How crowns are made for teeth. Ways to restore teeth: how to make dentures at home. Strengthening temporary structures

From this article you will learn:

• Does it hurt to put a crown
• stages of prosthetics,
• how much does it cost to put crowns on teeth - prices 2020.

The manufacture and installation of a crown on a tooth is a complex procedure consisting of many steps. In this article, we will talk about the many subtle points that affect the aesthetics and life of your crowns. These points concern both errors in choosing the type of crowns by the patient himself, and errors massively committed by dentists at the stages of their manufacture.

For example, most of the patients' complaints about the quality of prosthetics relate mainly to 2 things. Firstly, poor aesthetics, and the fact that the crowns stand out against the background of neighboring teeth. Secondly, the quality of therapeutic preparation of teeth for crowns. The latter just leads to complications - pain, suppuration, the need for retreatment and even tooth extraction.

Is it painful to insert teeth -

Usually, patients are interested not only in how a crown is placed on a tooth, but also how painful it is. The most unpleasant stages here, of course, are the preparation of teeth for prosthetics (i.e. their treatment, root canal filling), and sometimes the process of taking impressions. If already dead teeth are taken under the crowns, then their turning is completely painless and does not even require anesthesia. If live teeth are being ground, then an injection is first made.

The only painful moment that I myself (being a dentist) suffered from personal experience is when, when taking an impression, the doctor makes a gum retraction. Retraction is understood as the expansion and deepening of the gingival sulcus, which is accompanied to a small extent by the separation of the soft tissues of the gums from the tooth. This is done in order to make the impression in the neck of the tooth more accurate, and it is better to do it immediately under anesthesia.

How is a crown placed on a tooth?

If you decide to put a crown on your tooth, then it will be useful for you to know what stages of this process you will have to face. In the process of putting a crown on a tooth in dental clinics, the following stages can be distinguished ...

1. Initial consultation of an orthopedist (prosthetist) −

During the initial consultation, the doctor, assessing the condition of the teeth externally and on x-rays, must offer possible options for prosthetics, and the patient, accordingly, must approve one of the options. Based on this, a treatment plan is drawn up, which may take into account −

Important : at this stage, the patient must choose one of the types of artificial crowns offered to him. Choosing the type of crowns is not easy for an ordinary patient, and besides, there are a lot of pitfalls that the dentist will never tell you about. Articles to help you choose

2. Preparation of teeth for prosthetics -

In some cases, it is possible to install crowns on living teeth. This is preferable because dead teeth are more fragile, and therefore, if the teeth are left alive, this has a positive effect on the life of the crowns. In what cases can teeth be left alive? As a rule, we are talking about large chewing teeth. This is due to the fact that large teeth have a greater distance from the surface of the enamel to the pulp of the tooth (than single-rooted teeth) and, therefore, the risk of thermal pulp burns when turning the tooth under the crown will be much lower.

Moreover, even the majority of single-rooted teeth can be left alive under crowns made of metal-free ceramics. This is due to the fact that under ceramics, the tooth is ground by 1.0 from the side surfaces, and under cermet - on the same surfaces already by 2.0 mm. Therefore, metal-free ceramics also allows you to increase the life of the tooth itself under the crown.

When prosthetics with ceramic-metal single-root teeth - the nerve is almost always removed. If this is not done, then turning such a tooth can lead to thermal burns of the tooth pulp, i.e. neurovascular bundle. In this case, after some time, its inflammation will develop, and then the crown will have to be removed and the tooth treated. If the tooth under the crown is destroyed by a carious process (there is pulpitis or periodontitis), then planned depulpation of the tooth and treatment of inflammation at the root apex are required.

When depulpation of the tooth is carried out –

• removal of a nerve from a tooth
• instrumental processing and expansion of root canals (Fig. 2),
• canals are sealed with gutta-percha (Fig. 3),
• after which a filling is placed on the crown part of the tooth (Fig. 4).

Important : if the crown part of the tooth is destroyed by 1/2 or more, the tooth must be strengthened with a pin fixed in the root canal (otherwise the crown can easily fall out along with the filling). There are 2 main methods of restoring severely damaged teeth.

What is the best way to restore a badly damaged tooth? –

3. Preparation of teeth for crowns -

In the common people - turning teeth. The preparation process is carried out by an orthopedist, who (using a drill and a set of diamond burs) gives the tooth a certain shape. Preparation is a painful process if live teeth are turned. In this case, local anesthesia is required. When dead teeth are ground, then anesthesia is placed only if the doctor needs to strongly press the gum away from the tooth during the preparation.

The tooth tissues are polished by the doctor to the thickness of the future crown (Fig. 9-11). Crowns made of metal-free ceramics (for example, or) require less grinding of tooth tissues - from about 1.0 to 1.5 mm on different surfaces of the tooth. But under metal ceramics, teeth are ground from all sides by 1.5-2.5 mm - as a result, almost nothing remains of the tooth. As a result of the preparation, the tooth crown takes the form of a “stump”.

Preparation of a tooth for metal-ceramic -

Important : High-quality preparation of a tooth for a crown is a very complex and time-consuming process. The most difficult thing here is to create a ledge in the gingival part of the tooth crown. The reliability and service life of your bit depends to a very large extent on the correct formation of the ledge. It must be admitted that most doctors make a lot of mistakes at this stage. How the ledge is formed is well shown in the video below.

Turning front teeth for crowns: video

4. Taking casts, making plaster models of teeth -

With the help of special impression masses, casts are taken from the turned teeth (Fig. 12). In the future, based on these casts, plaster copies of your teeth are created in the dental laboratory (Fig. 13). Such plaster models with very high accuracy reflect the patient's teeth, including those turned for crowns, and it is on such models that they are made.

