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With significant carious damage, destruction of teeth for other reasons, it is not at all necessary to get rid of them and install a prosthetic structure. Modern dentistry owns the methods of their restoration from functions to appearance, even if only one root remains from the organ.

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Conditions required for growth

It should be understood that building up or restoring teeth implies the preservation of the rest of it.

This means that in order to carry out manipulations with the expectation of the desired result, certain conditions must be met:

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Teeth extension methods

An organ of which only his Bottom part, needs first of all to be strengthened in order to restore working capacity. Already then it is necessary to think about returning the tooth to its appearance.

Use of pins

The pin is a durable rod made of a hypoallergenic material that is biologically compatible with human tissues. There are transparent fiberglass, titanium fixtures, as well as those made from other alloys. The pin is designed to strengthen the tooth, increase its height above the gum and serves as a support for restorative structures or materials.

It allows you to save functions and appearance even a more than half-destroyed tooth. To restore the anterior organs are usually used fiberglass pins that do not shine through restorative material and do not let outsiders know of their presence.

Restoration of teeth with their help takes place in several stages, the duration of which will fit in one visit to the dentist:

• The rest of the organ is freed from bacteria and carious tissue, if any, is sealed;
• A hole is made in the cavity for installing the pin. Its dimensions and designs must match. The pin is firmly fixed in place so that its part remains above the gum. Its size should not be larger than that which is hidden in the depths of the tissues. Depending on the type of pin, it can be fixed in bone tissue using the threads on it, or due to special composition. With severe tooth decay, the first method is preferable. To restore the front, one rod is enough. Molars that have many roots can be restored with multiple pins;
• The crown part of the tooth is restored with composite materials that match the color of your own enamel. To give more natural look polished. If this is a molar tooth, it is more expedient to restore it with a crown, for which an impression is first made.

Extension using pins allows you to save it for 3-4 years. At the same time, the tooth looks quite aesthetically pleasing and remains functional.

The principle of tooth restoration in this way similar to a pin. At the root, a structure called stump tab, but unlike him, it is made according to individual parameters of the patient and in accordance with all configurations of the destroyed organ. A similar design is made smaller than a tooth, since it is covered on top composite layers or a crown. This is a more expensive recovery option, but it also
more reliable, allows the organ to serve for a long time, thanks to a uniform chewing pressure. The stump tab is monolithic or two-piece fixture made of ceramic, metal alloy, zirconium. One-piece structures are usually used for single root restorations. Collapsible is preferable for building multi-rooted.

The procedure for restoring a tooth using a stump tab looks like this:

1. At the appointment with the dentist, the ability of the tissues to withstand the installation of the structure is determined. Then the root canals are cleaned and processed. Impressions are taken from both jaws, which will help to determine the shape of the restored tooth, as well as the features of its contact with neighboring organs and antagonists. While the stump tab is being made on the basis of plaster models and auxiliary wax, the tooth is closed with a temporary filling and crown;
2. The following operations are performed on the second visit. A temporary filling is removed from the root canals, they are re-sanitized and dried. The lower part of the tab is placed in the resulting space. The remaining empty space is refilled dental material, which will serve permanent basis. The filling will protect the root canals from bacteria and hold the tab more firmly. Above the gum, the upper one joins its lower part. It looks like a tooth stump. Once this has happened, an impression is made from the top of the tab, which is needed to create a crown. If the clinic has modern equipment, this stage takes place using computer modeling, which allows you to determine the required configuration of the future tooth more accurately. Planted on the established tab temporary crown. If it is not supposed to be worn, composite materials are used. Of them form upper part teeth, grind and polish;
3. On the third visit to the dentist, after the crown is made, it is attached to the inlay with dental cement. Before committing to permanent wear, try on. In total, the process of restoring a tooth with the help of a stump tab will take at least a week.

Situations when a tooth is not yet completely destroyed, but at the same time it cannot perform its functions at all in the practice of dentistry, are quite common. Most often, the root system remains unaffected. Restoring a tooth from the root allows you to recreate the natural appearance of the dentition and restore chewing function without resorting to complex surgical operations.

Why do teeth break?

Every day, our molars and incisors are subjected to the strongest load. And no matter how hard food is included in your diet.

In addition to the natural load, they are also subjected to physical stress. Injuries to the jaw area are very dangerous for dental health. Even if no warning signs are found immediately after the injury, this does not mean that they will not appear after.

The most common cause of tooth decay is loosening after pulp removal. They are often referred to as nerves. It is a weave blood vessels and nerve endings. Its removal leads to the "death" of the tooth. It remains without internal nourishment, gradually dries out, and becomes brittle. Sooner or later dead tooth breaks from the daily load and most often under the root.

Usually, the restoration of a tooth from the root is necessary within a few months after the removal of the nerves.

Do broken teeth need to be restored?

Not many people immediately have such a question. In most cases, we are completely sure that the tooth can still be restored. Restoration can be carried out even in the most complex and running case, but is it necessary?

Do not look at laudatory odes different ways restorations such as veneers, composites, inlays, all of them are only a temporary measure. Some of them can last even several decades, but sooner or later the tooth will have to be restored again. Only this time the restoration will no longer fit. The natural part of the molar or incisor will be so weakened that it will have to be permanently removed. This time, restoration will require implantation, the implantation of a metal rod into the jaw bone.

Implant prosthetics is the most advanced method of restoring and replacing teeth available. The implant serves as a support for both removable and permanent dentures. It is surprisingly strong and able to withstand the strongest load. However, such an operation has a lot of contraindications and is impressively worth it. Therefore, it is abandoned to the last, preferring restoration.

