Stump cast tab. Is the core inlay under the crown the best method of prosthetics? Tab prices

The stump tab is an indispensable thing when restoring badly damaged teeth. There are cases when a patient comes to the dentist with such a broken tooth under the root that it is easier to remove it and put an implant, however, the patient’s will is the law, and if he wants restore a tooth at practically total absence walls, it is precisely stump pin tabs.

Enough long time, until the advent of commercially manufactured pins, the treatment of this kind of destruction was carried out using an individual approach.

A stump tab is a structure specially made from an impression and fixed with a cementing compound into the pre-treated holes of the restored tooth, on which the dentist subsequently builds up the walls and crown.

Unlike pins, stump tabs are not installed on decayed teeth in one go, and for many dentists, and for patients themselves, this option is very inconvenient. And, nevertheless, their use guarantees that such a tooth will definitely never break and will not be subject to destruction, i.e. will exist with a person for the rest of his life, and will not be limited by the warranty period, which is typical for ordinary pins.

The fact is that, unlike the pin, the stump insert redistributes the load on the entire tooth evenly, because it has support on the entire surface and is fixed in each root canal. Mounting on the cementing composition provides a completely sealed fit to the remains of the tooth, which prevents the formation of microcracks, which could get food or liquid residues that provoke the development of caries.

Of course, the use of modern factory pins speeds up and reduces the cost of the process. restoration of a damaged tooth, which is sometimes beneficial for both the doctor and the patient, but the quality of work also suffers, which will not happen if your choice is a stump crown. Consider the main differences between pins and tabs.

Stump tab or dental pin?

AT last years very rarely, the dentist is faced with the question of what to choose to restore a damaged tooth, a stump tab or a pin. It is believed that the choice of standard pins for the treatment of any degree of destruction is most justified in all possible indicators, However, it is not.

The fact is that you can choose the restoration on the pin only if the destruction of the walls does not exceed 40-50% of total mass tooth, i.e. in its treatment, the use of a crown is not indicated. To restore single-rooted teeth, on which it is planned to install a crown, pins will also come in handy.

In other cases, namely with serious (more than 50%) tooth decay with two or more roots, pin-stump structures will be the only reasonable solution. The fact is that the pin-stump tab is not only able to provide the restored tooth with high strength, but also guarantee the absence of further destruction throughout the rest of life.

Pins have their advantages too. If we compare the characteristics of the stump tab with the pin, we get the following list:

Treatment

Before starting restoration work, the doctor must check the root of the tooth for inflammation, purulent discharge, cysts. The use of stump pin tabs is possible only with the reliability of the root tissue and in the absence of any hint of an inflammatory process. The fact is that after the correct installation of the structure, the extraction of the stump tab is possible only together with the tooth itself.

The length of the root cannot be less than the height of the installed crown, and the walls must be at least 1 mm thick so that they do not crack under pressure. The remaining walls are removed to a height of approximately 1-2 mm above the gum level, the tooth is prepared under the stump tab.

Before installation, the doctor files additional pins located on the top of the insert, thanks to which it is easy to install. After fixing, they break off, and the surface of the inlay is polished. To fix the tabs in the root canals, apply various types composite cements. The cementing agent is introduced into the channels, applied to the pins, after which the insert is inserted into the prepared holes and securely fixed. Preparation for the installation of the crown is made already at the next visit to the dentist.

Cast tab

In modern dental practice cast stump pin tabs are used much more often than collapsible ones, since their manufacture and installation are much simpler than the latter. Such an insert usually consists of a main platform, which restores a defective tooth, and fixing pins, which ensure reliable fastening of the entire structure in the canals of the tooth.

A cast stump insert means parts that are monolithically connected to each other, the separation of which during installation or further use is impossible. Most often, such structures are used to restore single-rooted teeth, as well as double-rooted teeth with non-parallel canals. The use of a one-piece inlay in teeth with three and four canals is extremely problematic.

Collapsible stump tab

Since it is impossible to insert a cast insert into a root with three or four canals without damaging the tooth tissue, it becomes necessary to make a collapsible structure. After taking an impression of the tooth, the inlay maker must determine which posts are free to enter and exit the canals, and which will need to be made removable due to their angle to the bulk of the inlay or center posts.

With proper manufacture and installation, the collapsible stump tab is not much different from the cast one. It perfectly fits the shape of the tooth, leaving no gaps and gaps due to the ease of insertion into the canals. After installation, it is simply unrealistic to remove such an insert from the tooth, since all the pins are located at the root at different angles, which is why it will have a lifetime warranty.

