Crowns on teeth are big what to do. How to make a crown on a tooth, the stages of manufacture and installation. Options for prosthetics of the anterior teeth

Installing crowns is a technique that helps save a tooth in the most hopeless situation, when it is badly damaged and a filling cannot help. About what designs are, how a crown is made on a tooth and how they are placed, read the article.

- this is nothing more than a fixed prosthesis, which is a single element. It is designed to replace the visible part of the destroyed tooth, restoring its aesthetics and functionality. Testimony to install are:

• Destruction of the visible part by more than 60%. This is especially true in cases of “dead” teeth with a removed nerve, which become brittle and may not withstand fillings.
• Enamel abrasion, which has a pathological character.
• Fixation of a clasp or bridge prosthesis. In this case, the crowns are installed on the abutment teeth adjacent to the defect.
• The need to change the shape or color of the tooth when this cannot be done by other methods.

Crowns are made from various materials.

Crowns differ depending on the material from which they are made:

1. made of alloys (such as chromium and cobalt) or precious metals, which can also be used as a spray. Metal products are comfortable and durable, but they look unaesthetic.
2. , consisting of a metal base and ceramic cladding. The most common option due to its affordable cost, however, in terms of aesthetics, they are inferior to non-metal ones.
3. made of porcelain or zirconium dioxide. The optimal choice for anterior teeth, as such crowns are highly aesthetic.

How are dental crowns made?

Regardless of what material was chosen, the designs are made according to a similar algorithm. The manufacture and installation of crowns are carried out in several stages.

Initial consultation

At the first meeting with the patient, the dentist (orthopedist) examines the oral cavity and proposes a treatment plan, including the material for manufacturing. Using a special scale, the color of metal ceramics or ceramics is selected, after which a preliminary cost can be announced.

The doctor makes a decision about prosthetics based on x-ray data, which allows you to get an idea of ​​​​the state of the dental canals.

This is how prepared teeth look like under crowns.

Training

The quality and thoroughness of the preliminary preparation is one of the important conditions necessary for the long service life of the crown. Preparation includes:

1. Depulping. A crown can also be placed on a living tooth. Moreover, it is even preferable, since the dead are more fragile. However, most often, with a significant destruction of the visible part, the removal of the nerve is required. This is also due to the fact that when turning it is possible to burn the unremoved pulp. An exception is the prosthetics of chewing teeth, the large thickness of which avoids burns.
2. Restoration of the crown part of the destroyed tooth. It can be carried out - screws screwed into the canal, on which a composite seal is then formed. The second option is the installation of a stump tab, consisting of the root and crown parts.

preparation

It is a turning of a tooth in order to give it the shape necessary for reliable fastening. This is an obligatory stage of prosthetics, which is carried out both for dead teeth and for living ones.

Turning is carried out using diamond burs. If we are talking about living teeth, then this process can be very painful, so it is always done under local anesthesia. The thickness of the grinding depends on the thickness of the crown, usually 1.5 - 2 mm. Minimal grinding is required when installing cast products.

Taking impressions

With the help of a special silicone mass, casts are taken from the jaws. To do this, a thread is placed on the border of the teeth and gums, then an impression mass is applied to the teeth with a special spoon. In 2 minutes, it takes the form of a jaw, after which it is removed.

Casts are transferred to the laboratory, where a plaster copy is made on their basis. It is she who will become the model on which the technician will make individual crowns.

Crowns are made from impressions.

Crown making

Based on the created model, crowns are made from the material chosen by the doctor and the patient. This process takes several days, and during this time the patient wears, most often plastic ones. They are necessary not only for aesthetics, but also to protect the prepared tooth from the aggressive effects of microorganisms.

The fabricated prostheses are tried on by the patient. If they do not cause complaints, a temporary fixation is made. It is necessary for the patient to evaluate how convenient the design is, and the doctor can analyze how the tooth will behave under the crown. After 10-12 days, temporary cement is replaced by permanent cement.

CEREC system

The most modern approach to prosthetics is using the Cerec system. It is a set of materials and tools for prosthetics, including:

1. CAD - computer software for designing prostheses.
2. CAM - devices for the manufacture of prostheses from solid ceramic blocks.