A very important question here is what kind of impression mass you will be taking impressions with. Good impression masses are "A-silicone" or even better "polyester mass". But usually, in order to save money, alginate masses or C-silicone can be used, which will affect the quality / accuracy of the crowns for the worse. As a result, crowns may not fit well-turned teeth, poorly wrap around the neck of the tooth, and the latter will inevitably lead to decay of the tooth under the crown.

Removing an impression from the teeth is usually quite a tolerable procedure, not accompanied by painful sensations. However, when sometimes the doctor needs to insert a retraction thread deep into the gingival sulcus in order to move the gum away from the turned tooth and thereby obtain a better impression of the teeth at the gingival margin. Gingival retraction is quite painful and is best done under anesthesia. Gingival retraction also has a disadvantage - very often, gum detachment can lead to the appearance of a periodontal pocket.

But there is also a group of patients in whom taking impressions is a very big problem. For example, if you have an increased gag reflex. Of course, before taking the impression, you can spray Lidocaine spray (anesthetic) on the root of the tongue, but this still helps little. In this group of patients, it is desirable to additionally use sedatives before the procedure itself.

How to take impressions of teeth in dentistry: video

5. Making crowns in a dental laboratory -

So the casts were taken, the plaster models were made. The dental technician starts to make your future crowns according to these models. Because fabrication of metal ceramics and ceramics can take several weeks, while permanent crowns are usually made at the time of manufacture. They will not only restore aesthetics, but also protect the turned teeth from destruction by the aggressive environment of the oral cavity.

The most important thing at this stage –
we recommend prosthetics only in those clinics that have their own dental laboratory (and located directly in the clinic itself). This is necessary so that the orthopedic dentist has direct contact with the dental technician at the stages of crown manufacturing, and the dental technician can always come to the office when trying on the crowns.

The latter is very important if you want good crown esthetics, well formed contact points with neighboring teeth, etc. Of course, all this will not help if your prosthetist's hands are growing out of a bad place, but at least it will increase your chances of getting a quality service.

6. Crown fitting -

Before the dental technician finishes his work, it will be necessary to try on the unfinished work. For the first time, a crown frame is usually tried on, which can be either metal or made of metal-free ceramics. The second time they try on an almost finished crown, on the surface of the frame of which (already after the first fitting) layers of ceramic mass, as well as dyes, were applied.

It is at this stage that you can still say that you do not like something (color, shape), and this can be corrected. Those. it is at this stage that the color is finally agreed upon, and if you agreed on it and, moreover, signed the medical card that everything suits you, then it will be too late to make claims. Therefore, our advice: if at least something does not suit you and you are ashamed to point it out to the doctor, be sure to say this, and do not sign anything until the results of the work really suit you.

After the final try-in, your crown is returned to the laboratory where it goes through the glazing process and acquires its final look and shine. On the next visit, the finished crowns are fixed to you with permanent or temporary "cement".

Video of trying on E.max ceramic crowns –

7. Temporary / permanent fixation of crowns -

In principle, there is no need for temporary fixation as such. It is necessary, and you need to insist on it only if for some reason you are not sure about the quality of the work or something confuses you (the color / shape of the crowns, their visibility against the background of neighboring teeth). If the crowns are placed on permanent cement, they can only be removed by sawing.

If you insist on temporary fixation, and the dentist refuses you, this is also a signal to think about the quality of work. Such cases and conflicts about this between a doctor and a patient are not uncommon, and here you must remember that it is you who pay the money and decide how everything should be - you too. Usually 1-2 days is enough to get used to the new crowns, determine how the color matches the desired one, and after that, come back to the clinic and put the crowns on permanent cement.

Put crowns on your teeth: prices in Moscow

How much does it cost to put a crown on a tooth - the price in Moscow for 2020 (in economy class and mid-price clinics) can have a very wide range. For example, you can easily see that in one clinic you can put a dental crown made of metal-ceramic for 5,500 rubles, and in another - the price can be 10,000 rubles. And it's not just about pricing...

The fact is that the same crowns (for example, metal-ceramic ones) can be made of materials of completely different quality. For example, if cheap ceramic mass is used, then we can immediately say that the aesthetics of such a crown will be very weak. In addition, in addition to the standard cermet, there is also a “cermet with a shoulder mass”, which is much more aesthetically pleasing than the standard version, but at the same time costs 2-2.5 times more.

Installing a crown on a tooth: price 2020

Important : if you plan to install a crown on a tooth - the cost above does not include all items of possible expenses. Therapeutic preparation of teeth (if necessary) and the cost of manufacturing temporary crowns made of plastic are additionally paid. The latter are needed to protect the turned teeth while your permanent crowns are being made.

How are dental crowns removed?

Unfortunately, we must also state the fact that sometimes there are situations when the crown needs to be removed. For the removal of crowns, the price for 2020 will be about 1000 rubles per 1 unit. The need to remove the crown may be due to the following reasons ...

• With poor-quality tooth preparation for a crown –
  According to statistics, in 60-70% of cases, the root canals of the teeth are not sealed properly, which leads to the development of inflammation and the need for retreatment or tooth extraction. You can find out more about poor-quality preparation of teeth for prosthetics, what it leads to, and what to do about it.

• With manufacturing errors –
  for example, the crown did not tightly wrap around the neck of the tooth, and therefore, the destruction of tooth tissues began in days. A chipping of a large fragment of the ceramic mass could occur from metal-ceramic or non-metal ceramics, which may not be repairable and require replacement of the crown (site).

• Scheduled crown replacement required –
  All crowns have their own lifespan and will need to be replaced periodically. It should be noted that well-made modern crowns may well serve for 8-10 years, and even more.

Removing crowns: video

And here the question always arises: does it hurt to remove the crown ... It can really be a little painful, and therefore the procedure is performed under local anesthesia. Removing cermet, for example, is very difficult. The crown is sawn using special discs and burs, and there are frequent cases of damage to the gums next to the tooth. We hope that the article on the topic: How to put crowns on your teeth turned out to be useful to you!