It turns out that a person spends money on restoration, and after that he will still have to resort to more serious methods and spend money again.
In order to save money and maintain health, it is better to remove hopeless teeth immediately, but in any case, this choice depends only on the patient himself.

How is a tooth restored from its root?

Support is essential for any type of restoration. Usually, the preserved part of the tooth acts as this, but in our case, nothing was left of it except the roots.

One of the varieties of a standard implant, a pin (intra-root implant), can be implanted in them.

A pin is a thin needle, most often made of metal, fiberglass or ceramic, designed to strengthen and restore pulpless teeth. It allows you to save natural part tooth and fully restore the crown.

The pin can be active or passive. Active is installed in a non-expanded root canal using grooves. To install a passive, special cement is required.

The active pin holds much stronger and longer, but its installation is accompanied by a certain danger. During screwing, a huge load is applied to the root walls. If the dentist is not careful, they can simply break. Root failure will not only kill all hopes for recovery, but is also fraught with complicated operation to remove fragments.

Fiberglass pins are very popular today. This is a unique material. It consists of the smallest fibers of glass, held together by a special composition. The fiberglass pin is very strong and flexible at the same time. It does not break from excessive load and does not expand the root canal, which is quite often the case with metal rods. Still, you shouldn't blame metal. He copes with the tasks assigned and is the most accessible material of all possible. Ceramics are used least often when the appearance of the prosthesis is more important than its strength.

How is the restoration of the tooth from the root?

You can't do this in one day. Usually it is divided into several stages.

First, the dentist checks the condition of the oral cavity. You can start the operation only after getting rid of caries, pulpitis, fistula, cysts and others. infectious diseases. It may take a few weeks

An obligatory stage of the operation is anesthesia. Even though the pin is implanted into the pulpless root, the patient can still feel discomfort. Especially anesthesia is important for people with hypersensitivity.

Commonly used drugs local character. They are introduced into the body by injection. After a few minutes, the reaction is checked. If the remedy worked, you can proceed to the operation.

The root canal is expanded and treated with an antiseptic. If a passive pin is placed, cement is again poured into the root canal. The active one just twists inward.

Already at this stage, you can begin the restoration itself. Most often this is restoration with composite materials. The dentist layers the composition on the teeth and dries it under a halogen lamp. The end result is sanded and coated with a protective varnish.

If the tooth is restored with a prosthesis, the patient will have to wait a little longer. For its manufacture, casts are needed, and they can be removed only after the pin is installed.

How much does it cost to restore a tooth from the root?

The average cost of a pin is about 10 thousand rubles. Usually this amount includes installation, but additional services will have to be paid separately. For anesthesia, you need to pay about 400 rubles, for a composite restoration of one tooth - 3-4 thousand rubles.

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The essence of the procedure

Previously, any chip, injury, deep caries or age-related wear was solved in cardinal ways: a rough filling on half a tooth, amputation of the remaining stump, or the installation of expensive and imperfect prostheses. Ways to save a natural tooth, unfortunately, were not observed until the world learned about artistic restoration.

The doctor restores the molar with the help of special composites.

What is the need for restoration?

• allows you to adjust congenital pathologies and defects in the structure of the dentition;
• eliminates the consequences of trauma, bruise, impact, fall, chipping, age-related wear of the crown;
• restores the tooth in its original form, which is an important indicator in aesthetic dentistry.

Indications and contraindications for extension

There are a number medical indications for building up an anterior or other tooth:

• the need for aesthetic (artistic) enhancement, which is often required in a number of professions;
• elimination congenital anomalies structure of the dentition;
• the predisposition of enamel and dentin to rapid abrasion, wear in general;
• elimination of a sharp, dangerous edge for the mucous membrane, which was formed as a result of a chip, blow, bruise and other mechanical damage;
• restoration of the crown after a carious lesion, osteomyelitis;
• significant interdental spaces between adjacent molars;
• enamel pigmentation, fluorosis, increased sensitivity, etc.;
• the appearance of diastema (interdental gaps);
• malocclusion due to tooth damage.

According to the description, the restoration procedure is not difficult and hazardous to health, however, even for its implementation there are contraindications.

1. First of all, the procedure is prohibited if the patient has bite defects (improper closing of the teeth, which leads to an uneven distribution of the load on the restored crown).
2. Severe tooth decay, during which only part of the root remains. Many are interested in whether it is possible to build a tooth at the root. In dentistry, this is practiced, however, in some situations, the only right decision is complete replacement crowns, prosthetics or implantation.


3. The presence of serious diseases of the mucous membranes, gums or teeth. As a rule, diseases are treated before the procedure ( gingivitis, cystic periodontitis, pulpitis, deep caries etc.), after which high-quality rehabilitation and artistic restoration are carried out.
4. The patient does not pay attention and time to oral hygiene, and therefore chronic diseases and pathology, cases of recurrence of caries, osteomyelitis and other diseases become more frequent.

Restoration with photopolymer

Tooth extension to the root (photo below), as well as other types of crown restoration, become available through the use of photopolymer composites. This method is used when it is necessary to eliminate the consequences of caries, put a high-quality filling and restore the molar after mechanical damage.

Dentist performs sanitation oral cavity and the stump on which the extension will take place. Further, the cult is subjected to turning and grinding to the required shape. Technologist on a special table forms artificial crown from polymer material, puts it on the stump and literally solders it to the tooth using a UV lamp.

After the material hardens, it must be sanded, eliminating roughness and irregularities. The procedure is performed until the patient ceases to feel discomfort from the new tooth.

