The installation of the crown is necessary for a complete tooth replacement. Modern crowns are able to eliminate almost all possible defects, as they are fixed structures of a natural shape, identical to a healthy tooth or even better in terms of chewing properties. With the help of the latest achievements in dentistry with crowns, you can even eliminate the serious shortcomings of the dentition.
Indications for installing crowns
Patients who regularly visit their dentist can learn about the need to install the crown directly from him long before the onset of an urgent need. In other cases (with prolonged disregard for dental disease or trauma), the dentist needs some time for examination (visual examination, X-rays and other tests) to conclude that dental prosthetics are necessary.
The main reasons for installing crowns include:
The spread of carious lesions of more than 50% of dental tissues in the presence of a healthy, strong root to establish the pin,
Dramatic damage to the aesthetic appearance (for example, discoloration) of one or more teeth,
Rapidly progressive tooth decay due to non-carious disease
Complete tooth loss due to gum disease and periodontal disease
Pathological erasure of the enamel of one or more teeth
Removal of teeth adjacent to damaged, for the installation of a cermet bridge.
Preparation for prosthetics
For most people, any dental procedures are associated with the characteristic unbearable toothache and the inconvenience of the dental office. But do not be afraid of installing prostheses, because the most unpleasant of the stages of this operation - turning the tooth - is much easier tolerated than the standard cleaning of caries with a drill. Moreover, all operations take place under local anesthesia with the most effective drugs.
Other stages of preparing teeth for prosthetics include the cleaning of plaque and removal of tartar, as well as the treatment of caries. If the tooth on which the crown is installed is too damaged, it is restored before the prosthesis.
To begin with, teeth whose treatment is considered meaningless are removed. After two weeks, the prosthesis continues with a full antiseptic treatment of the oral cavity, filling of the canals and carious cavities with constant monitoring with x-rays. If the pin is established, the root of the tooth, which is unable to hold the prosthesis, should also be removed.
Sometimes the crown is placed on living teeth, i.e., a part of the tooth damaged by caries is sawn off and a prosthesis is placed on it. A lighter version of the procedure is possible for young people on teeth affected by a single foci of caries. (read also: what is caries?)
The patient himself makes all decisions regarding the methods of protection and prosthetics of the teeth after consulting the dentist.
Types of dental crowns
To date, developed many varieties of crowns, so for their proper distinction, there is a special classification for several grounds.
To destination are:
Reconstructive crowns necessary for the maximum possible anatomical, functional and aesthetic restoration of a lost tooth.
Supporting crowns, which are the basis for the bridge.
According to the material of the crown can be:
By the design of the crown are distinguished:
Full - completely replaces the lost tooth.
Equator - are a metal strip, which is tightened around the tooth to preserve its natural tissues with incomplete damage.
Kulev - crowns, recessed into the gums.
Half-crowns - Replace all parts of the tooth, in addition to the inner (facing the tongue) side. Subsequently, they can perform the function of supporting a bridge or cantilever prosthesis.
Telescopic - special crowns, whose height relative to the gums can be adjusted after the installation of the prosthesis.
Pin - used for installation on a titanium pin, replacing too weak or damaged root with a strong destruction of the tooth.
Jacket, fenestrated and others.
What are the best chewing teeth crowns? Many experts offer metal construction, because they have a lot of advantages, and their cost is relatively low. This option can be made of various metals.
Metal crowns are a classic example of prosthetics and have been used for several decades. The most common option - the teeth "under the gold."
The main advantages of such crowns - durability, reliability and durability. The elements are practically not subjected to the oxidation process, and the index of their abrasion is most closely related to the natural enamel, so the antagonist teeth are not damaged during chewing. The only drawback of this design is an unaesthetic appearance, therefore, as a rule, it is installed in an area inaccessible to prying eyes.
All-metal crowns are cast and stamped. Stamped belong to an outdated type of construction, are made on the basis of sleeves of steel, which are sprayed in the color of gold. They look unattractive, unstable in comparison with cast structures. The advantages of these crowns is an affordable price and minimal tooth damage during turning, necessary for their installation.
Solid crowns are made on the basis of a tooth, cast from metal, at their low cost, they do not wear out their teeth and serve for a long time, although they are not aesthetic.
A major disadvantage of these crowns is their unattractiveness - a tooth with a metal crown is significantly different in appearance from natural teeth, as well as low wear resistance due to thin walls. But, perhaps most importantly, their negative property is insufficient adhesion to the tooth surface, which is why pathogenic bacteria can multiply under the crown, causing tooth decay.
Metal composite crowns
Composite crowns are made of metal base and plastic framing. This is one of the fairly affordable materials, the advantage of which compared to pure metal is the appearance of a natural tooth.
The metal part of the metal crown is necessarily molded, so it firmly adheres to the dental root and does not allow bacteria to pass to it.
Unfortunately, the facing plastic wears out relatively quickly, which is manifested in a change in its color to gray, swelling due to frequent contact with liquids and weakening of its strength up to falling out of the metal base.
It is also possible to install metal composite crowns only for people who are not prone to allergic reactions, since plastic may release specific harmful substances into saliva.
Due to the disadvantages and advantages of the material, metal composite crowns are used only as a temporary prosthesis. Most often it is necessary to restore the tooth at the time of manufacture or engraftment of the pin and other prosthetic structures.
Metal-ceramic crown consists of a metal base with a thickness of 0.2-0.5 mm and ceramic lining. The patient chooses the metal for the manufacture of the frame on the basis of the cost of the material and its properties - wear resistance, hardness, inertness in relation to the body and other qualities. Various inert alloys and pure metals are used in dentistry: nickel, gold, palladium, platinum, etc.
The metal frame allows you to more firmly hold the crown, which practically does not differ from the real tooth, and reduces the cost of the prosthesis compared to the all-ceramic or porcelain base.
The advantages of this type of crowns is their strength, availability, reliability and good aesthetic conformity to the natural tooth. Unfortunately, to install a metal-ceramic prosthesis, it is necessary to depulpate (nerve removal) a tooth and to grind up to 2 mm of natural hard tissue for a long time.
As the name suggests, the ceramic crown is made entirely of ceramic without a frame. The absence of a metal part makes the prosthesis indistinguishable from a natural tooth, so that it absolutely does not stand out from the dentition, that is, it has excellent aesthetic properties. At the same time, ceramic crown is not much inferior to metal-ceramic in durability and reliability, but it costs much more.
