm. Thus, the teeth can shift relative to the bite along which the metal-ceramic crowns were made. Natural human teeth, which are covered with enamel, are erased against each other, but metal-ceramic crowns and bridges cannot naturally grind off so naturally, thus, overestimation points appear on the chewing surface of the teeth, which are called hypercontacts. If the hypercontacts are not grinded in time, then the breaking off of the ceramic lining of the cermet is ensured!

If there is a chipping of the ceramic cladding with cermet, what to do? How to repair a PFM crown and PFM bridge?

If the chip has occurred within the ceramic veneer of the crown, and there is no exposure of the metal frame, then two options are possible, if the chip is not large, then the edges of the chip are polished, the surface of the chip is polished and smoothed, if the chip is large, then retention points are formed with a dental bur, and restoration is done cleavage with composite materials. When the metal framework of the metal-ceramic is exposed, the integrity of the metal framework of the metal-ceramic crown is checked, if the framework is intact, then first a composite opaque is applied, the metallic shine is masked, then the chip is restored with composite materials. If the metal-ceramic framework is cracked, then such a metal-ceramic crown must be replaced.

The best cermets

In order for the dentist to decide which cermet is better for a particular patient, it is necessary to assess his clinical situation in the oral cavity and general state his health. Other equal conditions, the best choice is gold-ceramic. Today, gold-ceramic is the most biocompatible and durable dental prosthesis. The shelf life of gold-ceramic crowns reaches 20 years.

Sintered metal: the price of the issue

All other things being equal, the prices for cermets depend on the qualifications of the dentist, the method of turning the tooth (with or without a margin), the qualifications of the dental technician, the manufacture of a cermet crown with or without a shoulder ceramic mass, on the degree of aesthetics and the number of layers applied in ceramic veneering of metal-ceramic dentures, as well as due to the speed of production of metal-ceramic crowns and bridges. The average production time for cermet is from one to two weeks, if the patient wants to get cermet faster, it is more expensive.