The final stage is the application of a special protective composition to the tooth, which allows the composite to retain its color for many years.

But in some cases, a photopolymer filling remains useless:

• weak tooth root or its and infection, inflammatory processes;
• tooth mobility (stage 4);
• absence of 2 or more adjacent teeth (exit - prosthetics or implantation).

Restoration with veneers

Many patients are interested in how they build up their front teeth with veneers and inlays. Outer side of the central incisors practically determines the aesthetics of the entire smile, so their restoration should be the most accurate, without visible traces of restoration.

For these purposes, dentists use thin porcelain plates (veneers), which are superimposed on the outer surface of the incisor and fixed with a special compound.

Veneers completely hide imperfections and look natural, and the service life ranges from 5 to 10 years.

Another plus is the resistance of porcelain to food dyes and natural pigments (nicotine, caffeine, beets, wine, etc.).

Unfortunately, even this perfect method has its drawbacks:

• price - even one veneer will cost you quite a lot;
• before installing a porcelain onlay, a natural tooth is heavily ground, which affects even healthy tissues;
• a smile with veneers looks too perfect and snow-white, which cannot but catch the eye of the interlocutor.

The second drawback can be eliminated by resorting to the so-called "lumineers". This modern version of porcelain plates is installed without turning the tooth, remains strong and durable, albeit more expensive.

Restoration of a tooth on a post

The dentist takes an x-ray of the area and with the help of computer programs recreates the exact look and shape of a natural tooth.

Then a metal, glass or hydrocarbon pin is placed in the sealed root canal. A composite restorative material is placed around, recreating the natural appearance, texture and shape of the crown.

The advantage of the technique is the preservation of a healthy root, which, together with the pin, creates reliable support for artificial material. Also, the service life of the extended structure is more than 10 years. Using a pin, you can build up only the base of the crown, strengthen a pulpless tooth, restore some parts of the molar, etc. It is impossible not to mention that with the help of this method it is possible to build up the front teeth (see photos before and after).

Pros and cons of restoration

This method has significant advantages over cardinal decisions such as implantation and prosthetics.

First of all The technique is safe, so the restoration of teeth is used even in pediatric dentistry. Toddlers often fall, get into fights and put hard objects in their mouths, which is why chips and cracks are not surprising.

Secondly, with the help of restoration it is possible to return the natural healthy tooth in the presence of a small stump or even a root. The artificial material is selected in such a way that it completely imitates bone tissue, and also matches it in terms of strength, shade and texture.

As for the disadvantages, these include the presence of contraindications, the limited service life of the material and the need to comply special regime: exclude solid food(nuts, crackers, etc.), get rid of the habit of opening bottles with your teeth.

We examined the pros and cons of building teeth in general and separately according to the methods.

Remember that only careful attitude to the dentition timely treatment diseases, avoidance of blows and bruises, prompt replacement of worn fillings, etc. help keep your teeth healthy and healthy.

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What is extension

Tooth extension despite misconception many, is a set of methods that allows you to restore the dentition. This is not one way. With the help of dental crowns, a dentist can restore a damaged tooth completely or only part of it - it all depends on the specific case.

On a note! It is not always possible to restore a tooth with a filling. This may be due to the global destruction of the diseased tooth. For such cases, there are other extension methods - for example, using a pin.

In most cases, the extension process looks like this: a special rod is installed in the bone tissue, on which composite material. Under the influence of ultraviolet light, this material quickly hardens. But there are other ways of building that have nothing to do with installing a metal rod.

When they come to him

There are certain indications and contraindications for tooth extension. The dentist recommends extension in such cases:

• a small part of the tooth was lost due to caries;
• tooth enamel has worn off over time and has become very thin;
• malocclusion;
• trauma to the tooth or teeth, as a result of which the integrity was broken;
• the occurrence of interdental gaps;
• discoloration of the teeth, which cannot be corrected even with the help of cleaning or bleaching (an advanced form of fluorosis);
• cracked enamel, the presence of other mechanical damage;
• chipped tooth.

One of the best inventions in dentistry, of course, is the extension of teeth. Thanks to this procedure, patients have the opportunity to eliminate various aesthetic problems, which are most often associated with damage to the front row of teeth in the so-called smile zone.

Prerequisites for the procedure

Since the process of restoring the dentition is a way to save the rest of the damaged tooth, in order to obtain an optimal result when building up, it is necessary to follow some recommendations:

• give up bad habits for your teeth. In the presence of such a pathology as bruxism, the restored teeth will not be able to serve the owner for a long time. This also applies to the use of teeth "for other purposes" (opening beer bottles, biting threads, splitting walnuts and so on);
• caries. It must be removed before the start of the build-up process. Otherwise, under the installed restorative materials, this process may continue, as a result of which the remains of the teeth will have to be removed;
• oral hygiene. Compliance with these rules will extend the operational period of the restored tooth. It is necessary not only to perform cleansing procedures, but to do it correctly;
• no health problems. As a rule, doctors do not recommend building up if a person suffers from pathologies. nervous system or blood;
• tooth mobility. There must be no mobility for the effective fixing of restorative materials, otherwise the structure will soon fall out, and the restoration itself will be a waste of money and time;
• reliable installation of devices implies a sufficient length of the tooth root. A short length will reduce the strength of the restored tooth. Usually, optimal length must correspond to the length of the crown part, and the thickness of the walls of the tooth root must exceed 1 mm;
• Availability correct bite. If it is incorrect, it may cause increased load on a built-up tooth, which may soon be damaged. Malocclusion makes it meaningless to perform such a procedure;
• financial part. The patient must have the necessary amount of money to perform restoration procedures, which, by the way, cost a lot.