Manufacturing

The process of making inserts is not as simple as it might seem at first glance. To begin with, the doctor must prepare the remnants of the living tissues of the tooth for taking an impression. The channels, if necessary, are ground to parallelism, the inside of the tooth is treated with petroleum jelly. Special plastic for modeling is diluted to liquid state, poured into a syringe and carefully introduced into the channels and onto inner walls, then ashless pins are inserted into the channels.

To create a tab model required size, the tooth is limited by a special matrix, along the height of which quick-drying plastic is added. When the plastic hardens, the tab is carefully removed from the tooth. the main task doctor for this stage- do not damage the model, since plastic is a very capricious material.

The doctor should check the finished model for defects and pores and eliminate them if possible. If elimination is not possible, it is better to redo the model. After removing the tab, the canals of the tooth should be disinfected and place a temporary filling, and transfer the finished model to a dental technician for the manufacture of a stump crown. The manufacture of stump inlays for 2-3-root teeth with parallel channels does not differ much from single-channel ones, but if the channels are not parallel, the manufacture of a cast or collapsible structure depends on the position of the tooth.

What material to choose

The selected material for the manufacture of the inlay must meet a number of requirements: be hard and elastic, bioinert, shrink to a minimum during casting, and have low thermal conductivity.

Modern dentistry can offer the following options:

In any case, if you still decide to restore a damaged tooth using an inlay, and not using standard factory pins, discuss your decision with your doctor in advance and get detailed advice on this issue.

Greetings, dear readers! The review topic we have chosen today is the stump inlay.

What are stump tabs

Many people face problems when trying to repair a decayed tooth. On the one hand, there are many techniques, on the other hand, they have certain disadvantages. In some cases, you are offered to set and grind healthy teeth, in others there is nothing to cling to the bridge, because on neighboring teeth there are fillings, etc. In fact, for a tooth that has lost 50-70% of its volume, there are not many options. Trying to restore it with a photopolymer filling? The remaining walls simply can not withstand the load. As a result, the rest of the tooth will break and fall off along with the filling. As a result, you will have one root and sharp edges. Not the most pleasant prospects for the development of events, which is why it is recommended to use this option.

The stump tab consists of two parts. One is immersed in the root, the second is on the surface and a crown is mounted on it with the help of special cement. This is one of the many devices used to successfully restore teeth destroyed by caries or trauma.

In what cases is the use of tabs shown?

Installation indications are as follows:

• the need to build a "bridge";
• the need to strengthen the tooth on which it is planned to install the crown;
• a healthy root canal;
• destruction of more than 2/3 of the tooth.

So, let's imagine a situation that you want to put, but the teeth for which it should be attached are badly damaged. Place implants? Wait 3-6 months and all this time walk with toothless mouth? This option will not suit everyone. For similar situations and the installation of a stump tab under the crown is used.

Main contraindications

There are situations when the use of this method is impossible or temporarily not recommended. For example, if the tooth has not been treated or there is inflammation in the root area, the tab cannot be installed until these problems are eliminated. If the tab is metal, it should not be installed by people with allergies.

At advanced stages periodontal disease with tooth mobility should also be completed first, and then proceed to restore the tooth.

What materials are stump-type tabs made of?

AT modern dentistry apply different materials from which tabs are made. What does the choice depend on?

1. position in the dentition. For example, a metal tab is not suitable for prosthetics of the front teeth included in the smile zone. It will be too well visible under the crown.
2. Client's budget. Not every person can afford an alloy of precious metals.
3. Having an allergy to metals.

In some cases, a ceramic stump insert is used. The main advantage of ceramics is an excellent imitation of a real tooth. The main disadvantage is low strength. That is, the risk of breaking a tooth is much higher than in normal conditions.

For this reason, more reliable cermets are usually recommended to patients. It is based on a popular material - zirconium dioxide. They serve up to 10 years. Installed in 2 visits. Your tooth will be restored in 5-7 days. The material does not change color over time. Therefore, your tooth will not darken over the years. Zirconium does not cause allergic reactions, as opposed to metal.

According to many experts, one of the best choices when choosing a metal/alloy for stump inlays is gold. Moreover, this is not at all the alloy of 585 samples from which rings and earrings are made. AT this case we are talking about 750 samples and above, with the addition of 10% platinum. This makes it possible to process the material much more precisely, resulting in an excellent marginal fit. Silver and silver-palladium alloys are also used. The gold tab will last 15 years or more.