Sources:

1. Personal experience as a dentist
2. “Orthopedic dentistry. Textbook "(Trezubov V.N.),
3. National Library of Medicine (USA),
4. "Orthopedic treatment with fixed prostheses" (Rozenshtil S.F.),
5. "Crowns and bridges in orthopedic dentistry" (Smith B.).

Prosthetics is a popular dental service that helps restore the beauty and charm of a smile. Insufficient care, non-compliance with the doctor's recommendations and mechanical damage lead to the formation of cracks and chips. Of course, you should immediately contact a dental technician, but the false teeth can be damaged during a vacation or business trip. Not surprisingly, many are wondering how to make dentures at home.

Only professionals know how to make dentures at home with high quality and reliability

What to make a denture at home?

The repair of the dental product is carried out using dichloroethane adhesive, which is applied to the split lines to bond the parts. This stage is not final, but preparatory, designed to perform precise subsequent manipulations - the preparation of a plaster cast and the connection of parts.

Professionals use acrylic plastic and special resins to glue the prosthesis, which can only be bought at a dental store. Some craftsmen seal it with wax extracted from a slightly melted prosthesis. This approach is recognized by dentists as incorrect and unreliable - most likely, the repaired product will not last even a week.

How to make a denture with your own hands?

When restoring false teeth at home, it is better to focus on the work of masters. What is the process of restoring a prosthesis?

1. Grinding. On the surface of all parts of the product there should be no irregularities or roughness. This is done using carborundum stones or discs.

2. Cleaning. Each element of the prosthesis is removed from contamination and disinfected.

3. Assembly. All parts of the product are arranged in the correct order tightly to each other -

so that there are no gaps.

Installing crowns on teeth is one of the most common options in modern dentistry to restore their shape and functionality. The procedure requires time and some manipulations, but in many cases this is the only right way to take care of your health and aesthetic component. Let's figure out how crowns are placed on the teeth.

Teeth under the influence of various factors are destroyed, subjected to caries, injured or completely removed. When filling and other methods of eliminating defects are not possible, crowns are placed.

This is one of the types of prosthetics. With the help of a fixed design made of special materials, pronounced anomalies are eliminated.

Main indications:

• Severe destruction of one or more teeth due to extensive caries or trauma with preservation of the root - 70% of all cases. It is necessary to prevent splitting of the base and properly distribute the chewing load;
• The presence of pathological abrasion of enamel. All teeth are preserved, but protection from environmental negative factors is required;
• , resulting in a noticeable loosening. Stability is given with the help of temporary crowns;
• Installation of a bridge structure: crowns for support can be fixed on healthy teeth;
• Unaesthetic appearance caused by defects or significant discoloration of the enamel.

The decision in which cases a crown is placed on a tooth is made based on the results of a consultation with a dentist on an individual basis. As a rule, in addition to examination, an X-ray examination is required.

Dmitry Sidorov

Dentist-orthopedist

A crown is one of the types of prostheses. Therefore, further in the text, the word "prosthesis" can be safely considered its synonym.

Types of crowns

Several materials are used for the manufacture of prostheses, each of which has its own advantages:

• Ceramic or porcelain. The metal-free design conveys the natural look as accurately as possible and does not lose its properties for a long time. A significant drawback is that this expensive material is not able to withstand a large chewing load. Most often used for incisors.
• Metal (cast). A classic that has been used for many years. The metal may vary. It is characterized by high strength and abrasion coefficient as close as possible to natural enamel. The most famous example is gold teeth. A significant drawback is an extremely unaesthetic appearance.
• Metal-ceramic. It is characterized by durability, good aesthetic performance and strength. Metal ceramics optimally combines the properties of porcelain and metal both in terms of price and quality. The disadvantage is the preparation of a large volume of dental tissues and an increased coefficient of abrasion of natural tissue.
• Temporary plastic. It is installed on turned teeth for the period of manufacturing the main crown and in order to protect them from aggressive environmental influences.

Installation steps and features

Installing a crown on a tooth is a multi-stage procedure that involves multiple visits to the dentist. High-quality performance and a responsible approach to each stage are important, both on the part of the dentist and the patient.

The initial stage includes treatment planning, the choice of a specific method and the preparation of the object. The conclusion and recommendations are given based on the results of the examination, x-rays and on the basis of an analysis of the clinical case.

The treatment plan may include the following items:

• filling, removal of stone and non-viable teeth, treatment of inflammatory processes;
• agreement on the issue, put in a specific case;
• preparation of the tooth for the procedure;
• determination of the number of supports for;
• calculation of the total cost of the procedure;
• determination of the terms of production and fixation, coordination of the schedule.

Before installing the crown, the tooth is processed as carefully as possible. If necessary, tartar is removed, canals are sealed, and depulpation (that is, removal of the nerve) and turning are carried out.

Depulpation is used in the preparation of single-rooted teeth to eliminate the likelihood of pulp burns during the turning procedure. In addition, the expansion of root canals and instrumental processing is performed. For chewing teeth that have multiple roots, this risk is much less. Most often they are left "alive", that is, the nerve is not removed.

After that, the stage of restoration of the prosthesis begins, which is carried out in one of two ways: using a pin or a stump tab.

Font usage. A special mechanism - a font - is screwed into the sealed canal, and on its basis the prosthesis is restored. Turning is done after that.

Turning (preparation) is the process of giving a special shape by grinding with the help of diamond burs, as a result of which a stump remains, a crown is already placed on it.

Stump tab. This is a device specially made in a dental laboratory, consisting of two parts: a root one, which is fixed in the root canal, and a crown one, prepared for fixing the prosthesis.

According to the criteria of reliability and practicality, this method is considered the best when installing dental crowns.