The main methods of building teeth

For a tooth, of which there is not much left, namely its lower part, a reliable fastening is required to help restore working capacity. Only after strengthening can one think about giving the restored tooth its former appearance. There are several methods of building teeth, consider the main ones.

Using filling materials

Using modern filling materials when building up teeth, you can achieve the maximum result by performing reliable and high-quality prosthetics. The material has a good appearance and is perfectly combined with the patient's dental tissues. The use of such compounds does not lead to damage to the oral mucosa and tooth enamel. it great method restoration of the dentition.

Over time, the materials used do not fade, so the artificial teeth will not stand out too much from the real ones. They contain fluorine, which makes it possible to restore the tooth after various types of damage, ranging from minor mechanical damage to significant damage to the tooth resulting from a failure. metabolic processes in the body. Using modern filling materials experienced professionals can create natural transparency of teeth.

The main advantages of this method include:

• the ability to mask minor defects, including cloudy fillings, stains, and so on;
• correction of the shape and size of the restored tooth;
• the natural appearance of the tooth, the restored part of which is difficult to distinguish from the real one;
• the speed of the procedure. It is possible to build up a tooth in just one session, as a result of which all its functions return to the destroyed tooth;
• preservation of the nerve, which means that the tooth is still alive.

Use of veneers and lumineers

With these overlays you can create extraordinary beautiful smile, popularly referred to as "Hollywood". The installation of veneers allows you to hide minor defects in the teeth, which include the occurrence of interdental gaps, chips, darkening of tooth enamel, and so on. Veneer is very thin plate ceramic with high strength. Outwardly, it resembles enamel. The procedure for building a tooth by this method involves attaching a plate to the surface of the tooth, which creates an irresistible effect.

As a rule, at least 3 appointments with the dentist are required to complete the restoration of the dentition with the help of veneers. At the first stage, the doctor provides his client with consulting assistance, presenting various types of plates. If necessary, he can X-ray patient's dentition. The second appointment is already more like an operation: the doctor makes an anesthetic injection, after which he grinds off a small layer of enamel on the damaged tooth. Then an impression of the teeth is formed. At this point, the doctor suggests installing temporary veneers, since permanent ones are made for a long time. At the last visit, the plate is tried on and the veneers are fixed with a cement base.

On a note! Approximately 14 days elapse between the second and third visits to the dentist's office. During this period of time, individual veneers are made.

There are practically no disadvantages of this method, with the exception of the need to grind tooth enamel. Therefore, if possible, it is better to put Lumineers. They practically do not differ from veneers, except for the thickness of the plate - Lumineers are much thinner. This allows you to maintain the integrity of the tooth surface, in addition, lumineers can be painlessly removed if desired. Another downside is the price. The cost of lumineers is several times higher than the price of veneers, so not everyone can afford to install such plates.

Using extension pins

The pin is a special rod made of a durable material that is biologically compatible with human tissues. Various post materials can be used, ranging from titanium to fiberglass. Its main task is to fix the tooth and raise it above the gum surface.

When a tooth is seriously damaged, doctors often use pins, with which you can restore the appearance and basic functions of the tooth. If metal is often used to restore lateral teeth, then only fiberglass products are used for the anterior teeth, which are not translucent.

Table. Pin extension technology.

How much does the procedure cost

Per full recovery a damaged tooth will have to pay at least 5,000 rubles. This includes the use of painkillers (200-300 rubles), expendable materials, isolating the damaged tooth from saliva (about 400 rubles). Also, do not forget about the sterilization of the set of instruments used - the cost is low, about 100 rubles, but still people often do not take this into account. The main amount spent is spent on the purchase of filling materials that are used to build up the tooth. This is around 3000 rubles. Also, the use of technology using a pin involves the purchase of an imported product, which also costs a lot. Prices may vary depending on the clinic where the procedure is performed.

You can save a lot by using a domestic fiberglass pin, the cost of which is 60-100 rubles. But, as a rule, they do a poor job of fixing the tooth in the root canal.

Regardless of the chosen method of extension or materials, the main thing is not the procedure itself, but the subsequent care. After all, what's the point in an expensive procedure, if after installation artificial tooth the patient will not follow the rules of oral hygiene? The main thing is to follow the recommendations of the doctor and do not forget that caring for the extended tooth affects its service life. Therefore, he (care) should not be less thorough than caring for living teeth.

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Conditions required for growth

It should be understood that building up or restoring teeth implies the preservation of the rest of it.

This means that in order to carry out manipulations with the expectation of the desired result, certain conditions must be met:

Teeth extension methods

The organ, from which only its lower part remains, needs first of all to be strengthened in order to restore its working capacity. Already then it is necessary to think about returning the tooth to its appearance.

Use of pins

The pin is a durable rod made of a hypoallergenic material that is biologically compatible with human tissues. There are transparent fiberglass, titanium fixtures, as well as those made from other alloys. The pin is designed to strengthen the tooth, increase its height above the gum and serves as a support for restorative structures or materials.

It allows you to save the functions and appearance of even a more than half-destroyed tooth. To restore the anterior organs, fiberglass pins are usually used, which do not shine through the restoration material and do not let outsiders know about their presence.