Of the inexpensive metal options, chromium-cobalt and chromium-nickel alloys, titanium and surgical steel are popular.

On the one hand, doctors recommend materials based on silver, because it has bactericidal properties. On the other hand, it has one drawback, which is expressed in the staining of the gums. Pigmentation is noticeable enough to cause anxiety and dissatisfaction in patients.

Alloy with nickel shrinks and is harmful to health. Cobalt-chromium is better, but harder to process. Titanium is more convenient in this regard, but in some cases it turns out to be too fragile. After all, usually more massive products are made from it.

The simplest and cheapest is the composite tab. In fact, this is the same photopolymer filling, which differs only in that it is not formed right in your tooth, but in advance, in dental laboratory. The disadvantages are the same - low strength and durability. If dropped, then no warranty obligations with a free replacement is usually not. And it can fall out pretty quickly. Statistics show that for many people such a tab falls out after a year or two. That is, it makes no sense to install it. Composites are used under restoration tabs. Photopolymer materials are not suitable for stump inlays at all.

Video - Stump tab for crown and filling

Inlays for chewing and front teeth

If you need to restore a 50-70% destroyed molar that does not fall into the smile zone, it makes no sense to spend money on expensive metal-free products. It is much easier to use CCS (cobalt-chromium alloy). It is much cheaper, durable and reliable. The only option when it does not fit is an allergy to metal.

If you are going to bet, any metal will shine through. In this case, the optimal solution is zirconium dioxide. If you are persuaded to put a crown with a fiberglass pin, do not agree. The durability of this design is questionable. There is a high chance that you will forget about maximum load and break a tooth.

Pros and cons of stump tabs

This method has many advantages. For example, the tab is much better than the pins, fixed inside the channel. The load on the teeth (especially chewing ones) is uniform and natural. If you damage the crown, the inlay does not need to be changed. You will simply be made a new one according to an existing cast.

Tabs are one-stop solution. They can be used for complex shape and obstruction of root canals. The product is cast, i.e. the crown and root parts will not split in half, and the upper part will not fall out.

The disadvantages include prices and terms. Although the second point is debatable. Two visits within a week is, of course, longer than a single filling, but much faster than half a year of torment. Also, some people believe that too much dentin has to be removed to install such an inlay. But we all understand perfectly well that they install it with a significant destruction of the tooth crown, when other methods are not effective.

Are complications possible? Theoretically possible if the tab was placed in a tooth that was not depulped. Possible it secondary caries and . Sometimes patients complain that they have a toothache. If there are similar symptoms, you should immediately consult a doctor for help. You may need to take a picture to determine what caused these symptoms.

Video - Preparing a tooth for a stump tab

Stump tab or pin?

Why do people often put pins right away, without even offering the option of making an inlay? Surprisingly, the layman will think, because the tab is more expensive and the doctor could earn more. The only problem is that many dentists believe that it is better to take a lot of patients and put pins in them than to mess around with each one for longer, and even for two visits. Companies that produce prefabricated pins also go out of their way to promote the idea that their products are the answer to everything.

Comparisons, pros and cons of a stump tab and a pin:

Orthopedic dentists are well acquainted with the statistics of the use of pin restorations. They know that service life rarely exceeds 3 years. Why do they continue to make a mistake, obviously knowing about it? Because no guarantee for a seal on a pin exceeds its service life. They have nothing to fear. The warranty period has ended, and then it is no longer their problem. Then people come to their colleagues whose tooth, restored in this way, simply fell apart. Everything would be fine if we were talking about single teeth, but often these are impressive bridges that have lost one of the important supports.

Composite on a pair anchor pins cannot guarantee the reliability of the design.

Manufacturing process

The procedure is quite complicated and is carried out in several stages. First you need to prepare the tooth itself. Excess tissue is removed from it. Then, if required, each channel is processed to achieve a parallel run. Prepared surfaces are treated with petroleum jelly. The liquid modeling resin is now poured into the tooth. After that, special ashless pins are installed in each channel.

Next, the tooth is limited with a matrix so that plastics can be added in height. Now the model freezes, it is removed and checked for defects. If they are not there, or their elimination is possible, the cast is brought to the ideal. A temporary filling is placed in the tooth at this time. The impression is sent to the dental laboratory, where an inlay is made on its basis.