When using this system, the model of the oral cavity is not created by a technician in the laboratory, but by a computer program using a special scanning device. Further, the data is transferred to the milling machine, which automatically grinds the prosthesis of the desired size and shape.

The use of this system makes it possible to significantly reduce the duration of the manufacture of crowns, however, the cost of such prosthetics is not affordable for all clinics and patients.

Sources:

1. Kopeikin V.N. Orthopedic dentistry. Moscow, 2001.
2. Lebedenko I.Yu. CAD/CAM tooth restoration technology – CEREC. Moscow, 2014.

You need to install these prostheses in the following cases:

• when most of the tooth is affected by caries;
• severe destruction of the dental organ (more than 70%);
• the tooth is destroyed after injury, while the root must be intact;
• external defects of teeth (hereditary or acquired), change in their color when aesthetics suffer;
• predisposition of enamel to pathological abrasion;
• loosening of the teeth, which is the cause of periodontal disease (temporary dentures will make them more stable);
• when a bridge is installed, thanks to the crowns, it is fixed on the supporting teeth;
• the presence of uneven edges on the tooth, which injure the mucous membrane.

What material to choose?

Thanks to new developments, in modern dentistry there are several types of materials from which crowns are made. Let's consider the main ones:

1. Metal - classic prostheses that have been used for many years. Most often they are made of gold. The advantages of such products are strength, reliability and durability. They do not oxidize, have an abrasion coefficient almost like that of natural enamel, and do not damage opposing teeth. The main disadvantage is the minimal aesthetics, which is why they are placed on invisible parts of the jaw.
2. Ceramic-metal, combining the advantages of metal and ceramics. They have durability, strength and high aesthetic performance. They cost less than all-ceramic ones. The downside of these prostheses is the mandatory preparation of a large amount of living tissue before their installation, as well as the possibility of abrasion of enamel on opposite dental organs. A band of black metal near the gum may also be visible if its edge is lowered or the product was not made accurately.
3. Crowns are made from ceramic or porcelain, which have the most aesthetic appearance. They are as similar as possible to natural teeth and retain their properties for a long time. However, ceramics are significantly brittle and cannot always withstand the stress of chewing. For this reason, more often ceramic products are placed on the anterior teeth. The main disadvantage of these crowns is the high price.

Manufacturing

Crowns are made from plaster casts. Metal, cermet and ceramics can be used as the material to be produced.

The production is quite laborious and time-consuming, so while the dental technician is working on their creation, the patient is put on temporary plastic products. Thus, the aesthetic appearance of the turned teeth is restored, and they are protected from external influences and infection. These prostheses, in addition to protecting the teeth, also allow you to fully use them when chewing.

Grinding teeth for installation on their crowns

The grinding of teeth is called preparation. This procedure is performed using a drill into which a diamond bur is inserted. So the tooth can be given the desired shape.

When grinding live teeth, the procedure is painful, so anesthesia is administered to the patient before it is performed. If you need to grind a pulpless tooth, anesthesia is not always used, but if you need to retract the gums, it is better to do it.

The orthodontist needs to grind the tissue of the dental organ, the layer of which will be equal to the thickness of the prosthesis. Depending on the crown used, 1.5-2.5 mm of dental tissue can be removed from all sides of the dental organ. When attaching cast structures, less turning will be required, and if products made of ceramics or cermets are installed, more.

The turned tooth is a stump where the crown will subsequently be fixed.

How is the crown part of the tooth restored?

The crown part of the tooth in different cases can be destroyed in different ways, and therefore it is restored in different ways. To do this, either a stump tab is installed in the tooth, or a pin is placed, and this does not affect the appearance of the tooth in any way.

The pin is a high-strength rod that is screwed into the root canal after it has been filled. It plays the role of the basis for fixing the filling material. Then the tooth is built up and turned under the prosthesis.

With the help of a stump tab, you can make a very reliable restoration of the dental organ, which will last a long time. It is made in the laboratory from a special metal that is non-toxic. The tab consists of the crown and root parts. The root is fixed in the root canal of the tooth, and the crown has a view that is already ready for attaching the crown to it.

The first stage of installation - preparatory

Before installing the crown, the dentist must carefully examine the patient's oral cavity, if necessary, an x-ray can be taken. Based on the results of the examination, a treatment plan is drawn up and the necessary procedures are recommended. It is also important to examine the patient for contraindications and allergies to any material.