Porcelain, zirconia or, in rare cases, aluminum oxide are used to create this type of prosthesis.
Porcelain among artificial materials accessible to humans possesses the physico-optical properties closest to natural teeth. A properly made porcelain prosthesis has a hue and translucency corresponding to the rest of the teeth, and there is no doubt about the artificiality of an abstract observer. Thus, an ideal aesthetics is achieved, which any other material that is known and convenient for processing cannot give.
Of course, the porcelain crown in its own way is an ideal prosthesis, but in some cases its installation is not relevant, for example, in the manufacture of a metal-ceramic bridge.
The most perfect prosthesis is considered a ceramic crown based on zirconium. This type of crowns takes the best of metal-ceramic (durability, reliability) and ceramic (perfect aesthetics), although it is formally a subspecies of ceramic dentures.
Zirconium dioxide, unlike metals, is the best material for the frame, since it has light-transmitting properties and makes it possible to provide greater accuracy of fit.
Due to this, it is possible to produce excellent single and bridges ceramic prostheses, the only significant disadvantage of which is their high cost.
Ways to fix the crown
Now that we have dealt with the varieties of crowns and the characteristics of the materials from which they are made, it is necessary to understand how the denture will be fixed in the jaw, whether it affects the adjacent teeth and how durable is the resulting artificial analogue.
Modern dentistry allows you to install the crown in one of three ways.
A pin is the most common method of fastening a crown, since it is not very expensive, it corresponds in strength to a real tooth and is fairly easy to install. The pin itself is a metal, plastic or gutta-percha rod placed in the root hole of a tooth and fixed in it with the help of special hardening solutions.
An intracanal pin requires a healthy tooth root, sufficient in size to install an artificial support. For a tooth with a single channel, the placement of the pin is limited in the case of small root sizes, and for a tooth with several channels, even with their health, twisted and too thin strokes will become an obstacle to the installation of the pin.
In any case, the pin is also prohibited to put in such cases:
For serious diseases of the blood or nerves
In case of injury and periodontal disease,
Fixed obstruction of the tooth canals, which prevents their quality filling,
When detected at the apex of the root, in which the pin is to be placed, a cystic formation.
The technical characteristics of the prosthesis will depend on the material from which the pin is made: strength, elasticity, safety for tissues, etc. If a prolonged high load on the tooth is expected, an elastic carbon-fiber pin is used, if there is a negative reaction of the tissues to any materials recommend titanium or zirconium rod. Installing the pin is the second most unpleasant operation during the prosthesis, after which the nozzle and the fastening of the crown occur without pain and discomfort.
Fixing the crown using the tab
The stump tab is a cast tooth stump with a root part. To install this design, the root of the tooth is sealed the same way as for the pin, and a hole is prepared in it, in which the root of the tab will be laid. If possible, the root part can be branched out according to the number of channels of the tooth and the team to facilitate insertion of a tab on non-parallel channels. The crown is installed on the stump as well as on a natural, grinded tooth.
For metal and metal-ceramic crowns, tabs made of cobalt-chrome alloy are used, and for ceramic crowns, a tab of zirconium is needed, since the dark metal shines through the ceramics and gives the crown a bluish tint.
The prosthesis on the stump tab is considered to be more durable than on the pin design.
Fixed prostheses have much greater reliability than removable structures, nor do they stand out among the dentition and can last much longer. However, in order to install the crown, a strong fixation on the patient's teeth is required, often with a long preparation needed to form the support of the future prosthesis.
Unfortunately, a strong dental root, on which a crown could hold, is not always maintained. In this case, a complete tooth replacement is required, which begins with the installation of an implant - a titanium, plastic or fiberglass screw that looks like a small bolt screwed into the place of a lost root.
Implantation of a denture takes longer and more difficult to install a crown on the remains of a tooth or its root, but as a result, the patient receives, in fact, a new tooth that is not prone to caries and other diseases and is not able to hurt in principle. For the front teeth, it is possible to install a ceramic abutment, due to which the implant becomes completely invisible, which means that the artificial tooth will be identical in appearance to the present.
Turning a tooth before installing the crown
To preserve the natural shape of the tooth after the installation of the crown and ensure its tight fit, it is necessary to turn the tooth. This is a painful and unpleasant procedure, during which 1-2 mm of hard tissue is ground off from the surface of the tooth. The magnitude of the turning depends on the thickness of the crown and varies depending on the material used in its manufacture - for example, ceramic crowns require minimal turning, unlike metal-ceramic structures.
The procedure is performed under local anesthesia, so that the patient does not feel pain. In some cases, it is recommended to carry out the removal of the pulp in order not to burn it during turning. When processing chewing teeth, the risk of burn is not so great, so they try to keep them alive.
The procedure of nerve removal or depulpation takes place with the processing of channels and their filling, otherwise inflammatory processes are possible. If the pulping and canal filling were performed poorly, it may be necessary to cut the installed structure for treatment, which can be wasteful and can be traumatic for the tooth.
Laboratory stage of preparation for prosthetics
In the dental laboratory, on the basis of tooth casts, provided by the dentist, plaster models are cast, which are later used to cast metal crowns.
During the manufacture of a permanent metal or ceramic crown, a temporary plastic construction can be installed to the patient, which will protect the grinded tooth from damage and restore its chewing function. They are fixed on a temporary cement and are easily removed when it is necessary to install a permanent crown, allow you to maintain the aesthetic appearance of the teeth.
Does it hurt or not?
Almost all dental procedures are painful, but this problem is solved with the help of local anesthesia. As for the installation of crowns, the most unpleasant moment is the preparatory stage: nerve removal, grinding of hard tissue. But all these procedures are performed under local anesthesia, so the patient does not feel discomfort and pain.
Expert opinion. Dentist Avdeeva OL: “The immediate process of fixing the crown is not painful, since the nerve is removed, so it cannot get sick. Even if a live tooth (in which there is a nerve) is ground, the patient will not feel pain, as in modern dental clinics all manipulations that may cause discomfort are always carried out using local anesthesia drugs. ”
How to prepare the tooth to install the crown?
Prosthetics with crowns are several stages and, accordingly, more than one visit to the clinic. The first visit is a survey of the patient, an inspection of the oral cavity and an assessment of the state of his tissues, an X-ray and, if necessary, other studies.