Restoration of teeth with their help takes place in several stages, the duration of which will fit in one visit to the dentist:

• The rest of the organ is freed from bacteria and carious tissue, if any, is sealed;
• A hole is made in the cavity for installing the pin. Its dimensions and designs must match. The pin is firmly fixed in place so that its part remains above the gum. Its size should not be larger than that which is hidden in the depths of the tissues. Depending on the type of pin, it can be fixed in the bone tissue using the thread on it, or due to a special composition. With severe tooth decay, the first method is preferable. To restore the front, one rod is enough. Molars that have many roots can be restored with multiple pins;
• The crown part of the tooth is restored with composite materials that match the color of your own enamel. Sanded for a more natural look. If this is a molar tooth, it is more expedient to restore it with a crown, for which an impression is first made.

Extension using pins allows you to save it for 3-4 years. At the same time, the tooth looks quite aesthetically pleasing and remains functional.

The principle of tooth restoration in this way is similar to a pin. At the root, a structure called a stump tab is strengthened, but unlike it, it is made according to the individual parameters of the patient and in accordance with all configurations of the destroyed organ. A similar design is made smaller than a tooth, since it is covered with composite layers or a crown on top. This is a more expensive recovery option, but it also more reliable, allows the organ to serve for a long time, thanks to uniform chewing pressure. The stump tab is a monolithic or two-piece fixture made of ceramic, metal alloy, zirconium. One-piece restorations are usually used for the restoration of teeth with a single root. Collapsible is preferable for building multi-rooted.

The procedure for restoring a tooth using a stump tab looks like this:

1. At the appointment with the dentist, the ability of the tissues to withstand the installation of the structure is determined. Then the root canals are cleaned and processed. Impressions are taken from both jaws, which will help to determine the shape of the restored tooth, as well as the features of its contact with neighboring organs and antagonists. While the stump tab is being made on the basis of plaster models and auxiliary wax, the tooth is closed with a temporary filling and crown;
2. The following operations are performed on the second visit. A temporary filling is removed from the root canals, they are re-sanitized and dried. The lower part of the tab is placed in the resulting space. The remaining empty space is again filled with dental material, which will serve on a permanent basis. The filling will protect the root canals from bacteria and hold the tab more firmly. Above the gum, the upper one joins its lower part. It looks like a tooth stump. Once this has happened, an impression is made from the top of the tab, which is needed to create a crown. If the clinic has modern equipment, this stage takes place using computer modeling, which allows you to determine the required configuration of the future tooth more accurately. A temporary crown is placed on the inlay. If it is not supposed to be worn, composite materials are used. They form the upper part of the tooth, grind and polish;
3. On the third visit to the dentist, after the crown is made, it is attached to the inlay with dental cement. Before fixing for permanent wear, try on. In total, the process of restoring a tooth with the help of a stump tab will take at least a week.

A broken, worn or destroyed tooth brings physical and psychological discomfort. Damaged tissues open access for bacteria, deteriorate neighboring organs, bad breath appears, eating becomes painful due to hypersensitivity. Damaged front teeth make a person complex.

It is always useful to know which teeth can be restored. Almost any destroyed unit can be made functional again. Photos on the Internet allow you to assess the advanced level modern medicine. There are three exceptions for restoration:

• severe inflammation of the root, not amenable to treatment;
• destruction has spread deep under the gum;
• the tooth is loose.

Why do teeth break?

Dental problems are primarily caused by caries. The dentoalveolar rows are subjected to a heavy load every day: chewing, acidic environment, pathogenic microorganisms gradually destroy the enamel even with careful care. Factors are conditionally divided into external (mechanical and temperature effects, poor hygiene) and internal (various diseases of organs and unbalanced diet). Chipped or decayed teeth are provoked by:

• jaw injuries from bumps and falls;
• low quality enamel with a lack of calcium, phosphorus;
• sudden weight loss;
• pregnancy
• bruxism;
• diseases genitourinary system and gastrointestinal tract;
• an improper diet that excludes important vitamins and minerals.

Methods for the restoration of worn or destroyed teeth

This article talks about typical ways to solve your questions, but each case is unique! If you want to know from me how to solve exactly your problem - ask your question. It's fast and free!

About whether there is a chance to restore a chipped, broken tooth, you need to find out immediately after the injury. Dentists try to preserve the tissue as much as possible without removing the root, since its natural in the human body is always better than an artificial substitute. If the incisor or molar has fallen apart, the dentist can offer 2 methods of restoration, depending on the condition of the tissues:

When the tooth is removed and the installation of an artificial structure is required, its service life with proper operation will be 20-25 years. At the same time, careful care and regular examination by a specialist is important.

Building

Restoring a tooth with an extension is a rather unpleasant procedure for the patient, it is performed under local anesthesia(We recommend reading:). The drug is injected into the tissues of the oral cavity close to the affected organ, in which the nerves are preserved. Many patients after a serious injury are interested in the question: is it possible to build up a tooth if only its root remains? This method restorations are often performed in the smile zone, it is also used for small child on milk incisors and molars. The method of restoring a destroyed frontal tooth involves maintaining the aesthetics of the front rows. Methods are applied:

1. The use of a heliocomposite. The technique is effective when the root below the gum remains intact, and the crown part is destroyed. A pin is placed in the tissue, around which an organ is built up, repeating the shape of the real one.
2. Working with composite material without a pin. The method is used when a strong load is not expected on the tooth, and its walls do not need to be further strengthened. The composition is applied in layers, hardening is carried out under the action of a UV lamp.

Pin installation

• ceramics;
• carbon fiber;
• titanium.

Fiberglass structures are used to make a tooth in the front if it has broken off - the material has a color and properties similar to dentin. It reduces the risk of root fracture after restoration and does not react with saliva and crowns. Before installation anchor pin the dentist prepares the root canal and restores the coronal part with a composite.