The doctor, together with the patient, selects a more suitable type of crown. They specify the terms when the prostheses will be made and installed, as well as the cost of treatment.

In the presence of diseases of the gums and teeth in the oral cavity, they are cured.

1. Removes the nerve from the tooth and grinds it. It is important to grind such a layer of the tooth that will correspond to the thickness of the prosthesis. When attaching the crown to the anterior units with one root, the removal of the nerve is mandatory, because during the grinding, a pulp burn may occur. Depulpation of a multi-rooted tooth is not necessary, because the risk of burns in such a situation is minimal.
2. Treats teeth affected by caries. Performs root canal filling. Cleans teeth from tartar and plaque.
3. If the dental organ is severely destroyed, it is depulped, the canals are sealed and the crown part is recreated with a filling composition.
4. When attaching a crown to a living tooth, anesthesia is required.
5. If there is a filling on the supporting tooth, it is replaced with a new one.

After preparing the teeth for fixing the prosthesis, impressions are taken from them, according to which crowns will be made in the laboratory.

Laboratory (second) stage of installation

According to the casts taken from the prepared dental units, models of dental organs are made from plaster in the laboratory. So the dental technician gets an exact plaster copy of the patient's teeth, which maximally reflects all their features. With the help of these models, further production is carried out.

Fitting and fastening - the third stage of installation

Before the crown is installed and even before the end of the manufacturing work, the first fitting of the prosthesis is performed. They check that it sits on the stump accurately and firmly.

Further, if necessary, adjustments are made to the product and it continues to be formed in the laboratory. If cermet is used as the material to be manufactured, the metal frame must be coated with an aesthetically pleasing ceramic compound.

After completion, the prosthesis is fixed with a temporary composition, which makes it possible to assess the comfort when wearing the prosthesis, the possibility of allergic reactions, and eliminate the possibility that it will interfere when connected to opposite teeth. Check the reaction of dental units and adjacent tissues to the presence of a new element in the oral cavity.

At this time, defects in the filling of the dental canals, inflammation or severe pain may appear.

The most common defect is the following: overbite, due to which it turns out that the prosthesis does not fit tightly on the neck of the tooth, injuring the gum and causing it to bleed.

If there are such complications, measures should be taken to eliminate them.

Temporary dentures are worn from two weeks to a month. If the patient has no complaints, they are removed, the dental unit is cleaned and the permanent product is fixed with permanent cement. Then the crown is irradiated with a special lamp, which helps to harden the cement. All excess cement is carefully removed.

On a note: You can chew on the tooth where the crown was placed after a couple of hours, and the maximum load can be given to it after one day.

Cases in which the removal of crowns is necessary

The need to remove the crown can be caused by the following reasons:

1. The tooth was poorly prepared for the installation of a prosthesis. Statistics show that 60% of root canal fillings are performed with errors. This is a prerequisite for the development of inflammation, and the treatment of the tooth leads to the need to remove the structure.
2. Construction error. If the product distorts the bite, loosely covers the neck, or causes physical or aesthetic problems, it is removed.
3. Planned replacement. At the end of the service life (usually 10-15 years), the prosthesis is changed.
4. Damage to the structure, the appearance of cracks on it or holes from washed cement requires an urgent replacement of the product.
5. The occurrence of complications.

Removal methods

Removing the product is quite difficult, especially if you need to keep it intact in order to install it again.

If the removal is due to a structural failure, it is better to saw it with special tools.

If it is necessary to preserve the prosthesis, to remove it, use:

1. Crown lifters (Kopp hooks are the most common) are special tools in the form of flat hooks that can be automatic or manual. With their help, the prosthesis is removed in the part of its connection with the tooth.
2. Forceps securely grasp the prosthesis with jaws and remove it from the base.
3. Ultrasonic installations. Ultrasound waves are able to destroy the adhesive cement, after which the prosthesis can be easily removed.
4. Pneumatic tools, the use of which also contributes to the destruction of cement and facilitate the removal of the crown.

What are the complications?