Before installing the crown, the tooth is prepared.
Based on the diagnosis and survey conducted, the dentist develops a plan for the upcoming prosthesis, which consists of several points:
- selection of material, its color,
- calculation of the cost of prosthetics,
- taking impressions, transferring them to the laboratory,
- manufacture, fitting, fixing structures.
If you plan to carry out prosthetics with the help of a bridge, the doctor selects the abutment teeth, evaluates their condition and conducts appropriate training. The direct preparation of the support for fixing the prosthesis, which many patients are so afraid of, occurs as follows:
- the doctor removes the nerve (in dentistry, this process is called depulpation),
- the tooth is prepared under the crown thickness: a layer of hard tissue is removed from it, the cone is shaped so that the crown fits tightly on it,
- the nerve from the same root elements is removed in order to be safe from its possible burn, which can occur during the turning process,
- the preparation of chewing teeth in rare cases leads to a burn of the nerve, therefore, in some cases it is not removed,
- All procedures are performed under local anesthesia, so the patient will not feel pain.
Why do you need turning, is this procedure painful?
Turning is an obligatory stage of prosthetics with crowns and bridges. Dissection is performed using diamond boron, and the dentist grinds a layer of hard tissue that is as thick as the product. This is a necessary measure, since the crown should sit as tightly as possible on the tooth, and there should be no gaps between them.
The procedure is performed under local anesthesia, even if a dead tooth is ground (after removing the pulp). There is a nerve in a live tooth, so anesthesia is simply necessary here. When turning a pulpless tooth, the gum is moved away, which also requires the use of an anesthetic drug.
For the period of manufacturing the crown, a temporary plastic crown is fixed to the ground tooth.
The peculiarity of the preparation: for fixing the cermet, a larger layer of tissue is removed than before prosthetics with non-metal ceramics.
Product manufacturing process
The prints, which are necessary in the laboratory, where plaster models of the teeth are cast on the basis of these casts, are removed from the ground tooth. Prostheses are made on their basis. For the period of production, the grinded tooth is covered with a temporary plastic crown, which provides protection to the grinded tooth and also relieves the patient from emotional discomfort.
Before fixation, the dentist conducts a fitting of the structure to assess the quality of its manufacture. For example, before you apply a ceramic layer on a metal-ceramic crown, a metal frame is tried on a stump. If the base sits on it tightly, final work is carried out and the crown is fixed.
The construction must first be placed on temporary cement in order to assess whether it will not interfere or break the bite. If the doctor notices any blemishes in the product, it can be removed without harm to the tooth. If all is well, the crown is already installed on a permanent cement.
When is it recommended to put the crown?
It is necessary to install these prostheses in the following cases:
- when most of the tooth is affected by caries,
- severe destruction of the dental organ (more than 70%),
- the tooth is destroyed after injury, the root must be intact,
- external defects of the teeth (hereditary or acquired), a change in their color when aesthetics suffers,
- enamel susceptibility to pathological abrasion,
- loosening of the teeth, which is the cause of periodontal disease (temporary dentures will make them more stable),
- when a bridge is installed, thanks to crowns it is fixed on the teeth-supports,
- the presence on the tooth of uneven edges that injure the mucous.
What material to choose?
Thanks to new developments, in modern dentistry there are several types of materials from which to make crowns. Consider the main ones:
- Metal - classic dentures, used for many years. Most often they are made of gold. The advantages of such products are durability, reliability and durability. They do not oxidize, have a coefficient of abrasion almost like natural enamel, do not damage opposite teeth. The main disadvantage is minimal aesthetics, for the reason why they are placed on invisible parts of the jaw.
- Metal-ceramic, combining the advantages of metal and ceramics. They have durability, durability and high aesthetic performance. They cost less than all-ceramic. The disadvantage of these prostheses is the obligatory preparation of a large number of living tissues before their installation, as well as the possibility of abrasion of enamel on the opposite dental organs. A strip of ferrous metal at the gum may also be visible if its edge is lowered or the product has been manufactured inaccurately.
- Ceramic or porcelain crowns are made that have the most aesthetic appearance. They are most similar to natural teeth and retain their properties for a long time. However, ceramics are significantly fragile and can not always withstand the load when chewing. For this reason, more often ceramics put on the front teeth. The main disadvantage of these crowns is the high price.
Make crowns made of plaster models. Metal, metal ceramics and ceramics can be used as manufactured material.
The manufacture is rather laborious and time consuming, therefore, while the dental technician is working on their creation, the patient is put on temporary plastic products. This restores the aesthetic appearance of grinded teeth, and they are protected from external influences and infection. These dentures, in addition to protecting the teeth, also allow them to be fully used when chewing.
Grinding of teeth for installation on their crowns
Turning teeth is called a preparation. This procedure is performed using a drill into which the diamond bur is inserted. So the tooth can give the desired shape.
When grinding live teeth, the procedure is painful, therefore, before its implementation, anesthesia is administered to the patient. If you need to grind a pulpless tooth, anesthesia is not always applied, but if gum removal is required, it is better to make it.
The orthodontist needs to sand the tissue of the dental organ, the layer of which will be equal to the thickness of the prosthesis. Depending on the crown used, 1.5-2.5 millimeters of dental tissue can be removed from all sides of the dental organ. When fastening cast structures, less turning is required, and if you put products made of ceramics or metal ceramics, more.
A grinded tooth is a stump where the crown will subsequently be fixed.
How to restore the crown of the tooth?
The crown part of the tooth in different cases can be destroyed in different ways, and therefore restore it in different ways. To do this, either a stump tab is inserted into the tooth, or a pin is inserted, and this does not affect the appearance of the tooth.
The pin is a rod with high strength, which is screwed into the root canal after sealing. It plays the role of the basis for fixing the filling material. Then the tooth grows and grinds under the prosthesis.
Using the stump tab, you can make a very reliable restoration of the dental organ, which will last a long time. It is made in the laboratory of a special metal that is non-toxic. The tab consists of a crown and root part. The root is fixed in the root canal, and the crown is already ready to be attached to the crown.
The first stage of the installation is preparatory
Before installing the crown, the dentist should carefully examine the oral cavity of the patient, if necessary, an x-ray can be taken. Based on the results of the survey, a treatment plan is drawn up and the necessary procedures are recommended. It is also important to examine the patient for contraindications and allergies to any material.