What to do if the tooth is broken, and only the root remains? The installation of a pin will also help here, if the tissue is not inflamed, and it will be difficult to restore it. It is mounted only after complete reorganization, after which an extension is carried out or a crown is placed.

Microprosthetics

Implantation

After tooth extraction, implantation can be performed - it will allow you to recreate the anatomical shape of the organ and not injure neighboring units, as when installing a crown. Immediately after the operation, the doctor implants the implant into the jaw tissue. After its fusion with the periosteum, a support and a ceramic crown are placed on it. The structure can be made of zirconia, titanium or Roxolid material. Extracted tooth is replaced by an artificial one, looks aesthetically pleasing and retains its function.

Enamel restoration

Enamel is a shield against caries, it contains 95% inorganic substances. When defects appear, sensitivity increases, so dentists recommend using the remineralization procedure. For this, several methods are used:

• coating with varnish containing fluorine;
• self-application of a cap at home;
• one-time use of trays at the dentist with fluoride gel.

For each patient, silicone caps are made separately so that the device repeats the anatomical shape of the dentition. The specialist will offer a medical paste or coating with a fluorine-containing substance for minor enamel defects.

Is it possible to restore a broken or completely destroyed tooth in a child?

What to do if a child of 3-4 years old or a preschooler has collapsed, a tooth has broken off or there are slight injuries (we recommend reading:)? Milk units also need treatment: their untimely loss leads to the development of bite defects. The doctor chooses how to repair a broken or decayed tooth based on the type of damage, location, and number of units:

• drilling and restoration with photocomposites;
• installation removable dentures(console, plate, bridge, sliding).

When the crown of a tooth breaks down to the root, it is worst case, in which it is almost impossible to do without removing the part remaining in the gum. It is important to try to save the organ in the child, since nearby teeth can change location after removing the damaged one.

Rules for caring for restored teeth

For teeth restored after destruction for various reasons, it is required permanent care. They are less reliable than natural ones, so careful hygiene is important: the use of dental floss, rinse, regular cleaning and getting checked out by a doctor.

Careful eating is important:

• using a fork and knife to separate small pieces of food;
• avoiding biting off too hard foods (especially after restoration of the frontal organ);
• exclusion from the diet of seeds, nuts and crackers;
• quitting smoking, drinking coffee, tea, red wine.

Prevention of repeated damage

Tooth decay can be stopped, as well as the emergence of new problems that require serious material costs to restore the organs of the oral cavity can be prevented. Preventive measures include:

• daily care;
• the use of therapeutic pastes that strengthen the enamel;
• taking vitamins for teeth;
• compliance with the rules of proper nutrition;
• obligatory use of hard and soft food;
• control chronic pathologies GIT.

If a tooth is broken to the base of the gum, or the visible part is completely destroyed, in most cases it is restored. When at pathological processes no pain, the patient should see a specialist. A hidden problem and subtle damage can cause serious harm in future.

"Doctor, I was just chewing on a soft bun, and I felt something crunch." This is how the patient's story usually begins about how it happened that some incomprehensible stump remained from the tooth. Is it possible in such cases to "save" the tooth from extraction? What criteria are guided in such cases by the dentist? Finally, how exactly is it right to restore a tooth in such situations - close up with a filling, put a crown, "strengthen with a pin" or something else? We'll talk about this today.

Let's start with a little theory. Why dead teeth so often break down? By creating access to the root canals, the doctor removes a lot of tissue. In this case, as a rule, neglected caries leads to the need for root canal treatment, which by the time of treatment has already "eaten" part of the tooth. As a result of these two reasons, after root canal treatment, the patient gets a severely weakened tooth. Some walls may be completely absent, some will be very thin. Imagine an unopened can of cola... or beer (whichever is closer to you). Try to break it with your hands. This will not be easy to do. Now open it, drink the contents and you will get a tooth model with the insides removed and thin walls. You don't have to be a jock-bodybuilder to now easily crush it with your hands. Pretty much the same thing happens with dead teeth. Fragile walls do not withstand a large and constantly repetitive cyclic load during chewing. Our chewing muscles can develop force up to 400 kg cm2. Imagine that such a 400-kilogram young man jumps on your tooth every day.

At the same time, it doesn’t matter at all what you eat: crackers, nuts or a fresh roll. Sooner or later, weakened tooth walls will crack. And this is the inevitable result.

What to do if a tooth is broken? Delete it? Or can it be restored? And if so, how can it be done better? The main criterion by which the doctor decides on the advisability of preserving the "hemp" is the quantity and quality of hard tissues that rise above the gum. Ideally, it should be like this: the edges of the tooth along the entire perimeter are above the level of the gums, the height of the walls is at least 2-3 mm, the thickness is at least 1-2 mm.

Moreover, the higher and thicker the walls, the better the prognosis for restoration. If chipped tooth wall occurred deep under the gum, then such teeth often have to be removed. Because no design with a good prognosis for such teeth can be made. If this rule is neglected, then in the foreseeable future we will get something like this ...

The crown is in the hands, not in the mouth. Any filling, crown, whatever ... on such a root will not last long. The main reason for this is that somewhere in the depths, in the depths of the gums, it is impossible to achieve a perfect fit of any material to the tooth. Any restoration, if it is nevertheless done, will quickly begin to “leak” under such conditions. This means that an infection living in the oral cavity will easily penetrate into the tooth, “grinding” the tooth from the inside. Therefore, it will be much more reliable to replace such a root with an implant. Of course, you can always find a compassionate dentist-plasterer who sticks something, somehow greases it and at the same time sleeps peacefully. But if we are talking about quality and durability, then such options are not for us.