Living teeth must be prepared under local anesthesia. The procedure involves retracting the gums, which causes discomfort. Therefore, when working with dead teeth, anesthesia is also recommended.

The tissues are polished to the thickness of the future prosthesis: it is 1.5–2.5 mm. Installation requires the removal of a larger layer than with cast prostheses.

After preparing the base for the crown, an impression is taken using a special impression mass and transferred to the dental laboratory. Based on it, a plaster model of the teeth is made. This is a model for casting a crown.

This process is quite lengthy. It is mandatory to try on, including when installing crowns on implants. This is necessary to determine the quality of the product, the color ratio, and to check how accurately the contour and density are reproduced. At this stage, there is an opportunity to eliminate shortcomings and make adjustments.

In order for the patient not to feel discomfort while the crown is being made, a temporary one made of plastic is placed for him. It is very fragile and simply protects the turned tooth from external influences.

When the crown is ready, the final stage of installation begins. Its algorithm is the following:

1. The crown is fixed with temporary cement. The doctor and patient observe the reaction. Considering that the permanently cemented prosthesis can only be removed by sawing, temporary fixation is necessary to prevent possible problems in the future;
2. After removal from temporary cement, a thorough cleaning is carried out;
3. Before a crown is placed on a tooth, a final fitting is mandatory. The doctor is convinced of the correct location of the prosthesis and comfortable closing of the teeth;
4. The final fastening is carried out by applying a special permanent cementing compound to the inner surface. The dressed prosthesis is irradiated to accelerate hardening;
5. Removal of excess composition to avoid irritation and inflammation of the gums.

After an hour, chewing loads are acceptable, and after a day you can use the maximum pressure.

Varieties of fastening

You can put a crown on a tooth using special locks. Abutment teeth are minimally ground. The process of installation and removal is greatly facilitated due to the fact that the locks perform the function of a support. This method is called fastening with locks and is considered a very promising direction in prosthetics.

Installing a crown on an implant involves the use of a special prosthetic technology. Treatment of adjacent teeth is not required. If implantation was previously applied, the structure can be installed in two ways of fixation:

1. Screw. Used for single crowns. The adapter-abutment and the crown are connected outside the oral cavity, after which they are attached to the implant through a special hole with a screw. A filling material is used to close the canal.
2. Cement. When prosthetics of several teeth, the abutment is fixed to the implant, and then the crown is attached with cement.

Reasons for removing dental crowns

The most common cases where its removal becomes a necessity include:

• Poor preparatory work. According to statistics, 60% - unsatisfactory filling;
• Planned replacement;
• Design errors, poor workmanship or materials that cause pain and discomfort;
• Violation of the integrity of the structure;
• The occurrence of complications: allergic reaction to materials, galvanic syndrome, prosthetic stomatitis.

The main question that interests most patients is whether the procedure is painful? Like any dental manipulation, the installation of a ceramic-metal crown or any other causes some discomfort.

The most painful is the preparation stage, namely tooth extraction, turning, filling. But modern means, including anesthesia, allow dentists to carry out absolutely painless procedures.

A high-quality and timely delivered prosthesis allows you to get rid of serious diseases and prevent their occurrence, while providing an impeccable aesthetic appearance.

Crown restoration is one of the types of fixed prosthetics. It is placed when the tooth is destroyed by 50% or more: under this condition, it is irrational to restore the unit with a filling, because. it will not withstand the load and break.

Installing a crown is a long and complex process with its own characteristics. But there is no need to be afraid: with the right choice of materials and the good work of the doctor, an artificial tooth will not differ in appearance and strength from natural ones.

What are the steps in preparing a tooth for a crown?

Prosthetics with crowns or bridges occurs in 3 step-by-step stages:

• preparatory– examination, restoration of the crown part of the tooth, turning;
• laboratory– taking impressions and making a prosthesis;
• final– fitting, fitting, correction, cementation. Read also What is denture correction?

Each stage will require a minimum of 2 dental visits. And all you need is at least 10 visits to clinics.

Prosthetics with a crown occurs in 3 stages

Preliminary procedures

The preparatory stage of prosthetics begins with a complete examination of the oral cavity. Not only the area of ​​intervention is examined, but also all teeth and mucous membranes. If the patient has inflammatory processes, prosthetics is impossible until they are eliminated.

During the examination, the patient finds out possible contraindications to prosthetics. It can be:

• pregnancy;
• oncology;
• chronic diseases in the acute phase;
• neurological disorders.

In addition, they specify whether and for what substances. The choice of material for crowns and anesthetics depends on this.

Then X-ray photos of the prosthetic area are taken. With their help, the condition of the crown and root parts of the tooth, as well as the tissues adjacent to it, is revealed.

An x-ray image allows you to assess the condition of the root canals and nearby tissues

The doctor will offer options for prosthetics, based on the clinical picture, the technical equipment of the clinic and the financial capabilities of the patient. Only after that a treatment plan is drawn up taking into account:

• types of crowns - metal, porcelain or zirconium dioxide;
• the number of teeth to be restored;
• volume of preparatory therapeutic procedures.

Restoration of the crown part of the tooth

Usually, crowns are placed on already severely damaged teeth, from which only the root system or thin walls remain. Naturally, there is nowhere to fix the prosthesis in this case. Therefore, it is necessary to restore the supragingival part.

If the tooth is severely damaged, it is restored with a stump tab, and then the crown is fixed

They do it in 2 ways:

• pin and seal- use is justified when the destruction takes 30-50%;
• stump tab- shown with a loss of 50% or more of the coronal part.

With both options, the root system must be intact. Otherwise, prosthetics is impossible: the destroyed canals will not withstand the load and will break, or inflammation will develop in them, followed by granulomas or cysts.