Consider the complications that can appear after the installation of crowns:

1. The strong pressure of the product on soft tissues disrupts blood circulation, contributes to the formation of bedsores. At the same time, the soft mucous membrane can die at the point of contact between the gum and the crown. So prosthetic stomatitis can develop.
2. The defeat of the supporting dental units by caries. Poor cleaning of the oral cavity or poor preparation of the dental organs for the installation of a prosthesis lead to the accumulation of food particles under the crown, where bacteria that cause the disease develop.
3. An allergy to the metals that make up the prosthesis may not appear immediately after the installation of the structure, but after some time. There is a burning sensation in the mouth, dryness, inflammation is formed.
4. Galvanic syndrome can be caused by the presence of various metals in the mouth. The result is the formation of an electric current, which enhances oxidative reactions. At the same time, the patient feels a metallic taste in his mouth, there may be a general malaise, a headache, the structure and neighboring dental organs may change color.

Each of these complications requires a quick reaction and a visit to the attending physician, otherwise you can lose the abutment tooth. The doctor will most likely remove the crown, treat it and put in a new one.

The most interesting questions for patients

Question

Does it hurt to install a crown?

Answer

Fitting a denture can be uncomfortable, just like any other dental procedure. The greatest amount of discomfort occurs at the preparation stage, which includes drilling, turning the dental organs, cleaning and filling the canals. But the fact that the crown is mainly fixed on pulpless teeth minimizes the likelihood of pain. If they grind live teeth, anesthesia is used. And the very fastening of the crown on the stump is completely painless.

Question

What is the duration of the procedure?

Answer

The installation has several steps. To prepare your teeth - you need to visit the dentist one to two times, and sometimes more. The duration of each visit depends on which teeth are planned to be crowned and their condition. It may take several weeks to make a crown. The prosthesis is placed on temporary cement for a period of 2 to 4 weeks. Then it is finally fixed. In this case, the total time spent on the installation of the crown can be from 1 to 2 months, and sometimes more.

Question

Are crowns placed on living teeth?

Answer

For live multi-rooted teeth, the condition of which does not require depulpation, a crown is allowed to be placed. You can also put them when installing the bridge, when the crowns are attached to the turned healthy teeth.

An anatomical dental crown is a hard shell made up of 95% inorganic minerals that covers the top of the tooth. Dental crowns are subject to mechanical, thermal and chemical effects, so often in order to save the tooth and restore its functions, the question arises of installing a crown made of artificial materials.

Tooth crown - what is it?

A crown on a tooth is a non-removable structure, which can be fused or consist of interlocking elements (dentures). Installing a crown on a tooth is the most affordable, simple and popular type of dental prosthetics, but this method of restoring the dentition is not suitable for everyone, so the dentist should make the final decision on the possibility and expediency of setting a dental crown.

What is a crown for?

A dental crown is necessary not only for a beautiful appearance, a dazzling smile and psychological comfort - it performs a number of functions, among which the most important is the protection of a damaged or destroyed tooth from external influences.

In addition, the installation of the crown allows you to solve several more problems, for example:

• preservation of speech function and proper functioning of the speech apparatus;
• restoration of full chewing ability, necessary for healthy digestion and prevention of diseases of the stomach, intestines and esophagus;
• reconstruction of an anatomically correct tooth shape (necessary to prevent bite pathologies).

The decision on the possibility of prosthetics is made by the doctor after a visual examination and study of radiographic data, which allow assessing the degree of damage to the tooth root and identifying the presence of hidden purulent or inflammatory processes. Indications for the appointment of prosthetics may be diseases and pathologies listed below.

Premature wear of tooth enamel

Tooth enamel is the hardest tissue of the human body, consisting of minerals of inorganic origin (more than 97%). It protects the tooth from damage and pathogens. Premature erasure of the enamel coating can contribute to:

• alcohol abuse and smoking;
• frequent use of coarse food, seeds;
• prolonged use of toothpastes with a high content of abrasives, etc.

Prosthetics allows you to protect the tooth from further destruction and solve the problem of hypersensitivity.

Tooth decay of 70% or more

If most of the hard tissue is completely destroyed and the tooth cannot be restored with a filling or extension, the doctor may recommend prosthetics and the installation of an artificial dental crown. This type of treatment may be required after tooth depulpation (removal of the dental nerve), since the “dead tooth” is devoid of nutrition and becomes susceptible to external factors and pathogens.