The doctor together with the patient selects a more suitable type of crown. Specify the time when they will be manufactured and installed prostheses, as well as the cost of treatment.
In the presence of diseases of the gums and teeth in the mouth - they are cured.
Next you need to prepare for the installation of the tooth itself, which is one of the main points of prosthetics. In this case, the doctor does the following:
- Removes the nerve from the tooth and grinds it. It is important to grind a layer of tooth that will match the thickness of the prosthesis. When attaching the crown to the front units with one root, removal of the nerve is necessary, because a pulp burn may occur during grinding. Depulpation of a multiroot tooth is not necessary, because the risk of burn in such a situation is minimal.
- Treats the teeth that are struck caries. Produces canal filling. Brushing teeth from stone and plaque.
- If the dental organ is severely destroyed, it is depulped, the canals are filled and the coronal part is reconstructed with a filling composition.
- When attaching the crown to a live tooth, anesthesia is required.
- If there is a seal on the abutment tooth, it is changed to a new one.
After the preparation of the teeth to the attachment of the prosthesis - they take prints, which will be made in the laboratory crowns.
Trying and mounting - the third stage of installation
Before the crown is installed and before the completion of the manufacturing work, the first fitting of the prosthesis is carried out. Check that she sat on the cult accurately and firmly.
Further, if necessary, make adjustments to the product and continue to form it in the laboratory. If metal-ceramic is used as the material to be made, it is necessary to cover the metal frame with an aesthetically attractive ceramic composition.
After completion, the prosthesis is fixed with a temporary composition, which makes it possible to evaluate the comfort when wearing the prosthesis, the possibility of allergic reactions, to eliminate the possibility that it will interfere with the connection with opposite teeth. The reaction of dental units and neighboring tissues is checked for the presence of a new element in the oral cavity.
At this time, defects in the filling of the dental canals, inflammation or severe pain may appear.
The following defect is the most common: overbite of the bite, which is why it turns out that the prosthesis on the neck of the tooth is sitting loose, injuring the gum and appealing its bleeding.
If there are such complications, measures should be taken to eliminate them.
Temporary prostheses are worn from two weeks to a month. If the patient has no complaints, they are removed, the dental unit is cleaned and the permanent product is fixed with a permanent cement. Then the crown irradiation is made with a special lamp that promotes cement hardening. All excess cement is carefully removed.
On a note: It is possible to chew on the tooth where the crown was placed after a couple of hours, and the maximum load can be given to it after one day.
Cases in which you need to remove crowns
The need to remove the crown can be caused by the following reasons:
- Tooth poorly prepared for the installation of the prosthesis. Statistics show that 60% of cases of dental canal filling are not correct. This is a prerequisite for the development of inflammation, and the treatment of the tooth leads to the need to remove the structure.
- Error in the manufacture of structures. If the product distorts the bite, loosely covers the neck or causes physical or aesthetic problems, it is removed.
- Planned replacement. At the end of the service life (usually 10-15 years), the prosthesis is changed.
- Damage to the structure, the appearance of cracks or holes in it from washed cement requires an urgent replacement of the product.
- The occurrence of complications.
Removing the product is quite difficult, especially if you need to keep it intact in order to reinstall it.
If the removal is due to structural failure, it is better to cut it with special tools.
If you need to save the prosthesis, for its removal apply:
- Crown pickers (the most common Kopp hooks) are special tools in the form of flat hooks that can be automatic or manual. With their help, the prosthesis is removed in part of its connection with the tooth.
- Nippers securely grab the prosthesis with the branches and remove it from the base.
- Ultrasonic installation. Ultrasound waves can destroy adhesive cement, after which the denture is easy to remove.
- Pneumatic tools, the use of which also contributes to the destruction of cement and facilitate the removal of the crown.
What are the complications?
Consider the complications that can occur after installing crowns:
- The strong pressure of the product on soft tissues disrupts blood circulation, promotes the formation of pressure sores. The soft mucosa may die off at the junction of the gum and the crown. So prosthetic stomatitis can develop.
- The defeat of the supporting dental units caries. Poor cleaning of the oral cavity or poor-quality preparation of dental organs for the installation of the prosthesis, lead to the accumulation of food particles under the crown, where bacteria that cause disease develop.
- Allergy to metals that are part of the prosthesis may not appear immediately after the installation of the structure, but after a while. There is a burning sensation in the mouth, dryness, inflammations are formed.
- Galvanic syndrome may be caused by the presence of various metals in the mouth. The result is the formation of an electrical current that enhances oxidative reactions. At the same time, the patient feels a metallic taste in the mouth, a general malaise may occur, a headache, design and neighboring dental organs may change color.
Each of the listed complications requires a swift response and a visit to the attending physician, otherwise you can lose a supporting tooth. The doctor is likely to remove the crown, hold treatment and put a new one.
The most interesting questions for patients
- Does it hurt to install the crown?
- Installation of the prosthesis can cause discomfort, like any other dental procedure.The greatest amount of unpleasant sensations falls on the preparation stage, which includes drilling, turning of the dental organs, cleaning and filling the canals. But the fact that the crown is mainly fixed to the pulpless teeth minimizes the likelihood of the presence of pain. If you grind live teeth - apply anesthesia. And the very attachment of the crown to the stump passes completely without pain.
- What is the duration of the procedure?
- Installation has several stages. To prepare the teeth - you need to visit the dentist from one to two times, and sometimes more. The duration of each visit depends on the teeth on which the crown is to be fastened and their condition. To make the crown may take several weeks. For temporary cement prosthesis put for a period of 2 to 4 weeks. Then it is fixed completely. In this case, the total time spent on the installation of the crown can be from 1 to 2 months, and sometimes more.
- Do crowns put on live teeth?
- For live multi-rooted teeth, the state of which does not require depulping, the crown is allowed. You can also put them when installing the bridge, when the crowns are attached to the ground healthy teeth.
After building two front incisors, one of them fell off completely, and only half remained on the other. Now I think, whether to put on them crowns, or is it better to increase again with another specialist?