The method of restoring the stump tab is better. The insert imitates a natural tooth (it has a root and crown part), is firmly fixed in the canals, evenly distributes chewing loads on the tooth and withstands strong physical impact. Therefore, it is preferred to a pin even with damages of less than 50%.

Before the restoration of the crown part of the tooth (the nerve is removed). And the root canals are carefully obturated: if they are not completely cleaned or sealed to the top, inflammation will develop in them within a few months / a couple of years. About .

Nerve removal is a mandatory part of preparing a tooth for prosthetics with a crown

Turning

Preparation of a tooth for a crown is an integral part of prosthetics. This is how excess tissues are removed, the stump is given the desired shape, and damaged and carious areas are removed.

If the tooth is planned to be restored with a stump tab, the walls of the tooth are completely grinded. And if the structure is attached to its own stump, the tissues are simply removed to the thickness of the future prosthesis.

Teeth grinding is carried out in stages:

1. Grind off enamel and dentin. Dental burs remove tissue from all surfaces of the tooth. How much you have to grind depends on the type of prosthesis. So, under metal, 0.3-0.7 mm is removed on each side, under metal-ceramic - up to 2.5 mm, under all-ceramic and zirconium - 0.3-1 mm.
2. Gingival retraction is performed. It is lowered down with special threads so as not to be damaged during preparation. After the gum edge will return to its place.
3. Form a ledge. This is the part at the neck of the tooth, which is a couple of millimeters wider than the stump. The ledge allows you to hide the base of the prosthesis and tightly fix the crown, evenly distribute the load on the root, avoid washing out of the cement and the development of caries.

After depulpation, the tooth is ground to the thickness of the crown.

It is better to take impressions from a smooth surface. Therefore, at the end, the stump is ground and polished. But the adhesion of the crown is stronger with rough walls - so before fixing the prosthesis, the rest of the tooth is roughened with fine-grained burs.

Taking impressions

The next step is getting casts. They are removed in two ways:

1. Dental impression masses: polyester mass, A-silicone, C-silicone, alginate masses. The method is used in 90% of cases.
2. intraoral camera. The intraoral scanner reads the data and transfers it to a computer. After that, a three-dimensional model of the crown is created in a special program.

Removing impressions with impression materials is the most common method. It is performed as follows:

• a retraction thread is laid between the gum and the neck of the tooth in order to move the mucosa and gain access to the entire surface;
• dry the enamel
• silicone mass with the help of an impression spoon is placed on the teeth;
• after the cast has hardened, it is removed from the mouth;
• The resulting impression is dried and transferred to the laboratory.

Impressions are taken from the turned teeth and transferred to the dental laboratory for the manufacture of prostheses.

The technique for making impressions with impression materials is different. The easiest way is to make a silicone model only in the area of ​​intervention - it will reflect the condition of the prosthetic tooth and 2-3 neighboring ones, and it will take less than half an hour. But future prostheses will turn out to be low-current, they will not display all the features of occlusion. This method is used to make cheap metal and plastic crowns.

Another option is to take casts of both jaws. The method is the best, although it lasts up to 2 hours. It is used for the manufacture of metal-ceramic, porcelain and zirconium crowns.

It does not matter how many crowns you need to make - one or more. To take into account all the features of the bite, you need impressions of both dentitions along their entire length. For the first time, the orthopedic dentist applies the impression mass to the chewing surfaces of the teeth of both jaws. Then a couple more layers are added to the resulting frame, taking impressions from the oral and vestibular surfaces.

After the preparation of the teeth and taking impressions directly in dentistry, they are made. They will protect the stump from damage and allow the patient to chew food normally, talk freely and smile.

Temporary crowns are made in the laboratory to protect the teeth until the permanent denture is fixed.

Laboratory stage

After taking the impressions, they are transferred to the dental laboratory, where the prosthesis will be made according to the models using one of three methods:

1. casting method. They are used for prostheses, whose frame is made of metal alloys - stamped, titanium, gold, metal-ceramic.
2. pressing method. Used for IPS E-max Rpess ceramic crowns. They are made by injection molding at high temperature and under strong pressure.
3. milling method. Another name is CAD/CAM technology. Crowns are made from virtual impressions. A 3D model of the future prosthesis is transferred to a milling machine, where a crown is machined. This technology is used to make constructions from zirconium dioxide and IPS E-max CAD glass ceramics.

The technologies of each method also differ. There are 2 types of prostheses - frame or layered and frameless or monolithic. For the first, the manufacturing sequence is as follows:

• make a frame - metal, porcelain or zirconium;
• the base is lined with ceramic spraying;
• sintered in an oven at 900°C.

Monolithic structures are milled from solid blocks of ceramics or zirconium dioxide on automatic machines.

CAD / CAM technology involves the manufacture of crowns from virtual impressions

Fitting and fixation of crowns

The final stage goes side by side with the laboratory: during the fitting, inaccuracies are identified and the prosthesis is sent for correction to the dental technician. And so on until the crown perfectly matches the bite and appearance of neighboring units.

For the first time, only the frame of the prosthesis is tried on. The orthopedist, together with the dental technician, looks at how the crown sits: how tightly it fits to the stump, whether there are any gaps, whether it interferes with the bite. If there are inaccuracies, the design is fitted or a new one is made.

If there are no complaints, they select the color for the ceramic cladding. They choose as close as possible to natural enamel on the Vita scale - it is a set of tooth-shaped plates painted in different shades of gray and yellow.

The last fitting is carried out with a prosthesis lined with ceramics. The doctor puts it on, re-evaluates the occlusal contacts, compliance with the shape and color of the tooth. Further, 2 options are possible before a crown is installed on a tooth on a permanent basis:

• the patient is given 10-20 minutes to check how the structure sits - does it interfere with talking, closing teeth, etc .;
• The crown is fixed with temporary cement and the patient is released for 3-7 days.