Dental crowns - before and after photos

Pathologies of the maxillofacial apparatus

Most of these disorders are congenital defects that occur during the period of intrauterine development of the fetus. If the bones of the skull do not form and grow properly, this can lead to serious problems in the future, for example:

• speech disorder;
• curvature of the dentition (in the absence of the effect of the use of bracket systems);
• wrong bite.

All these pathologies often require the extraction of one or more teeth, so prosthetics in such a clinical picture is necessary to restore the integrity of the dentition and preserve the basic functions of the upper or lower jaw.

The need for prosthetics of adjacent teeth

If the patient needs other types of orthodontic or orthopedic care, for example, the installation of a clasp or bridge prosthesis, it is required to perform prosthetics of adjacent teeth, even if they are completely healthy. The installation of a crown is also a mandatory procedure after implantation of a dental implant - this will protect the structure from possible damage and extend its life.

What are crowns?

All crowns are divided according to three criteria. Products that are used as the basis for bridges are called abutment crowns. Restorative crowns are used to restore the appearance of the tooth, its anatomical shape, as well as the functions that a particular tooth performs. They allow you to restore the integrity of the dentition and provide psychological comfort.

Table. Classification by design and structure of products.

Note! The choice of a crown depends not only on the cost of the product and the work on its installation, but also on the available indications and contraindications. The final decision must be made by the prosthodontist.

What materials are crowns made from?

Crowns for a tooth can be made from different materials, which is why the cost of some products can differ by dozens of times (the average cost of dental crowns varies from 3 to 40 thousand rubles). Below are the main materials used for the production of such structures, and their brief characteristics.

Porcelain

A rather expensive material, but its cost is justified by the properties of the material. Porcelain crowns in appearance are as close as possible to real teeth: they have a natural milky shade, the necessary degree of smoothness and a translucent coating. It is almost impossible to visually distinguish an artificial prosthesis from a real tooth, but only if the person takes good care of the teeth and tartar or dense bacterial deposits do not accumulate on their surface.

note! Porcelain crowns are not suitable for all patients. For example, when installing a ceramic-metal bridge, the use of such crowns is impractical.

cermet

These crowns are made from a metal base, which can be gold, platinum, nickel, palladium and other metals, and ceramic lining. The thickness of the metal plate does not exceed half a millimeter, and in some cases ultra-thin alloys of 0.2 mm are used.

Metal-ceramic crowns are the most popular type of such structures, as they have a large list of positive characteristics, including:

• long service life and wear resistance;
• good survival;
• hypoallergenicity;
• attractive appearance.

The cost of metal-ceramic crowns belongs to the middle price segment and starts from 6,000 rubles.

Zirconium

In the production of dental prostheses, zirconium dioxide is mainly used - a refractory oxide in the form of a white crystalline powder, practically insoluble in water, acids, alkaline solutions and other liquids. Zirconium crowns have high hermetic properties, have a long service life (the maximum among all types of crowns) and do not differ from other teeth in appearance.

The only drawback of zirconium-based crowns is their cost - the price for such prosthetics ranges from 11,000-27,000 rubles.

Ceramics

Crowns made without the use of a metal frame cost almost 2 times more than metal-ceramic products, while they have almost the same characteristics and properties. They do not stand out from the rest of the teeth, have high wear resistance and withstand maximum chewing loads, which is especially important if prosthetics are performed on small or large molars.

The cheapest are metal products or mixtures of metal with the addition of composite materials. Their price is about 3000-4500 thousand rubles, but outwardly such products do not look very attractive. According to the main characteristics (strength, wear resistance, tightness and durability), they can be compared with ceramic-metal products.

Among the huge variety of artificial crowns, you can choose what suits a particular person only with the help of specialists. Before prosthetics, the doctor will prescribe an x-ray to the patient, and also conduct therapeutic treatment, if necessary, since any prostheses are installed only in the absence of any dental pathologies. After installing the crown, it is important to follow the recommendations of the doctor so that the product lasts a long time and does not need to be replaced after a few years.

Video - Dental crowns in dentistry

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.