Very worried after fixing crowns on a permanent cement. Before that, he had already twice put on crowns and always the doctor strongly pressed on the prosthesis when putting on, and for the last time he simply held. Panicked that he would quickly fall away. He asked another specialist - he explained that after putting the prosthesis on the cement, I process it with a special lamp, which leads to hardening, therefore, there is no need for strong pressure. While I go with crowns for more than a month. Everything suits me.
Put the zirconia crowns on the 3 front cutters. Spent a lot. But a week later one of them fell out. I went to the doctor, he said that there was a temporary cement and installed it again. Then alternately with the interval of two days, the remaining two crowns fell out. Again I went to the doctor twice and twice he changed the type of temporary cement is not permanent. I can't understand why he couldn’t fix me all three on permanent cement right away when I turned for the first time? And it is also annoying that after the crowns were re-set, it was somehow not so painful to bite on these teeth, but rather scary. And this fear does not pass still.
After installing the crown, I feel that it bothers me, does not connect properly with the opposite tooth. And a little sore gum. Although during the fitting everything was fine. What to do in this situation? Have to remove the prosthesis?
How much the installation costs a crown depends on various factors. This is the experience and professionalism of the doctor, the status of dentistry, the material produced, the method of manufacturing the crown, as well as the amount of work, both during prosthetics and in preparation for it.
On average, metal crowns will cost 3-16 thousand rubles, ceramic structures can be supplied for about 20 thousand rubles, and metal ceramics costs from 6 to 40 thousand rubles.
We offer a review of turnkey prices in prosthetics clinics in Moscow:
|Dentistry Mendeleev||St. Novoslobodskaya Street 36 / 1s1||From 7900 rub|
|Dentistry Aktivistom||4th lane Krutitsky, 14||From 2500 rub|
|Dental Studio||Michurinsky Avenue, 80||From 6000 rub|
|Doka-dent||St. 1st Tverskaya-Yamskaya, 27||From 2500 rub|
Feedback from the patient on the full restoration of aesthetics and chewing function using methods of single-stage implantation
Fitting and installation - the final stages of prosthetics
Installation of the crown takes place in three stages. The first one is the fitting, it is necessary to determine the quality of the fabricated structure, how tightly it fits to the tooth. Only after this, ceramic layering is made on the metal frame and fixed on the stump with temporary cement.
For a temporary cement, the crown is held for several weeks, during which it is observed that it does not interfere with the chewing process or cause bite problems. An important indicator of the quality of the installation of the crown is its closure with antagonist teeth, otherwise the natural teeth will be badly damaged.
Only a couple of weeks later, in the absence of bite problems and complaints from the patient, the crown is finally fixed using dental cement.
When do you need to remove the crown?
The process of removing the crown is complicated and time-consuming, is carried out only by a specialist with an arsenal of necessary tools - dental discs that are sawn into the structure.
The crown may need to be removed in the following cases:
Upon expiration of the service life,
In the presence of damage, deformation of chips or cracks of the crown,
If the tooth under the crown begins to ache due to the inflammatory process, the crown must be removed in order to treat it, a cyst, remnants of dental instruments, inflammation of the top of the canal,
If the crown is not properly installed, it is therefore loose on the tooth.
The most common situation in which it is necessary to remove the crown is the doctor's mistakes at the stage of tooth preparation and canal filling. Perforation of the walls of the canal, fragments of instruments, channels that are under-filled at the top of the canals lead to inflammation and pain of the tooth, which makes it impossible to wear the crown until it is treated.
To prevent this, it is necessary during the treatment process to constantly monitor the quality of the work of the dentist with the help of X-rays. Otherwise, the risk of complications increases, and you will have to correct the dentist's mistakes in another clinic at your own expense.
Answers to frequently asked questions
The doctor suggests putting crowns on your teeth. Is it harmful for a tooth to turn? For high-quality installation of the crown, teeth turning is necessary so that the crown fits snugly to its surface. Turning itself is very traumatic, as it breaks the protective layer of tooth enamel and makes the tooth more vulnerable to bacteria and mechanical damage, but you cannot do without it.
How much does a crown for a metal-ceramic tooth cost? Prices for metal-ceramic crowns depend on the type of metal and its quantity used in the manufacture. The cost of crowns varies from 3-40 thousand rubles.
What does a crown on a ceramic tooth look like? Is it worth putting such a crown on the chewing teeth? Ceramic crowns look very aesthetically pleasing and are absolutely indistinguishable from natural teeth, but are noticeably inferior in strength and durability to metal-ceramic. Therefore, to install on chewing teeth, which are subjected to heavy loads, it is preferable to use metal-ceramic crowns.
What glue dental crowns to the tooth? To ensure that the crown fits snugly to the tooth, the dentist uses special glue or dental cement.
Do teeth deteriorate under the crown? Crowns save the tooth from damage, reducing the mechanical load that falls on it in the process of chewing food, and also protect it from microbial exposure. Therefore, if the crown is properly installed, the tooth will not deteriorate.
How to clean dental crowns? The hygiene of natural teeth and teeth with an established crown is no different - they are also cleaned with a toothbrush and toothpaste, and the interdental spaces are treated with floss.
Can there be any complications after installing the crown on the teeth? If, before installing the crown, the dentist performed a high-quality treatment of the tooth, then no further complications arise.
Prices for dental crowns
The prices for crowns depend on many factors, among which are the presence of the own laboratory in the clinic and its pricing policy, the qualification level of personnel, the amount and type of material from which the crowns are made. At the same time, the material of construction is almost of paramount importance in shaping the price of the crown.
So, metal solid crowns are among the most affordable ones - from 3 thousand rubles per piece. Metal-ceramic crowns will cost more - at least 5 thousand rubles. Ceramic porcelain crowns cost about 11 thousand, and ceramic zirconium dioxide structures - no less than 20 thousand.
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Toothache is always the cause that upsets the quality of a person’s life. The pain may be insignificant and unbearable, constant and periodically arising, aching, pulling, shooting, throbbing, etc. In order to understand why teeth hurt, it is necessary to determine all possible causes of this condition.
Toothache: acute, aching, pulling, shooting requires an appeal to the dentist. However, to quickly get to the doctor is not always possible, how to get rid of a toothache in this case? In this case, folk remedies may come to the rescue. At the time, relieve it, reduce inflammation and wait for the moment when visiting the doctor will be possible.