The crown is fixed with a special cement

It is better to insist on the second option. For 10 minutes it is impossible to assess the convenience of the prosthesis. In addition, discomfort in the first 2-3 days is normal. Only by the end of the first week the patient ceases to feel the structure as a foreign element and gets used to it.

While trying on or wearing a temporary cemented crown, discomfort or color mismatch can be reported. After fixing with permanent glue, it is unrealistic to fix the prosthesis: it will have to be sawn, removed and a new one made.

On the last visit, the crown is fixed with permanent cement: an adhesive is applied to the stump and inside the “cap”, put on and pressed. Be sure to remove the remnants of the adhesive around the gums and from the interdental spaces, otherwise it will harden and cause inflammation of the mucosa.

Are crowns placed on a living tooth?

Whether it is necessary to depulp a tooth before prosthetics, orthopedists have been arguing for decades. Both approaches have pros and cons.

So, vital teeth under crowns:

• less prone to developing caries;
• stronger, because trophic (nutrition) of tissues occurs;
• cost longer than dead units.

This is the effect you can achieve if you install crowns

On the other hand, pulpless teeth:

• exclude inflammation of the pulp - in case of pulpitis, you will have to remove the crown, carry out endodontic therapy and prosthetize the unit again;
• less sensitive - no acute reaction to thermal and chemical stimuli.

To exclude possible damage to the pulp chamber or burn of the neurovascular bundle during turning, most dentists prefer to extirpate the pulp. But you can leave it if:

• a chewing element is closed under the crown - a premolar (4, 5) or a molar (6, 7, wisdom tooth): they have more dentin than the anterior units (incisors or canines), so there is less chance damage the pulp chamber;
• it is planned to set up an all-metal, frameless ceramic or zirconium crown - a smaller amount of tissue is prepared under it than under metal-ceramics or layered structures.

If pulpitis (?) has already developed, there are inflammatory processes at the root apex (periodontitis, granuloma, cyst), medium or deep caries is present - the tooth is depulped, regardless of its type and type of crown.

Before and after prosthetics

How is the crown holding up?

How strong, long and comfortable the prosthesis will hold depends on:

• quality of tooth preparation;
• skills of an orthopedist;
• dental technician qualifications;
• type of materials used;
• technical equipment of the clinic and laboratory;
• crown material.

The first 3-5 days after installation, there is discomfort, a feeling of “not your own” teeth, difficulty in talking and chewing. This is fine. You need to be wary if the design interferes with closing the jaw, provokes pain, injures the gums or staggers.

Average service life:

• 3-5 years - metal;
• 8-10 years - ceramic-metal;
• 10-12 years - porcelain;
• 15 years and above - zirconium.

Zirconium crowns last the longest - about 15 years

Does it hurt to put?

Prosthetics is an uncomfortable and traumatic process. There is nothing terrible in it, but at certain stages painful sensations are possible:

1. Training. If a living tooth needs to be treated for caries, pulpitis and other inflammatory processes, it is anesthetized. Anesthesia is not necessary before endodontic treatment of dead units.
2. Grinding and formation of a ledge. Vital teeth are prepared under anesthesia. Depulpated grind down on a living, but, because. damage to the gums is possible, at the request of the patient, a superficial injection is given.
3. Retraction. It is carried out during the formation of the ledge and before taking casts. The laying of the thread is accompanied by a slight separation of soft tissues from the tooth and the formation of gingival grooves. This is a painful manipulation, so anesthesia is required.
4. Taking impressions. It does not hurt, only pressure on the jaw is felt. But vital units can react sharply - in such cases anesthesia is given. Nausea is also possible in patients with an increased gag reflex. Such patients are recommended a few days before going to the clinic to start taking weak sedatives - valerian, motherwort. And just before applying the impression mass, the doctor sprays the root of the tongue with a spray of lidocaine.
5. Cleansing of interdental areas from the remnants of the impression mass. It is removed with dental floss and thin metal plates. During this, pressure and bursting are felt, and injury to the gingival papillae is possible. But in general, manipulation is tolerable.
6. Sample and fix. Painless, accompanied by only slight pressure on the jaw.

Stages of prosthetics

In general, the installation is more uncomfortable than painful. Any sudden discomfort is reported to the doctor - he will immediately put anesthesia.

Installing a crown on an implant, features

Crowns are installed not only on their own units, but also on artificial ones - implants. These are metal rods made of titanium alloys that imitate the root. Their upper part remains open and this is where the prosthesis is needed to imitate teeth.

Prosthetics during implantation has its own nuances:

• turning is not needed;
• instead of a pin or a stump tab, an abutment is inserted - it will replace the tooth stump;
• long terms of prosthetics - after installing the implant, it takes 3-6 months for it to take root.

Removal of impressions, fabrication of the structure and fixation are the same. The only point is that the abutment and the crown must be made of the same material. The metal base will show through the zirconia or ceramic. And it is pointless to put a zirconium abutment under a metal-ceramic prosthesis - it will not be visible.

The implant plays the role of the root of the tooth, then the abutment is fixed, and the crown is placed on it

How long does it take to install crowns?

How long a crown is put on a tooth is an ambiguous question. Direct fixing takes 10-20 minutes. But it takes weeks or even months to install from scratch. Moreover, the duration of each stage is different:

• preparatory lasts from one visit to a couple of months - it all depends on whether you need to treat or remove teeth;
• restoration on the pin is carried out in one session, it takes 1-1.5 weeks to make and fix the stump tab;
• turning and taking impressions is carried out in 2-3 visits - on average, it takes a week;
• it takes 1-2 weeks to make prostheses, depending on the workload of the dental laboratory;
• how long it will take after the first fitting depends on the accuracy of the frame manufacturing: if it is made correctly and only lining is needed, the process will take a couple of days, and if correction is necessary, 1-2 weeks;
• if the patient asks for time to get used to prostheses with temporary cement, it will take another 3-5 days.