What then is for us? Here are a few possible correct options restoration of severely damaged dead teeth.

1. Restoration of the tooth stump with a filling + crown.

For example, as in this clinical case. To recreate the base of the tooth in such cases, a special composite material or amalgam is used *

2. Restoration of the tooth stump with a filling on a fiberglass pin + crown.

Everything is the same, but filling material"reinforced" with a pin. This is usually done when there is very little tooth tissue and there is not much hope for them.

There are many opinions on the advisability of "pinning" teeth, and even among dentists there is no unity on this topic. Someone shoves the pins into all the teeth in a row, someone does not do them at all. The truth, as always, is somewhere in the middle. One thing is for sure - the use of the so-called. anchor metal pins (similar to small screws) are already mauvais ton today.

3. Stump tab + crown.

AT this case the basis for the crown is made in dental laboratory and is a monolithic structure glued inside the channel. Stump inlays today can be made of metals (cobalt-chromium and gold-platinum alloys) or zirconium dioxide.

These are the main methods of restoring a tooth if it is broken. Each dentist makes the choice between them at his own discretion. The only thing to remember is that any technique that involves the installation of a pin in the root canal requires them. ideal treatment, because there will be no repeated relatively easy access to them. Therefore, any treatment with pins is in fact the last for the tooth, after which only extraction is most often possible. For this and some other reasons, today there is a tendency to move away from the manufacture of any pin structures, especially stump inlays.

So now you know how and what is the best way to restore broken dead teeth.

From this article you will learn:

• Which crowns are best for front teeth?
• pros and cons different options crowns,
• how much does it cost to insert anterior tooth.

When prosthetics of the anterior teeth, patients always make rather high demands on aesthetics. The most important of them is that crowns for the front teeth should not be visible against the background of your own teeth, matching them in shape, color and transparency.

To date, there are only a few aesthetically acceptable options for prosthetics of the anterior teeth. These include - metal-ceramic prosthetics, zirconium crowns, as well as E-max crowns (glass-ceramic). Moreover, patients are equally often dissatisfied with both metal-ceramic and ceramic crowns, and we will tell you why this happens.

Crowns on the front teeth: photo

The reasons often lie not only in the low quality of work, but also in the initial wrong choice type of crowns, for example, not taking into account the level of transparency of the patient's tooth enamel. The complexity of the choice also lies in the fact that each of the above types of crowns (depending on the quality of the materials used and the manufacturing features) can have both good and bad aesthetics.

For example, the aesthetics of standard metal-ceramic crowns(made from inexpensive materials, costing about 6,000 rubles) - the aesthetics of metal-ceramic crowns with a "shoulder mass" for 13,000 rubles will be very different. We understand that within each type of crown there are manufacturing options, and therefore even the choice of expensive ceramic crowns will not be an unconditional guarantee that you will get good aesthetics.

1. Metal ceramics on the front teeth -

The aesthetic problem in the prosthetics of the front teeth with ceramic-metal is associated with the presence of a metal frame under the surface layer of porcelain. To give the crowns an aesthetic appearance, layers of porcelain are applied to the surface of the metal frame, which must necessarily be opaque (otherwise the metal frame will shine through the ceramic layer).

In turn, the tissues of the teeth have a certain translucency - the enamel is able to transmit about 70% of the light, and the dentin lying under the enamel - about 30%. Such optical properties give the crowns of the teeth a certain degree of transparency, which is especially visible in the region of the cutting edges and lateral surfaces of the tooth (especially in bright light).

Clinical case No. 1 - before and after photos

Clinical case No. 2 - before and after photos

It should be noted that the different people the transparency of the enamel of the teeth may vary slightly. Therefore, with a high transparency of enamel, cermet will not suit you at all. But if your teeth have low enamel transparency, then a well-made metal-ceramic can be good option. But in any case, keep in mind that in bright natural light, the difference in color and transparency between metal-ceramic crowns and living teeth will be most noticeable.

Disadvantages of cermets on anterior teeth –

However, the lack of translucency is not the only aesthetic problem with metal-ceramic crowns. Many patients almost immediately after prosthetics note that the gum around the crown has become cyanotic (Fig. 7). Also, after 3-5 years, many patients notice that the gum has receded, exposing the subgingival margin of the crown at the neck of the tooth - which looks like a “dark line” (Fig. 8).

Patients react calmly to such things if they occur in the area chewing teeth. But on the front teeth, especially if the patient has a gingival type of smile (i.e., the gums are exposed during a smile), this is a serious aesthetic problem. All this arises due to the fact that the edge of the metal frame of the metal-ceramic crown is in contact with the gum in the area of ​​​​the neck of the tooth - slightly below the level of the gum. It is the metal that leads to a change in the color of the gums, and also helps to reduce the level of the gums.

However, such problems with the aesthetics of the gums are typical only for standard metal-ceramic crowns of the economy class. There are also highly aesthetic metal-ceramic crowns.

Metal ceramics of increased aesthetics -

Important : The minus of metal-ceramic crowns with a shoulder mass is their cost, which is 2 times more than standard metal-ceramics, approaching the cost of ceramic crowns. But in addition to aesthetic problems, metal-ceramic still has other disadvantages in comparison with non-metal ceramics, regarding the thickness of the turning of the teeth, the service life of the crowns. Read more about all this in the article -

2. Prosthetics with zirconium crowns -

Metal-free ceramics include several types of materials, one of which is zirconium dioxide. Porcelain crowns made of this material do not have a metal frame, which allows them to look more like real teeth - compared to metal-ceramic crowns. However, the most important advantage of zirconia crowns is their strength, not aesthetics.

