How to put a crown on a tooth - the stages of manufacturing and installing a crown. Should crowns be placed on front teeth? Preference for a crown over other methods of tooth restoration

A crown is a fixed structure, which is one of. Its installation is resorted to in cases where the tooth has a large percentage of destruction and treatment using it is not possible. Also, crowns are installed with a pronounced anomaly of one or more teeth for aesthetic purposes.

In any case, this is a rather complicated dental procedure that requires a certain amount of time and manipulation. Therefore, the emergence of many questions related to it in patients is quite natural.

Indications for installation

The decision to install can only be made after consulting a dentist, and often this also requires an x-ray examination. Typically, such prostheses are placed under certain conditions:

In order to preserve or prevent further destruction of the chewing element, the dentist may recommend the installation of crowns in some other cases.

Installation of a crown from "A" to "Z"

Installing a crown on a tooth takes place in several stages. This is a complex procedure that requires more than one visit to the dentist.

Preparatory stage

The first step is a complete inspection. oral cavity, the condition of the teeth is ascertained, if necessary, x-rays. Based on the results of the examination, the dentist gives recommendations on prosthetics and draws up a detailed treatment plan.

After that, the preparation of the tooth for the installation of a crown on it begins.

This is an extremely important point in the process of prosthetics, requiring a very responsible attitude:

Laboratory stage

In the photo, a cast under the bridge prosthesis

At the end of the preparatory stage, the dentist, using a special viscous mass, takes casts from the patient's dentition. On their basis, first created plaster models teeth, and then the crowns themselves.

The process of making prostheses takes a lot of time, so for this period the patient is offered temporary plastic crowns.

In the case of prosthetic front teeth, they will hide unsightly turned stumps. In addition, chewing elements in this state are very vulnerable to mechanical stress and infection. Temporary dentures will help protect the teeth prepared for installation and allow them to fully perform the chewing function.

Fitting and fixing

Before the final stage of production, it is certainly tried on for the patient. This is necessary to assess the quality of work, the tightness of the prosthesis and to identify possible inaccuracies. If necessary, the prosthesis is being finalized.

Before the final installation of the crown on the tooth, the latter is fixed with temporary cement and worn for some time.

Usually this period is from two weeks to a month. This is necessary in order to follow the reaction of the tooth to the installation of the prosthesis, to check whether the patient's bite is disturbed, whether he experiences discomfort.

At the end of the trial period, the prosthesis is easily removed by the dentist, all temporary cement is carefully removed, and the crown is permanently placed. This step is carried out under the condition that there are no complaints from the patient during the period of temporary fixation.

Methods for restoring the crown part

In the photo, a tab in the tooth under the crown

In the case when the tooth is destroyed very badly, before installing the crown, it is necessary to restore its part located on the surface of the gum.

This can be done in two ways:

1. Pin. Such restoration is carried out by screwing a pin into the sealed canal of the tooth. Then a filling made of a special material is placed on it. Only after that the tooth is turned.
2. Stump tab. More reliable and desirable is the restoration with the help of a stump tab. It is a structure that has a root and crown parts and is made by specialists in a prosthetic laboratory. The root part of the dental inlay is necessary for fixation in the canals of the tooth, and the crown part is already prepared for the installation of the prosthesis.

The photo shows the installation of a stump tab under the crown of the tooth.

Features of the manufacture and installation of stamped crowns

For the manufacture of stamped crowns, a clinical and laboratory stage is necessary. Clinical includes:

This is followed by a laboratory stage, during which a plaster model of the patient's teeth is made on the basis of the cast. Then melted wax is applied to it to give the crown an anatomical shape, after which a plaster stamp is made.

Subsequently, it is replaced by a stamp made of light alloy metal and the most suitable metal sleeve is selected, which is given the desired shape using a screw press.

Finally, the crown is polished and polished, and it is transferred to the dental clinic.