On average, prosthetics takes 2-4 weeks. But it can take 1.5-3 months.

It takes 2-3 weeks to make a crown.

Installation cost

Prices for the installation of crowns vary greatly. The variation is due to the materials of prostheses, their quality, the pricing policy of clinics and the skill of the doctor. In Moscow, the cost is as follows:

• temporary plastic: minimum 800 rubles, maximum 7,500 rubles, average - 1,500 rubles;
• metal: for alloys of cobalt with chromium or nickel 1,500-4,000 rubles, the price of a titanium structure reaches 20,000 rubles, gold items will cost 10-15 thousand rubles.
• ceramic-metal: at least 5,000 rubles, on average - 10-12 thousand rubles;
• ceramic-metal of increased aesthetics with a shoulder mass: 12-16 thousand rubles;
• all-ceramic: from 12,000 rubles, on average - 25,000 rubles, in some clinics the cost reaches 50-70 thousand rubles;
• zirconium: at least 15,000 rubles, on average - 25-30 thousand rubles, in a number of dentistry the price of the service reaches 40-55 thousand rubles.

Some dentistry include turnkey prices for the preparation, manufacture and installation of crowns. The latter indicate only the cost of the prosthesis itself. And pre-treatment is always calculated separately for each patient.

What problems can arise with crowns?

Not always the installation of dental crowns allows you to forget about the problem tooth. With poor-quality prosthetics, it is possible:

• inflammatory processes at the top of the root - occur if the channels were not sealed to the top;
• violations of occlusion - when the structure is higher in bite, it interferes with the closing of the jaws;
• the development of cervical caries - with a loose fit of the base of the prosthesis to the neck of the tooth;
• washing out of cement, followed by loosening of the crown - if it was not made accurately;
• chipped ceramic cladding - occurs due to insufficient adhesion of the coating to the frame, in the manufacture of a structure with a violation of technology, as a result of injuries, inaccurate handling of the prosthesis.

Due to the numerous possible complications, it is important to choose - otherwise a lot of money and time will fly into the pipe, and the tooth will have to be treated or removed altogether.

Installing crowns is long, uncomfortable and expensive. But prosthetics are worth it: it will extend the life of the tooth by at least 5 years. And with a successful procedure, he will keep the unit until the end of his life.

Prosthetics using modern materials is a method of restoring chewing function and aesthetics of the dentition.

Often people gather for a long time for an appointment with a specialist, fearing pain and discomfort in the oral cavity, but in most cases the fear is completely in vain.

Before going to the office of an orthopedic dentist, it is important to learn how crowns are placed on teeth in order to better understand the essence of the process.

The more information about the preparation for prosthetics and the stages of fixing strong linings, the easier it is to get rid of unreasonable fear.

When is a crown placed on a tooth?

Prosthetics is carried out with significant tooth decay, when conventional filling does not work.

Other indications: decrease in chewing function, deterioration in appearance. Rough edges of problem units injure delicate mucous membranes, an inflammatory process develops.

The faster the restoration of the shape, strength, chewing ability of the tooth, the lower the risk of damage in the oral cavity.

It is important to know: poor-quality chewing of food leads to swallowing large pieces, excessive stress on the stomach and intestines. Uneven, dilapidated teeth are not only a repulsive appearance of the oral cavity, but also prerequisites for the development of pathological processes.

In large teeth, the distance from the enamel to the neurovascular bundle (pulp) is further, the risk of burning sensitive fibers is lower. Smaller crowns are installed on single-root units (incisors).

Before prosthetics, the specialist must remove the nerve to reduce the risk of thermal burns in the pulp area.

How to put a crown on a tooth

The process of preparation for prosthetics, manufacturing, fitting, final fixation of durable overlays takes several weeks. During this period, a person makes scheduled visits to the prosthetist.

Haste in such a responsible and delicate process as the installation of crowns is inappropriate: poor-quality treatment of units, poor turning of canines, incisors or molars reduces the service life of products, provokes discomfort and microtrauma of the oral mucosa.

Photos before and after the installation of crowns

At the first appointment, the doctor:

• examines the oral cavity, identifies problem units;
• prescribes radiography to assess the condition of the roots, detect defects in dental tissue;
• talks with a person, learns wishes, briefly talks about the process of prosthetics.

After receiving x-rays, assessing the situation, the doctor develops a treatment plan. It is important to take into account the limitations: chronic diseases, pregnancy, nervous disorders, problems with blood clotting, the development of tumor processes in the oral cavity, and other factors. The dentist needs to know if the person is allergic to medications and other irritants, and which antibiotics and anti-inflammatory compounds cause side effects.

The future owner of ideal teeth should receive comprehensive information about suitable methods of prosthetics, taking into account the condition of the units, the optimal type of crown prostheses. The doctor talks about the stages of work, indicates the estimated cost of products and additional services.

Crown installation scheme

It is important to focus on the average price threshold, to clarify what manipulations are included in the specified cost. If the clinic offers the installation of high-quality products at a reduced price, then you should not immediately be tempted by a tempting offer: you will have to clarify whether all services are included in the announced figures.

Treatment plan:

• Removal of "dead" teeth (missing nerve). The gradual destruction of problem units provokes the development of negative processes in the oral cavity, reduces the life of dentures.
• Preparation for fastening crowns. Be sure to eliminate inflammation in the periodontal and periodontal tissues, seal carious cavities.
• Coordination of the type of crown prostheses. The cost of products and aesthetics depends on the material. Experts offer several options. They are relatively cheap (from 7.5 thousand rubles): metal-plastic, metal, cermet using non-drag metals. More expensive types of products made of zirconium dioxide, aluminum oxide (from 15-18 thousand rubles), metal-free ceramics (cost - 20 thousand rubles and more).
• Calculation of the approximate duration of prosthetics and the cost of all stages of work. It is important to clarify all issues, eliminate disagreements, so that the process of prosthetics proceeds without conflicts and hitches.