It is necessary to install the root part of the tab at a third of the depth of the root canal, otherwise the root may split, the inflammatory process will begin and the patient is guaranteed to lose the tooth.

Tabs are installed directly and indirect method. Direct is the easiest. The doctor makes an impression, and then an inlay is made. With indirect, the patient's bite is taken into account, so an impression is made from both jaws. It's more expensive, but more reliable. It is also possible to use computer technology. Specialists create a 3D model of the jaws to calculate how comfortable it will be for the patient. After all, an error of a few tenths or even hundredths of a millimeter significantly affects the bite.

Single-channel and multi-channel tabs

If the tooth is multi-rooted, then the question arises - to make a one-piece cast stump tab or a collapsible one? If the channels run in parallel, one-piece blanks can be used. It is possible to determine how to proceed further only if the doctor has pictures of your tooth in his hands and he sees how the channels pass. Some experts besides standard methods diagnosis, a CT scan is recommended. With help computed tomography can see:

• state of the root part;
• the shape of the root canals;
• the presence of periodontal and bone pathologies that require treatment. After all, you may have a cyst under the root that you were not aware of.

In general, a multi-rooted stump tab - perfect solution. Being held in several channels at once, it creates a uniform load on the entire tooth, is securely held and ensures that the root does not break. On a crown based on such an inlay, you can put a bridge mount without fear of damage and destruction.

It is not so easy to restore a tooth for 3-4 roots. But the reliability of the tab is significantly higher. If the canals cannot be made parallel, a collapsible design is used, consisting of several single-root stump tabs.

Prices for stump tabs

You are all interested in the cost of this method of restoring teeth. Here are the prices in major cities of Russia:

• for example, the price of a stump insert made of zirconium dioxide is on average 8-15 thousand rubles per tooth;
• a metal stump tab for 1 tooth costs 2,000 thousand, and a multi-root one costs 300 or more;
• for pressed ceramics, the patient will pay 10-12 thousand rubles.

Compare with the prices in the Kyiv clinic:

• steel stump tab for 1 root with pressed ceramics - 700 UAH;
• stump inlay made of zirconium dioxide, single root - 800 UAH.

The cheapest options cost 200-350 UAH. Collapsible - 550-600 UAH.

Features of caring for stump tabs on teeth

Let us immediately state that hygiene care behind this kind of tabs implies regular and high-quality brushing of teeth, as well as rinsing oral cavity after every meal. Characteristically, it is recommended to limit the load on the stump tabs, especially at the first time after installation.

If dental crown drops out along with the tab, we can safely say that the installation technology has been violated. In accordance with the instructions, after the stump tab has been installed, you should take a break for 24 hours to correct the results. After all, if you use a drill within 30 minutes after fixing the tab, not fully hardened cement can simply collapse under the influence of vibration. If this happens, the patient should see a doctor as soon as possible in order to re-install the dental crown.

Note! If after you have installed a stump tab, you began to suffer from a toothache, similar to unpleasant phenomenon can be attributed to high sensitivity teeth. But if your body did not have time to adapt in a few days, and at the same time toothache does not pass, it means that it is necessary to consult a doctor as soon as possible so that he takes an x-ray!

We also note that stump inlays, being an effective and relatively inexpensive method of restoring teeth, can be used both independently and in tandem with other methods of prosthetics.

Stump tab - reviews

The next point of interest to customers is the feedback from people who have installed crowns on this type of tabs. If you dig into review sites, you can easily find records of people who have had their teeth done this way. What do they write about their experiences? We came across a recording of a woman who restored two teeth in this way. She underwent one procedure seven years ago, the second about twelve.

The stump tab allows the dentist to restore the full functionality of a badly damaged patient's tooth. Part of the product is placed in the root of the tooth, and the other part is located on the surface and is a support for the crown, which will be installed in the future.

General information

The stump tab can be cast, in other words, solid or collapsible. Products are modeled individually for each patient, which is an advantageous difference from template pins in size and shape. Such prosthetics are widely used to restore the integrity of the teeth.

The stump tab can act as an independent type of prosthetics. But most often it is a reliable basis necessary for high-quality fixation of the crown. The service life of such products is at least ten years, nozzles made of precious metals serve up to twenty years or more.

Indications

In dental practice, this element is installed in the following cases:

• Progressive destruction of the apex of the tooth (more than 60%), provided that the dental canal is healthy (otherwise the stump tab is not installed).
• The need to strengthen the dentin before applying the crown.
• Reinforcement of dentin before the installation of bridges.