Dental prosthetics with crowns is a responsible process, since in addition to the aesthetic appeal of a smile, chewing functions of teeth are also restored due to crowns. Putting a crown on a tooth does not hurt, but this procedure lasts for several weeks, or even months - most of the time is spent on making a prosthesis. In addition, the result obtained depends on many factors, the main one being the competence of the specialist. Therefore, everyone who decides to install crowns should know how the main stages of prosthetics are carried out.

Initial appointment in dentistry

The crown is placed on the tooth immediately, first you need to go through several preparatory stages. One of them is an initial examination and consultation with a dentist. During the first appointment, the doctor conducts an examination of the oral cavity, identifies problem teeth, and collects an anamnesis. Then an x-ray examination is prescribed, with the help of which pathologies of the dental tissue, inflammatory processes in the reference units are revealed.

The specialist finds out the presence of factors that may affect the process of installing a crown on a tooth or become a contraindication to prosthetics:

• an allergic reaction to certain drugs or materials;
• pregnancy;
• tumor neoplasms;
• chronic pathologies;
• diseases of internal organs;
• CNS disorder.

Taking into account the wishes of the patient and the clinical picture drawn up, the doctor determines the treatment plan. Before prosthetics, dental units are extracted without nerves (“dead”). Gradually breaking down, they contribute to the development of various disorders that negatively affect the condition of the crowns and shorten their service life. In addition, medical procedures are carried out, during which inflammatory processes that affect the bone or gum tissue are eliminated.

At the same stage, a detailed consultation of the patient and coordination of the type of dental structures is carried out. The doctor selects the best option for prosthetics, taking into account the physiological characteristics of a particular patient, explaining his choice, agreeing on the cost.

Depending on the clinical case and the financial capabilities of the patient, it may be recommended to install a crown made of cermet, plastic, or ceramic. The most inexpensive, but also short-lived, are plastic and ceramic products. In most cases, dentists recommend placing metal-ceramics, which is due to:

• High wear resistance.
• Creating an aesthetic appeal that does not change over time.
• Structural features. Dental technicians make the frame of a metal-ceramic crown for a tooth from an alloy of medical or pure precious metals (gold).
• The ceramic-metal product has high hypoallergenic properties and biocompatibility with body tissues.
• Acceptable cost.

You can see how the teeth look before and after the installation of metal ceramics, you can in the photo:

Preparing a tooth for a crown, installation steps

The stage of prosthetics preceding the installation of a crown on a tooth requires special professionalism. Often, preparation begins with the removal of a nerve in a problematic dental unit. Indications for depulpation are:

• caries in the advanced stage;
• wrong position;
• caries damage to one or more roots;
• anatomical features of the dental unit;
• inflammation of the periodontium, pulp.

Depulpation is always performed when you need to put a crown on a single-rooted front tooth. Such an operation is necessary, since in the process of grinding the tooth in the form of a crown, the doctor can burn the pulp. Units with multiple roots do not require the removal of the nerve, since the chance of pulp burns when turning them is minimal.

At the preparatory stage of prosthetics, medical procedures are carried out, channels are sealed, dental units are professionally cleaned from plaque and hard deposits. By the time of grinding and installation of prostheses, the teeth should be healthy and clean, the presence of foci of inflammation in the oral cavity, irritation of the gum tissue is not allowed.

If the supporting unit is severely destroyed, then after removing the nerve and filling the canals, the dentist restores the crown part using a special material. This is necessary to create the necessary foundation for successful prosthetics.

Restoration of the crown part of the tooth

Preparation for prosthetics includes the restoration of the crown part, this procedure is necessary to create a base on which the tooth crown will be attached. Significant destruction of bone tissue with a preserved root requires the installation of a pin or stump tab.

The pin is necessary when hard dental tissues are damaged by more than 50%. The process of its installation is as follows: a strong rod is screwed into the sealed root canal, a filling material is applied to the rod, recreating the necessary basis for fixing the crown. After building up artificial tissue, it is turned under the prosthesis.

A stump tab is inserted into a completely destroyed tooth, thanks to which it becomes possible to install an artificial crown on the preserved tooth root. The stump insert is a fastener made of hypoallergenic and biocompatible metal. The design is inserted into the dental canal and fixed with a special cement mortar, and then the walls of the canal and the crown part are built up to fix the prosthesis.