Teeth whitening along with caries treatment is one of the most popular dental procedures. A snow-white smile is a sign of beauty, health and well-being, therefore people spend no time and money in pursuit of it. In the arsenal of modern dentistry there are lots of tools for teeth whitening, which make it possible to lighten them by 4-8 tones.
With all the strength of tooth enamel, it is not completely invulnerable and is subject to destruction under the influence of some factors. Thinning and defects of enamel lead to deterioration of the teeth, an increase in the risk of carious destruction of all its tissues, which do not differ in similar hardness. This situation is also dangerous because.
Dentistry is one of the areas of medicine where modern scientific technologies are being introduced most actively. The first drill, with the help of which attempts were made to drill through bad teeth, appeared in the Roman Empire. Since then, progress has gone far ahead, and now teeth can be treated quickly, painlessly and effectively.
The oral cavity in which the teeth are located is one of the most polluted cavities of the human body. Therefore, the question of how to properly brush your teeth is very important for the preservation of their health. The process of brushing teeth is a hygienic procedure aimed at removing c.
Most of the complications after tooth extraction are associated with the addition of an infection. Many microorganisms live in the oral cavity, many of them conditionally pathogenic - that is, under certain conditions they can provoke an infectious process. So, if the hole after the removal of the tooth is deep enough, it is not closed with a blood clot and.
Primary reception in dentistry
The crown is not placed on the tooth immediately, first you need to go through several preparatory stages. One of them is the initial examination and consultation of the dentist. During the first visit, the doctor examines the oral cavity, identifies problem teeth, collects anamnesis. Then, an X-ray examination is prescribed, with the help of which dental tissue pathologies and inflammatory processes in the support units are detected.
The specialist finds out the presence of factors that may affect the installation process of the crown on the tooth or become a contraindication to prosthetics:
- an allergic reaction to certain drugs or materials
- tumor tumors
- chronic pathologies,
- diseases of internal organs
- CNS disorder.
Taking into account the wishes of the patient and the compiled clinical picture, the doctor determines the treatment plan. Before prosthetics, extraction of dental units without nerves (“dead”) is carried out. Gradually collapsing, they contribute to the development of various disorders that negatively affect the condition of crowns and shorten their operational life. In addition, medical procedures are carried out, during which inflammatory processes affecting bone or gum tissue are eliminated.
At this stage, a detailed consultation of the patient and coordination of the type of dental structures. The doctor selects the best option for prosthetics, taking into account the physiological characteristics of a particular patient, explaining his choice, coordinating the cost.
Depending on the clinical case and the financial possibilities of the patient, the installation of a metal-ceramic crown, plastic, or ceramic can be recommended. The most inexpensive, but also short-lived, are plastic and ceramic products. In most cases, dentists recommend to put cermet, which is caused by:
- High wear resistance.
- Creating aesthetic appeal that does not change over time.
- Features constructive. Dental technicians make the skeleton of a metal-ceramic crown per tooth from the alloy of medical or pure precious metals (gold).
- Metal-ceramic product has high hypoallergenic properties and biocompatibility with body tissues.
- Acceptable cost.
You can see how your teeth look before and after the installation of metal-ceramic on the photo:
Preparation of the tooth under the crown, the installation steps
The stage of prosthetics, prior to the installation of the crown on the tooth, requires special professionalism. Often, preparation begins with the removal of a nerve in a problem dental unit. Indications for depulpation are:
- caries in the advanced stage
- wrong position
- defeat caries one or more roots,
- anatomical features of the dental unit,
- periodontal inflammation, pulp.
Depulpation is always done when you need to put a crown on a single root front tooth. Such an operation is necessary, because in the process of grinding the tooth in the form of a crown, the doctor can burn the pulp. Units with several roots do not require removal of the nerve, since the probability of burns of the pulp when grinding them is minimal.
At the preparatory stage of prosthetics, medical procedures are carried out, channels are sealed, professional dental units are cleaned from plaque and solid deposits. By the time of grinding and installation of prosthetic teeth, the teeth should be healthy and clean, the presence of inflammation in the oral cavity, irritation of the gum tissue is not allowed.
If the support unit is badly damaged, then after removing the nerve and filling the canals, the dentist restores the coronal part with the help of a special material. This is necessary to create the necessary basis for successful prosthetics.
Restoration of the crown of the tooth
Preparation for prosthetics includes the restoration of the crown part, this procedure is necessary to create the basis on which the crown of the tooth will be attached. Significant destruction of bone tissue while maintaining the root requires the installation of a pin or stump tab.
A pin is needed when hard dental tissues are damaged by more than 50%. The process of its installation is as follows: a strong rod is screwed into the root canal, a filling material is applied to the rod, recreating the necessary basis for the crown fastener. After building artificial fabric, it is ground under the prosthesis.
A stump insert is inserted into a completely destroyed tooth, thanks to which it becomes possible to install an artificial crown on a preserved root of the tooth. The core tab is a mount that is made from a hypoallergenic and biocompatible metal. The construction is inserted into the dental canal and fixed with a special cement mortar, and then the walls of the canal and the coronal part are increased to fix the prosthesis.
Preparation of the tooth under the crown includes turning it. Tooth preparation consists in removing the upper layer of hard tissue, the thickness of which depends on the crown being installed and varies from 1.5 to 2 mm. The specialist grinds hard fabrics to obtain the base or "stump", which in the future attach the crown. The resulting base is used for the manufacture of the impression on which the future prosthesis is made.
The grinding process is necessary to give the desired dental unit the desired shape for subsequent prosthetics. To grind a tooth, use a drill or diamond bur.
The grinding process is painless, but uncomfortable. Painlessness is achieved with the help of local anesthetics. Unpleasant and uncomfortable sensations arise only when treating dental units with nerves, giving the desired shape to the “dead” teeth occurs without the occurrence of pain, in this case painkillers may not be used.
During the procedure, a “stump” is formed from the ground tooth, which is used to make an impression for the manufacture of the prosthesis. The resulting crown is set on the prepared teeth.
Crown on the tooth is done in a special laboratory in the following order:
- First, make a frame-based design. The frame can be made of medical alloys with high wear resistance and durability, or compounds of precious metals (platinum, gold), which are hypoallergenic and biocompatible with body tissues.
- The next step involves layering a ceramic coating onto the framework. Ceramic mass is applied in the form of an imprint, taken from the ground basis or restored coronal part. This method of application ensures maximum compliance of the product with a “stump”, accurate fit of the fixed crown.