Contraindications

The tab on the tooth cannot be installed to the patient if there are such contraindications:

• Low-quality healed channels.
• Complete degradation of channels.
• Cyst.
• Granulomas.
• Inflammation that affects the tissues of the tooth.
• unhealthy
• The manifestation of allergic reactions to the materials used.

How is the installation done?

The treatment process is lengthy, due to strictly individual approach. In the dental laboratory, each patient has their own inlay for the tooth. The minimum installation period is one week. It must be borne in mind that high-quality work is carried out in specialized conditions ( good dentistry, polyclinic with dental office). You can not contact dubious specialists.

What to expect from the doctor at the first visit?

The initial visit to the dentist is accompanied by a whole range of activities:

• Removal of cavities affected by caries.
• If necessary, manipulations are carried out to treat the dental canal, including the removal of the pulp, the treatment of the cavity antibacterial drugs(The tab can be fixed on teeth with several roots or with one, the main thing is that they are healthy and strong).
• Filling.
• Preparation of the dental canal orthopedically. The doctor conducts deep drilling, reaching the roots. This type of pin will subsequently be inserted into the vacated cavity.
• The dentist takes an impression of the working tooth and neighboring ones placed on the opposite jaw. This approach allows you to model a perfectly convenient tab. Modern centers use computer simulation. In this case, the equipment itself scans the jaw, and the product is created using a special robot.
• Realization of temporary filling of teeth.

Second visit

The next visit to the doctor involves the following manipulations:

• Removal of temporary filling.
• Re-sanitization of cavities and channels, drying.
• The stump tab for the tooth is fixed with special solutions.

Modeling of the coronal part can be implemented in two ways. The first is by veneering the surface of the inlay with composite, which can be done at the time of reapplication. If a more durable and quality restoration, an impression is taken from the top of the pin, which is sent (any dentistry uses its services). Prosthetics are carried out later.

The third visit is carried out if necessary. The stump tab for the tooth is covered with a crown.

Product types

The main function of these elements is to strengthen the tooth. For the manufacture of inlays, the most reliable and durable materials are used, which determine the type of product:

• Made from precious metals. Usually gold is used, which is strong and durable. The disadvantage of this type is one - excessively high cost.
• Oxide-zirconium, titanium tabs. Such materials are characterized by high strength and are fully biocompatible with human body. Patients practically do not develop allergic reactions. Zirconium products are distinguished by high aesthetics. The disadvantage is that when the tab is removed (for whatever reason), it must be drilled out along with the tooth tissues.

  

• Cobalt-chrome look. The tab can cause allergies, but this is a very good option, based on the price / quality ratio.
• Ceramics. The element has a high aesthetic performance, but the strength leaves much to be desired. Typically, these inlays are used to restore front teeth.
• Metal ceramics. The product has a metal core and a ceramic shell. Such a stump inlay for a crown is cheaper than a ceramic one, and at the same time much stronger.

Product Benefits

Tabbed installation has the following positive characteristics:

• The doctor has the ability to restore even those teeth that are very badly damaged in the upper part.
• The tab is fixed with a permanent one that does not allow development carious lesions on the border of dentin and the element itself.
• The best strength.
• The crown can be replaced without removing the product (aesthetic dentistry).
• Prosthetics are performed when support is needed for and various kinds crowns.
• The dentist, at his own discretion, can change the direction of the supragingival surface in relation to the pin itself when correcting anomalies in the position of individual teeth.
• Aesthetics.
• It is used for the restoration of lateral and anterior teeth.
• The stump tab under the crown is securely fixed.
• A quality product has anatomical shape and adheres tightly to any cavities. This ensures an even distribution of the load.
• Large range of materials.
• Reliable fixation of the crown.
• Long service.



Disassembled or solid?

A cast post is often used to restore those teeth that have only one root. Collapsible products are recommended to be installed on multi-rooted teeth. Non-separable models consist of a stump and a pin, and the stump serves as an imitation of the crown part of the tooth, where the crown is subsequently installed. This design can be cast in parts and as a whole. If the patient needs to install bridges or a cast tab to avoid turning neighboring teeth. Such systems are more expensive than collapsible counterparts.