Turning

Preparing a tooth for a crown involves grinding it. Tooth preparation consists in removing the upper layer of hard tissue, the thickness of which depends on the crown being installed and varies from 1.5 to 2 mm. The specialist grinds hard tissues to obtain a base or “stump”, on which a crown is attached in the future. The resulting base is used to make an impression, according to which the future prosthesis is made.

The grinding process is necessary to give the problematic dental unit the desired shape for subsequent prosthetics. A drill or a diamond bur is used to grind the tooth.

The grinding process is painless, but uncomfortable. Painlessness is achieved with the help of local anesthetics. Unpleasant and uncomfortable sensations arise only when processing dental units with nerves, giving the desired shape to “dead” teeth occurs without pain, painkillers in this case may not be used.

During the procedure, a “stump” is formed from the turned tooth, on which an impression is made for the manufacture of a prosthesis. The resulting crown is placed on the prepared teeth.

Laboratory stage

A crown on a tooth is made in a special laboratory in the following order:

• First, the frame base of the structure is made. The frame can be made of medical alloys with high wear resistance and durability, or compounds of precious metals (platinum, gold), which are hypoallergenic and biocompatible with body tissues.
• The next stage includes the layer-by-layer application of a ceramic coating to the frame base. The ceramic mass is applied according to the shape of the impression taken from the turned base or the restored crown part. This method of application ensures the maximum conformity of the product to the "cult", the exact fit of the fixed crown.
• The manufactured prosthesis is subjected to special processing - it is fired in an oven at a temperature of up to 900 degrees. This stage of manufacturing provides fast adhesion and pronounced interaction of the components of the prosthesis, due to which its high strength and resistance to external negative influences are achieved.

It takes time to make a permanent crown, so during this period the patient is given temporary dentures made of durable plastic.

How crowns are made is shown in the video:

Fitting and fixation of crowns

Before installing a permanent prosthesis on the teeth, it is necessary to carry out a number of mandatory manipulations:

• Fitting, which is mandatory during the manufacture of a permanent crown. The procedure is carried out to assess the compliance of the frame base with the necessary parameters, the accuracy of its fit on the turned stump. In some cases, necessary adjustments are made.
• Temporary installation of a permanent prosthesis. The crown is placed on the prepared base and fixed with temporary cement. The procedure is necessary to get used to the prosthesis, to identify a comfortable or uncomfortable state when worn. Temporary models make it possible to determine the presence of inflammatory processes, to identify violations made during the treatment and filling of canals. In the process of wearing a temporary prosthesis, common defects can be revealed: loose fit of the crown, overbite.
• Final fixation of the crown. The period of wearing temporary prostheses is from 2 weeks to 1 month. In the absence of complaints, the specialist removes the prostheses and cleans the base from temporary cement. After the crown is removed, it is inserted back onto the teeth and fixed with permanent cement.

Photo: this is how they put a permanent crown on a tooth

Indications and contraindications

Specialists put a crown on a tooth in certain cases:

There are also a number of contraindications in which prosthetics are excluded.

• Dentures are not fitted to pregnant women.
• Prosthetics is contraindicated in severe forms of periodontal disease, the presence of foci of inflammation and infection in the oral cavity.

Important contraindications to the installation of crowns are psychopathology, disturbances in the work of the central nervous system, the presence of tumor neoplasms, infectious diseases (ARI, SARS).

Does it hurt to put a crown on a tooth?

Putting crowns is not painful, the process can be accompanied by only minor discomfort. However, the preparatory stage for the installation of crowns can be painful, since during this period teeth are drilled, root canals are cleaned and sealed, and hard tissues are grinded.

Prosthetics of "dead" teeth is imperceptible, since such dental units do not have nerves that respond to external influences. When crowns are put on living teeth, a high-quality anesthetic is used, which completely blocks the pain syndrome both at the preparation stage and during the prosthetics process.

How long does it take to install crowns

Prosthetics with crowns is not done in 1 day, as it includes several mandatory steps. The timing of the phased installation of prostheses reaches 1-2 months. The longest stage is the period of manufacturing dental crowns.

Dental prosthetics is the best solution not only for aesthetic problems. Crowns are installed in order to restore the integrity and necessary functionality to the teeth. Modern technologies used in dental prosthetics make the process as painless and effective as possible.