- The manufactured prosthesis is subjected to special treatment - burned in a furnace at a temperature of up to 900 degrees. This manufacturing stage provides fast adhesion and pronounced interaction of the prosthesis components, due to which its high strength and resistance to external negative influences are achieved.
It takes time to make a permanent crown, so for this period temporary dentures made of durable plastic are installed on the patient.
How crowns are made is shown in the video:
Fitting and fixing crowns
Before you install a permanent denture on the teeth, it is necessary to carry out a series of mandatory manipulations:
- A fitting that is necessarily assigned during the manufacture of a permanent crown. The procedure is carried out to assess the compliance of the framework with the required parameters, the accuracy of its landing on the ground stump. In some cases, necessary adjustments are made.
- Temporary installation of a permanent prosthesis. The crown is placed on a prepared base and fixed with temporary cement. The procedure is necessary for getting used to the prosthesis, identifying a comfortable or uncomfortable state when wearing. Temporary models allow to determine the presence of inflammatory processes, to identify violations committed in the course of treatment and canal filling. In the process of wearing a temporary prosthesis, common defects may appear: a loose fit of the crown, an overbite bite.
- Final fixation of the crown. The period of wearing temporary prostheses is from 2 weeks to 1 month. In the absence of complaints, a specialist removes dentures and cleans the base from temporary cement. After removal, the crown is inserted back onto the teeth and fixed with permanent cement.
Photo: so put a permanent crown on the tooth
Indications and Contraindications
Experts put a crown on the tooth in certain cases:
- One of the common conditions for prosthetics is severe tooth decay, when bone tissue is destroyed by more than 50%. In such a situation, the chewing load is unevenly distributed, which can lead to damage to the tooth base. A sealing and restoration are ineffective. The crown protects the tooth, minimizes the risk of its further destruction, return the necessary functions.
- Congenital abnormalities and hereditary anomalies. There are a number of pathologies that cannot be corrected with braces or other correction systems.
- The absence of one, two or more teeth. In the latter case, a bridge is installed, which is attached to the remaining healthy teeth - supports for the prosthetic structure.
There are a number of contraindications in which prosthetics are excluded.
- Prostheses are not installed for pregnant women.
- Prosthetics are contraindicated in severe forms of periodontal disease, the presence of foci of inflammation and infection in the oral cavity.
Important contraindications to the installation of crowns are psychopathology, disorders of the central nervous system, the presence of tumor neoplasms, infectious diseases (ARI, ARVI).
Does it hurt to put a crown on the tooth
It is not painful to put the crowns, the process can be accompanied by only minor discomfort. However, the preparatory stage of the installation of crowns can be painful, because during this period the teeth are drilled, the root canals are cleaned and filled, and the grinding of hard tissues is carried out.
Prosthetics of "dead" teeth passes imperceptibly, since such dental units do not have nerves that react to external influence. When crowns are put on live teeth, a high-quality anesthetic is used, which completely blocks pain syndrome both at the preparation stage and in the process of prosthetics.
How long does the installation of crowns
Prosthetics with crowns is not done in 1 day, because it involves several mandatory steps. Terms of phased installation of prostheses reach 1–2 months. The longest stage - the period of manufacture of dental crowns.
Dental prosthetics is the best solution not only for aesthetic problems. Crowns are installed in order to return the integrity of the teeth and the necessary functionality. Modern technologies used in dental prosthetics, make the process as painless and efficient as possible.
Secrets of the correct and successful prosthetics with crowns
How to put the crown on the tooth? This question should concern every patient who needs to undergo this procedure. The process of prosthetics differs by nuances and subtleties that you need to be prepared for if you want a truly high-quality and durable result. So all the details are analyzed in today's material.
What is prosthetics crowns
Artificial crown is a type of fixed prosthetic structure, which experts actively use in dental practice to preserve and protect the tooth from further damage, to strengthen it, to restore shape, beauty, functionality.
Important! The installation of the crown is possible only if there is a support: it is fixed either to the tooth, which has a root preserved, or to a pin or stump tab, used as a support. In the absence of a tooth in the case of prosthetics with bridges, the crowns are attached to the two extreme abutments or fixed on implants.
If the doctor has done his job professionally, then the patient may not worry about the well-being of the restored tooth for 7-10 years or more. The main thing that is required is to follow the rules of thorough hygienic care of the structure and to preserve it as well as native teeth.
What types of designs are
In this section, we consider what types of crowns exist. It is important for each patient to understand the fundamental differences, since the use of different types of structures can be caused not only by material capabilities and preferences, but also by a clinical case.
On a note! How many teeth are crowns placed in in the case of bridges? In such a case, it is necessary to dissect two extreme healthy supports on which the structure will hold.
Who shows the installation of crowns
in case of tooth decay by more than 50-70%: in half of all clinical cases, the installation of crowns is required for patients in whom the destruction occurred as a result of neglected caries, pulpitis, periodontitis. Installing a seal in such cases is impractical, since it will quickly become worthless and will squeeze under mechanical loads and pressure while chewing food. Or does it stick together with the tooth
What are the contraindications to the installation
The technology of installing a crown on a tooth requires the doctor to be responsible, therefore, a specialist must first exclude a number of contraindications: disorders of the central nervous system, bruxism, the presence of allergic reactions to different types of materials, cancers, pregnancy, acute inflammatory processes in the gums and other mucous membranes.
Stages of fixation of the product in the oral cavity
The installation process does not involve haste, because the structures themselves are pre-created in the laboratory and are designed for long-term operation. Accordingly, before their final fixation, the specialist performs many different manipulations.
Let's take a closer look at what stages of treatment the patient will have to go through.
Stage 1: consultation with a specialist and the definition of a further treatment plan
At this stage, the doctor necessarily conducts X-ray examination and collects the necessary history. Your task is to tell all about the state of your health and possible contraindications. After the examination, the specialist will propose solutions to the problem, with him you will choose the most suitable one.
Important! The most optimal prosthetic option is selected by the orthopedic surgeon, the same specialist takes part in the manufacture and installs the structures. As for preliminary preparation: treatment, nerve removal, canal filling - all this is done by a dentist-therapist. If it is required to perform prosthetics on implants, the implants themselves or the maxillofacial surgeon installs the implants themselves. The orthopedist should work in close cooperation with these specialists, which helps to achieve a good result.