Production of stump tabs

Most nozzles are produced in accordance with the following algorithm:

• An impression is taken of the prepared tooth. It should be borne in mind that the preparation for the tab is carried out using a drill. As a result, a finished cavity for the nozzle is formed, which has an individual configuration.
• Based on the impression, in the laboratory, the technician makes a model of the teeth (usually from plaster).
• A section of the prepared model with a tooth is scanned.
• The computer simulation of the inlay is being implemented.
• The computer transmits a three-dimensional model of the product to the milling machine, where it is sawn out.
• The nozzle is fired in special furnaces.
• The product is fixed on the patient's tooth.

Multi-root tabs

The production of such elements in a dental laboratory is no different from the production of a simple single-root tab, but provided that the tooth channels are parallel.

If this requirement is not met, in case of revealing two-channel teeth, tabs can be used in which there is one full and a second additional pin. It will enter a modified or artificially formed second channel.



If the tooth is three-channel, it becomes necessary to install collapsible structures. The simplest but most reliable way to manufacture these elements is to model a monolithic pin with channels for arranging additional ones. Such manipulations will solve the problem in most cases. When installing, the doctor must select the main root for the introduction of the main pin. The work of restoring a tooth begins with him.

What is the difference between tabs and pins?

The pin is a template design, which is a screw. It is installed at the root of the tooth. Metal under pressure can damage the weakened walls of the roots of the teeth, which causes loosening and loss. The stump nozzle evenly distributes the load, which eliminates negative consequences.

Root Requirements

As noted above, a stump pin tab can only be installed if the dentist is confident in the reliability of the root. In addition, it is necessary to exclude the development of inflammatory processes.

The root must have great length than the height of the tab itself. The walls of the site must be of sufficient thickness, at least 1 mm. This will allow the system to resist chewing pressure. It is good if at least some part of the dentin remains above the gum.

The dentist grinds down all remaining walls of the tooth up to 1-2 mm. The inlay should cover the remaining tooth stump. In some cases, gum trimming is required. This helps to expose the subgingival part of the root. After such manipulations and installation, the patient must wait for about 14 days for the coagulated area to epithelialize.

Rehabilitation and recovery

Before prosthetics, the tooth is prepared, so after installing the tab, complications such as pulpitis or secondary caries may develop. In a number clinical pictures pain appears. To avoid the occurrence of such consequences, it is necessary to strictly follow the recommendations of the doctor.

Tab Care

After the installation is completed, you must follow simple hygiene rules:

• Twice daily cleaning.
• Soft-bristled brushes are best used to clean the fitted tooth and adjacent gum. In addition, it is shown to use special dental brushes, threads that will help keep the spaces between the teeth clean.
• Should rinse after eating warm water or a dental solution that freshens breath and has an anti-inflammatory effect.
• An examination by a specialist is shown twice a year (for prevention purposes).



The cost of prosthetics

This method is quite costly. The dependence of the price on the materials of manufacture is indicated below:

• Stump tab (the price indicates the lower limit) single-root metal - 2000 rubles.
• Two-root metal tab - from 3000 rubles.
• Ceramic nozzle - from 12,000 rubles.
• Zirconia inlay - from 15,000 rubles.

Instead of a conclusion

Only experienced qualified specialist, working in appropriate conditions (licensed dentistry, a clinic with a dental office), is able to carry out all the manipulations at the proper level. You should not save on dental health, and contacting a practicing dentist will eliminate the need for repeated prosthetics.

The stump tab is orthopedic construction from a pin and a stump, installed in the dental canal. It is used to restore teeth with a high degree of damage and serve as the basis for a crown.

Indications for tooth restoration with a stump tab

Microprosthetics using such pin structures is recommended for patients who:

• the crown is destroyed to the level of the gums and filling is impossible (only the walls of the tooth remain or only the root is necessarily healthy);
• the damaged tooth is located next to healthy ones, which are not advisable to grind for installing a bridge;
• teeth have defects in shape or position.

The price of manufacturing a pin stump tab

The average price of microprosthetics with stump tabs in Moscow is 6,000 rubles, in St. Petersburg - 3,600 rubles, in Nizhny Novgorod- 2,900 rubles. The cost varies depending on the materials and designs used.