The best option is to mount the product on a living tooth. This moment is especially important when installing strong overlays on canines and molars, which are actively involved in the process of chewing food.

Preparatory stage

Before prosthetics, it is important to perform mandatory actions:

• treat pulpitis, caries, eliminate the inflammatory process in the periodontium;
• if there are indications, seal the root canals, remove the nerve fibers;
• restore the tooth if the unit is dilapidated. The lack of strong tissues on which to fix the crown leads to early loss of the filling along with the prosthesis.

Methods for restoring the crown part

Each case is individual: the choice of method depends on the degree of destruction of the problem unit. After installing a stump insert or a solid base resembling a mini-reinforcement, the restored teeth practically do not differ from healthy ones in terms of functional ability and appearance.

With a pin

A strong rod is screwed into the sealed root canal, creating a basis for fixing the filling material. The dentist builds up the tooth, then grinds it under the crown, goes through the standard process of prosthetics.

Use of a pin

With the help of a stump tab

A more reliable and durable option for restoring damaged areas. Specialists of the dental laboratory cast a stump masonry from a non-toxic, bio-inert metal. The finished product is a root part for a strong fixation in the canal and a coronal area that exactly repeats the shape of a certain unit of the dentition.

Tooth preparation

A rather unpleasant stage of prosthetics, during which the dentist gives the problem unit an optimal shape.

For turning teeth, diamond burs and a conventional drill are used.

Most of the reports of discomfort involve the processing of living units.

The use of local anesthesia makes the process painless, leaving only psychological discomfort at the sight of dental instruments.

The preparation of units without nerves (“dead” teeth) requires the introduction of anesthetic compounds in isolated cases, for example, if necessary, move the gum tissue far away from the unit of the dentition.

The thickness of the surface that falls under grinding depends on the type of crown prosthesis and is at the level of 1.5–2.5 mm. To install cast products, the doctor removes a smaller amount of hard tissue. After the preparation of the tooth, the base remains in the mouth - the “stump”.

The dentist takes an impression to create an exact replica of the units. It remains to create plaster models, under which the dentures are adjusted.

When a patient chooses a type of crown, it is necessary to know how long such a product lasts. and care tips - this article is devoted to this.

What to do if teeth crumble? Understanding the causes of this phenomenon and choosing treatment methods will help you.

Dental prosthetics is a common procedure in dental clinics. Sometimes patients have complaints that the tooth hurts under the crown. Why such symptoms appear, we will explain.

Laboratory stage: making crowns

The process is quite lengthy, depending on the type of prosthetics, material, number of ordered products. During the waiting period, a person cannot walk with “stumps” in his mouth: turned teeth worsen aesthetics, the risk of food and drinks affecting the base for attaching prostheses increases.

To restore the appearance of the dentition, temporary crowns made of sufficiently strong, but inexpensive plastic are attached to the turned base.

Metal-ceramic crowns

Based on plaster casts, a dental laboratory specialist forms a future tooth from the selected material.

Ceramic and metal-ceramic products require longer manufacturing time than cast metal crowns.

Fitting and fixation of crowns

Before the end of the work on the manufacture of the prosthesis, the first fitting is carried out. It is important to evaluate how firmly and accurately the frame sits on the prepared “stump”.

After quality control of work, making adjustments (if necessary), the dental technician continues the formation of a crown-shaped prosthesis.

For example, when using metal-ceramics on the base, the specialist applies a durable, aesthetic ceramic coating.

At the end of the work, the dentist performs a temporary fixation of the prosthesis. The stage is mandatory, although some patients think otherwise.

Why does a specialist attach a crown to temporary cement? The method allows you to assess whether the restored unit interferes with the teeth from the lower or upper row, located opposite: “two” - “two”, “four” - “four”, and so on.

It is important to check how the teeth and surrounding tissues react to a new element in the oral cavity, whether there is any pronounced discomfort and allergic reactions. Sometimes there are defects in root canal filling, the development of an inflammatory process and severe pain.

Common defects: overbite, the prosthesis does not fit tightly on the neck of the tooth, injures the gums, and provokes bleeding of soft tissues. If complications arise, it is important to contact the prosthetist, discuss the issue of eliminating the shortcomings. In each case, the decision is made by the specialist, taking into account the identified deviations.

Temporary crowns are on the teeth from 14 to 28 days. In the absence of complaints, the dentist removes the prosthesis, removes the temporary material, cleans the unit, fixes the product using permanent cement.

Is it possible to remove the crown

There are two options:

1. Planned replacement of products after 10–15 years of wearing prostheses.
2. Urgent replacement, if a tooth hurts under the crown, after a while defects in the product are revealed that interfere with chewing food, creating discomfort.

The process is quite unpleasant even when removing prostheses from the "dead" units of the dentition. To remove the crown, strong burs and discs are used, the product is sawn. In the presence of two layers, for example, metal and ceramics, it is not easy to cope with the task.

Local anesthesia is required. When removing crowns, trauma to the gum tissue around the problem tooth is possible.

To reduce the risk, it is important to go to an experienced prosthodontist with a good reputation.

Many people during their lives are faced with the need to restore dilapidated units of the dentition. Before installing crowns, it is important to learn how dentures are placed.

For more than 10 years they have been used for dental prosthetics. Are these crowns effective and how much will the treatment cost? About it on our website.

Many adults do not want to install braces, but teeth need to be straightened. Can you straighten your teeth without braces? Read.

Important points: find a good orthopedic dentist, choose the optimal type of products, follow all the doctor's recommendations during temporary and permanent wearing of crown-shaped prostheses. Only a balanced approach to prosthetics will save you from painful alterations and endless visits to the dentist.

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