Stage 2: preparation of the oral cavity
This includes sanitation, removal of soft, hard deposits and bacterial deposits, treatment and removal of non-viable units. These procedures are necessary to ensure that no pathogenic microflora remains in the mouth, which during prosthetics would become a source of infection of the tooth on which the crown is planned to be installed.
Stage 3: preparing the tooth itself
Let's now see what exactly is included in this stage and what is the sequence of actions:
nerve removal: this procedure is performed in most cases, because without it, experts risk damaging the nerve (burn the pulp) while grinding the enamel with a drill and diamond burs. Also, it can not do without, if the nerve is inflamed. After all, if you do not carry out the depulpation, then the chance of the development of the inflammatory process subsequently with poorly conducted treatment increases significantly. It is believed that on the anterior single-root incisors and canines it is much easier to touch the nerve when dissecting than when working on multiroot premolars and molars. But experts in any case prefer not to take risks and most often remove it,
Stage 4: installation of a temporary structure
Immediately after preparation for prosthetics, the doctor fixes a temporary structure (most often it is made of plastic or metal-plastic), which is designed to protect the grinded and very sensitive stump from the effects of adverse environmental factors: microbes, temperature nutrition. Also, a temporary product allows you to instantly restore the beauty of a smile and return functionality.
Stage 5: fitting a permanent structure
Notice that the doctor first fixes the crown in the laboratory to temporary cement. It will take several weeks to go with her (on average, from 14 to 28 days). During this time, you need to adapt to the artificial structure, evaluate all the possible disadvantages and advantages, tell the orthopedist about the difficulties and drawbacks that arise, about the body's reaction (allergy, inflammation of the mucous membrane). Also listen to your feelings and evaluate whether the restored unit does not interfere with "neighbors" and antagonists.
The doctor, in turn, also evaluates his work and observes, making the necessary adjustments. During this period of time, errors associated with a loose fit of the structure, with its overestimation or exit from the bite, with a traumatic installation, which could lead to bleeding of the gums and damage to the mucous membrane, can be detected. It may also be detected missed earlier or re-emerged inflammatory process, errors made during the filling of the channels.
Therefore, at this stage, it is important to be patient and not in a hurry to quickly install a permanent structure. After all, such a crown will be permanently fixed to the dental cement, in case of problems without damage, it will not be possible to remove it.
Stage # 6: final fixation of the permanent structure
When the doctor together with the patient makes sure that the crown is installed in compliance with all the rules, and the treatment of the destroyed tooth under it is carried out qualitatively, the final stage of the prosthesis is performed, after which the patient leaves the dentist's office with a beautiful smile.
How long does the prosthesis take?
How long is the crown? This process is long, so expect that immediately after the first visit to the dental office you will get a new prosthesis that will solve all the problems, you should not. At all stages of treatment can take from 2 weeks to several months of work. During this period of time you will have to visit the doctor at least three times.
Does the denture hurt
For many patients, the question of whether it is painful to put a crown is of most interest.Here you can answer as follows: modern dentistry allows you to carry out the procedure completely painless for you thanks to the use of anesthesia. But, of course, the process of depulpation itself (if there is a need for it) and turning the enamel under the non-removable structure are not psychologically pleasant moments, so you will have to put up with them. But anesthesia again allows you to feel nothing.
Painful sensations may occur after the preparation procedures. But such a phenomenon in most cases can be considered natural, because the doctor affected the living tissues, root canals. A certain sensitivity and discomfort when properly administered treatment should pass within 3-7 days after the procedure, otherwise be sure to report the problem to your doctor.
When the structure will need to be removed
If a professional has performed a high-level job, and the patient is carefully caring for artificial crowns, then the period for planned replacement of structures is approximately as follows:
- for metal plastic: after 2-3 years,
- for ceramics: after 5-7 years of operation,
- for ceramic granite: in 5-7 years,
- for cermet: after 7-10 years,
- for metal: 10 years or more
- for zirconium dioxide: after 15 years or more.
It may be necessary to remove the construction prematurely only when the patient experiences severe discomfort or the tooth under the prosthesis is repeatedly subjected to an inflammatory process, and it is already a question of saving it. This could happen if, for example, the doctor who performed the treatment made a number of mistakes when preparing for prosthetics: perforated the root, left a fragment of the instrument in the root canal, and sealed the canal leaking. All these errors often occur due to the lack of X-ray control at each stage of the treatment process.
“In my practice, there are situations when a patient comes to me from another clinic with a request to remove an artificial crown and re-treat the tooth under it due to inflammation. For example, a cyst often remains unnoticed under a prosthesis for a long time, because the doctor who performed the treatment did a number of poor-quality procedures without proper attention. This situation scares patients, until the last they do not want to remove the design, because then you have to make a new one. This requires additional expenses. Therefore, some ignore the problem and come at the advanced stages when the salvation of the tooth becomes impossible. Therefore, my advice to those who underwent prosthetics: be attentive to yourself and do not miss a single routine examination, because the presence of a crown does not always save you from problems. ”- considers Litvinenko OV, dentist-therapist, orthopedist.
Also, the reason for which the prosthesis will need to be replaced earlier than the prescribed period may be the patient’s injury, as a result of which cracks and damage have formed on the crown that cannot be repaired.
Advantages and disadvantages of prosthetics
The advantages are obvious here: restoration of aesthetic indicators, shape, function of natural teeth. Thanks to the installation of crowns, they are able to serve their masters for many more years, while they will be protected from destruction and will avoid premature removal.
As for the shortcomings, in single artificial crowns they are difficult to detect. Each patient will be able to choose the option that will suit him financially and aesthetically. The main thing is that the installation of the construction should be carried out by an experienced prosthetist, then it will serve without complaints.
But when prosthetics with bridge structures, there are still disadvantages. There are several of them: the first is the premature wear of the supports on which the prosthesis will be fixed, the second is the atrophy of the jaw bone tissue under the prosthesis in the place where the tooth is missing. Due to these two drawbacks, the product can fail very quickly and cause inconvenience to its owner. Are there alternatives? Of course: if you lose a tooth, you can give preference to crowns on implants.
Detailed report from the clinic on how to perform the basal implantation of teeth