Stages of installation of stump tabs

Tooth restoration takes place in several steps:

1. Preparation for microprosthetics. Mandatory conditions procedures - reliable roots and the absence of inflammatory processes. If there is periodontal disease, the patient is referred for treatment. In some cases, cutting or coagulation of the gums is indicated to expose the subgingival part of the root.
2. Root canal treatment. If there are no contraindications to the procedure, the doctor proceeds to excise the affected tissues, remove the nerve and expand the canal with its subsequent filling.
3. Modeling of a microprosthesis. It can occur by direct method (using wax or ashless plastic, the doctor creates a template for the stump insert directly in the oral cavity, then transfers it to dental technicians) or laboratory (the doctor makes an impression, according to which the technician models the template).
4. Making a stump tab according to a template.
5. Fitting and fixation of the micro prosthesis. If the design is suitable, it is fixed with a special cement.
6. Crown installation.

As a rule, to restore a tooth, the dentist's office needs to be visited three times.

Types of dental inlays: design, materials

Ideally, microprostheses and crowns put on them are made of identical materials. Depending on the raw materials for the production of such microprostheses, there are:

• Metal tabs. They are made from noble (gold, platinum, silver, silver-palladium alloy) and base (cxc, nxc, titanium, steel) metals. Extremely strong and reliable, but unaesthetic. Metal inlays are suitable for restoring chewing teeth.
• Ceramic tabs. Structures made of zirconia and pressed ceramic are in no way inferior in strength to metal ones. Outwardly, they look like porcelain, and therefore ceramic inlays are suitable for the restoration of front teeth.
• Metal-ceramic tabs. Not as durable and aesthetic as metal and ceramic inlays. Most often used for microprosthetics of posterior teeth.

According to the installation method, the tabs are classified into:

• Cast. One-piece structures, manufactured in conditions high temperature and under pressure. Suitable for single and double root teeth.
• Collapsible. They have additional removable pins and are used to restore teeth with three or four channels.

Removal of stump inlays

Molded micro prostheses can be removed, and demountable are installed with a lifetime warranty. It is impossible to remove such a structure.

Crowns fixed on stump tabs can be changed in the same way as ordinary ones.

Pros and cons of installing dental inlays under the crown

Advantages:

Flaws:

• To install the stump, a volumetric preparation of the tooth is required - excision of almost all of its living tissues.
• For the manufacture of a prosthesis, one visit to the doctor is not enough.

An example of the use of a stump tab

The effectiveness of microprosthetics using dental inlays depends not only on the materials used, but also on the experience and professionalism of the orthopedic dentist. Our website contains all the information about clinics that successfully practice restoration damaged teeth with the most modern methods.

From this article you will learn:

• what is a stump tab: photo, video,
• their advantages over pins and seals,
• stump tab: price 2019.

Stump tabs in dentistry (Fig. 1) - are used to restore severely damaged teeth, on which it is planned to put artificial crowns in the future. This inlay is a better alternative to conventional dental restorations. filling material and pin.

If the tooth is severely damaged, then in order to fix an artificial crown on it, it is first necessary to partially restore the crown part of the tooth. Bad dentists use ordinary metal pins and fillings to restore a tooth under a crown, despite the fact that most often such treatment leads to a quick loss of the crown along with the pin.

Stump tab on the tooth under the crown: photo

Thus, the tab under the crown is designed to be fixed on it. It is called a stump because after fixing such a tab in the root canal, it appearance is a stump of a tooth turned under the crown (Fig. 1-3). These tabs are the best option for fixation artificial crowns if the tooth was completely or almost completely destroyed.

Why do you need stump tabs -

Why do dentists most often restore badly damaged teeth not with stump inlays, but with pins and fillings? The fact is that usually the patient first gets to a dentist-therapist, who will treat all your teeth, and only then, if necessary, send you to an orthopedic dentist (prosthetist).

In most cases, in order to spoil the relationship with the patient and not retreat the tooth again for your money, the prosthetist grinds the teeth restored with pins and fillings, takes casts, on which crowns will already be made. But according to the rules, it is recommended to restore a tooth under a crown with a pin and a filling only if enough own tissues of the tooth (Fig.4-6).

Restoration of a tooth under a crown with a pin and filling -

Important : however, when only the root remains of the tooth, or very thin walls, restoring the tooth with a pin is fraught with two complications. Firstly, one day the root simply will not withstand the chewing load and will crack (a fracture of the tooth root will occur). And that would require tooth extraction.

Secondly, with such treatment, the artificial crown often falls out along with the pin and filling. If this happens, then the tooth will need to be completely retreated and a new crown made, which will require new financial expenses. Some clinicians try to cement these loose crowns with pins, but more often than not, the crown ends up either falling out again or starting.