Unfortunately, many patients with prosthetic anterior teeth remain dissatisfied with the aesthetics of zirconia crowns. What is it connected with? The fact is that zirconium crowns, although they do not have a metal frame, they still have a rather weak light transmission, i.e. transparency, which is very different from the natural transparency of the tissues of the tooth (enamel and dentin).

As a result, zirconium crowns for anterior teeth are not the best alternative for those patients who have a high transparency of the enamel of their remaining teeth. This means that in such patients, the artificial zirconia crown will not merge in color and translucency with neighboring teeth, and will stand out against their background. However, in patients with low enamel translucency, the aesthetic result can be very good.

Clinical case #4 -

Important : zirconium dioxide crowns are manufactured using CAD/CAM technology, which means milling crowns from zirconium dioxide blocks on a CNC machine (according to a 3D model of the patient's teeth). Moreover, in most cases, the crowns do not consist of monolithic zirconium dioxide, as well as for metal-ceramic crowns - at first only the zirconium frame is milled, which is later covered with layers of porcelain mass.

This technology has a big disadvantage. In advertisements for zirconia crowns, they usually say that they are very reliable, because. zirconium has the strength of a metal. The strength of the zirconium frame is indeed more than 900 MPa, but the strength of the porcelain layer on its surface is only about 100 MPa. It creates high risk chipped porcelain. According to statistics, after 3 years, chips occur in at least 6% of patients with zirconium crowns, after 5 years - at least 10% of patients.

Esthetically enhanced zirconia -

Standard blocks of zirconia, from which crowns are milled, are bright white and completely opaque. That is why finished crowns made of this material often look similar - they have an unnatural milky color and do not have transparency. It is these blocks of zirconia that are used by most dental clinics due to economy.

However, in last years A number of manufacturers have developed translucent zirconia blocks, as well as pre-colored zirconia blocks with a color and transparency gradient. All this allows you to create an artificial crown that is practically indistinguishable from real teeth, because all natural teeth have such a gradient of color and transparency (from the neck of the tooth to the cutting edge).

Clinical Case #6 -

Clinical Case #7 -

3. IPS E.max crowns –

IPS E.max is a metal-free lithium disilicate ceramic for crowns and veneers. E.max is a glass-ceramic with translucency/transparency values ​​almost identical to those of tooth enamel. As a result, lithium disilicate crowns and veneers can be completely indistinguishable from real teeth.

There are 2 main materials for E.max crowns. Firstly, it is "E.max PRESS", which is intended for the manufacture of crowns and veneers by injection molding with high temperature and pressure. Let's say right away that this material is the best if you want to make a single crown, veneer or bridge prosthesis of 3 crowns on the front teeth.

Secondly, it is "E.max CAD", designed for the manufacture of crowns and veneers using CAD / CAM technology. Compared to E.max PRESS, this material is already slightly less durable and is no longer suitable for the manufacture of bridges and thin veneers. Another disadvantage is that E.max CAD has a much smaller range of material shades, which limits the ability of the dental technician to really match the color of the crown with adjacent teeth.

Clinical Case #8– photo before and after

Comparison between E.max and zirconia crowns –

When choosing ceramic crowns for front teeth from zirconium, it is necessary to ask the doctor for information about the manufacturer of zirconium dioxide blocks from which your crowns will be milled. These should be exactly translucent/pre-colored zirconia blocks, for example, from manufacturers such as Katana ® UTML (Japan) or Prettau ® Anterior (Germany).

However, even crowns made of such cutting-edge zirconia will be slightly inferior in aesthetics to E.max glass-ceramic crowns. This is due not only to the translucency of the materials, but also to the fact that E.max PRESS ceramics have a much wider range of material shades compared to the choice of shades in the manufacture of zirconia crowns. And besides, a single E.max pressed ceramic crown is much more resistant to chipping than a single zirconia crown.

Summary: which crowns are better to put on the front teeth

And now the most difficult thing remains - it is accessible to answer the question about best choice crowns on front teeth. By the way, if you do not go into the question of price, the choice will be quite simple (the cost of all the above types of crowns - see the links above). So, we look at different clinical situations ...

• If you need a single crown on the front tooth - pressed ceramics from E.max,
• bridge of 3 units on the anterior teeth - pressed ceramics from E.max,
• bridge of 3 units on chewing teeth– zirconia crowns,
• if you need a bridge of 4 or more units for any group of teeth - only zirconium crowns.

If you have a limited budget –
choose a more aesthetic version of cermet - cermet with a shoulder mass. However, here it is necessary to warn that the cost of the latter in some clinics can even reach 15,000 - 20,000 rubles for 1 crown (on average - 12,000 rubles). At the same time, the cost of E.max in a number of economy class clinics starts from only 16,000 rubles.

If this is too expensive for you, the option remains with ordinary cermets, the prices for which are on average about 6000 - 7500 rubles. for 1 crown. In a number of clinics, you can find cermets even for 4,500 rubles, but in this case (whatever they tell you) it will be made from cheap materials from Russian or Belarusian production, a low-skilled dental technician. Therefore, do not be surprised later on by ceramic chips, poor aesthetics, or the fact that after a few years the tooth tissue under the crown can simply rot, and the crown will fall out.

From the point of view of aesthetics, the situation when you prosthetize symmetrical teeth with crowns (for example, 2 central incisors at once or all front teeth at once from canine to canine) is simpler, and in this case you can choose more economical options. The most difficult are the options when you need to take under the crown only 1 front tooth or 2-3 teeth located on one side of the dentition.