Clinical situation –
below you can see the clinical situation, when the patient complained about the strong mobility of the metal-ceramic crown (Fig. 7). During the examination, the crown was removed by force of the fingers. In Fig. 8 we can see a pin protruding from the crown, and in Fig. 9 a view of a decayed tooth root after removing the crown with the pin.

tab on a tooth under a crown: types

To make a stump tab - in the tooth, you first need a dentist-therapist. Next, an orthopedic dentist comes into play, who unseals upper part root canal to the planned length of the root part of the tab, and takes an impression..

In Fig.10-13 you can see the main stages of tooth prosthetics with a metal-ceramic crown, starting from initial situation(when the tooth is completely destroyed) - until the moment the crown is fixed on the stump tab. Please note that Fig. 11 shows a metal cast stump inlay made of a cobalt-chromium alloy.

Types of stump tabs -

As we have already said: the stump tab has a crown part (similar to the stump of a tooth turned under the crown), and a root part, which is fixed in the root canal. The root part looks like a metal pin, which is why dentists use a stump pin tab. Moreover, there can be 1, 2 or 3 such "pins" - this will depend on the number of roots / root canals in the tooth.

Division of tabs by the number of root canals -

• single-root / single-channel (Fig. 11),
• two-root / two-channel (Fig. 15),
• three-root / three-channel (Fig. 14).

Multi-channel tabs (two- and three-root) - very often make collapsible (Fig. 15). This is done because several root canals in one tooth almost always have a non-parallel direction, and therefore insert a non-collapsible tab into such root canals it will be simply impossible. Multi-channel collapsible inlays are always more expensive due to more complex manufacturing (see prices below).

Stump tab under the crown: video

Materials from which stump tabs are made -

Depending on the material of manufacture, the stump tabs are divided into metal and ceramic. Metal ones are made mainly of a cobalt-chromium alloy, and they are intended for crowns from, or under (see such metal tabs you can in Fig.1,3,11,12,14,15).

Ceramic stump tab for the tooth - made from zirconium dioxide. This is due to the fact that ceramic crowns are relatively translucent, which means that the metal of an ordinary stump tab will shine through the ceramic, giving it a terrible gray-cyanotic color. Therefore, artificial inlays are made only of ceramics (zirconium dioxide), which will achieve excellent aesthetics.

Ceramic core inlay and crown (zirconium dioxide) –

How much does a stump tab cost: price 2019

How much does a stump tab cost: the price for 2019 in economy class clinics in Moscow primarily depends on the material of manufacture. Under ceramic-metal and cast metal crowns, inlays are made of metal (cobalt-chromium alloy). Such tabs will cost much less. ceramic inlay from zirconia.

• one- or two-root tab made of metal - from 4000 rubles.
• three-root tab made of metal - from 4500 rubles.
• zirconium dioxide stump tab - price from 8000 rubles.

Pros and cons of stump tabs -

• Design reliability –
  reliability is higher because such a design as "tooth root - stump tab - tooth crown" holds and distributes the chewing load much better than the "tooth root - pin - filling - tooth crown" design. This will avoid both a fracture of the tooth root and the loss of a crown with a pin.
• Long service life of crowns –
  Ideally, the service life of artificial crowns is 10-15 years. However, in most cases, such a service life is simply not possible if the tooth was almost completely destroyed and it was restored under the crown with a pin and filling.

Minuses: higher total cost of prosthetics, plus slightly longer prosthetics. In addition, the manufacture of multi-channel collapsible inlays requires a high qualification of a dentist-orthopedist, as well as a dental technician.

Crown tabs: contraindications

We have already said that the indications for the use of inlays for crowns is the complete destruction of the crown of the tooth, or if only thin walls remain from the crown. However, there are contraindications to their use -

• the root of the tooth must not be destroyed below the level of the gums,
• root canals should be properly sealed,
• must be missing inflammatory processes at the roots of teeth
• allergy to inlay materials (rarely allergic to metal),
• should not be placed on moving teeth.

Important : if your root is still destroyed just below the level of the gums (by 1-2 mm), then in some cases it will still be possible to make a stump tab on it. To do this, the gum is exfoliated around the root of the tooth and the bone tissue is cut with a boron (osteotomy is performed). Such a height of bone tissue is removed so that the mucous membrane of the gums is just below the level of root destruction. Osteotomy is performed by a dental surgeon, and it is quite inexpensive.