Stamped crowns have very thin walls, so a very small layer of tooth enamel is required for their installation. Their installation is possible in cases where at least 30-40% of the crown part of the tooth has been preserved. In the manufacture of steel is used, rarely gold.

First, a metal prosthesis is temporarily installed and the reaction of the tooth to it is observed. If the patient does not experience discomfort, the prosthesis has the correct shape, fits snugly enough to the stump and does not cause malocclusion, then it is removed and cleaned of temporary cement.

After that, the stamped crown is fixed permanently on glass ionomer or zinc phosphate cement.

What interests patients most often?

Does it hurt to put a crown?

Any dental procedure causes some discomfort for most patients. In the process of installing crowns on the teeth, the most unpleasant is the initial stage - the preparatory stage, at which the teeth are drilled, the root canals are cleaned and sealed, and the prosthesis is turned under the prosthesis.

But given the fact that crowns are most often installed on dead teeth, the likelihood of pain is reduced to zero. If a healthy, living tooth is subjected to prosthetics, then all manipulations at the preparatory stage are carried out using local anesthetics. The installation of the crown itself is completely painless.

How long does the procedure take?

Installing a crown is a lengthy process. This is due to the fact that it is carried out in several stages. For the preparatory phase, 1 to 2 visits to the dentist are usually sufficient, but more may be required. The time of visits directly depends on the condition of the prosthetic tooth.

The fabrication of a crown in the laboratory takes a lot of time. This process is very complex and can take several weeks.

After the crown is ready, it is installed to the patient with temporary cement for 2-4 weeks. Only after that the prosthesis is fixed permanently. Thus, from the first visit to the dentist to the final result, it may take 1-2 months, and in some cases more.

Can crowns be placed on living teeth?

Crowns can be installed on living teeth in cases where they are not single-rooted and their condition does not require removal of the nerve. It is also possible with bridge prosthetics with the installation of crowns on healthy supporting chewing elements.

Installing crowns on teeth takes a lot of time. But the modern level of dentistry allows this procedure to be completely painless, and the installed prostheses do not look at all different from real teeth and are able to fully perform the chewing function.

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

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

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

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

When is a crown placed on a tooth?

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

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

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

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

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

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

How to put a crown on a tooth

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

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

Photos before and after the installation of crowns

At the first appointment, the doctor:

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

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

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

Crown installation scheme

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

Treatment plan:

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

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

Preparatory stage

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

Methods for restoring the crown part

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

With a pin

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

Use of a pin

With the help of a stump tab

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

Tooth preparation

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

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

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

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

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

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

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

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

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

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

Laboratory stage: making crowns

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

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

Metal-ceramic crowns

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

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

Fitting and fixation of crowns

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

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

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

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

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

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

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

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

Is it possible to remove the crown

There are two options:

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

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

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

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

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

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

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

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

Related video

For people who have lost one or more teeth, especially in the visible zone, the question “Why is a dental crown placed?” does not arise. But there are situations when it becomes necessary to put a crown even in the presence of all teeth:

1. The natural crown of the tooth is destroyed due to trauma or an extensive carious process, but the root is preserved and can perform a supporting function. In this case, it is possible to install the crown directly on the root of the tooth with a stump (while maintaining a sufficient volume of its own hard tissues). Either it is necessary to use pins or tabs for prosthetics, which make it possible to give the entire structure greater stability.
2. The patient's natural teeth have defects in shape or color and do not look aesthetically pleasing. Dental crowns correct these problems by giving an attractive smile.
3. All teeth are preserved, but there is pathological abrasion of the enamel. In this case, the crown serves to protect dental tissues from the effects of negative factors.
4. With periodontal disease, in some cases, there is a risk of loosening of the teeth. In this case, it is possible to use temporary crowns, which can keep the teeth in place until the moment of recovery.

What dental crowns to put

Currently, dentists can offer their patients several options for dental crowns, which are made from various materials and have their own advantages and disadvantages.

metal

Dental prostheses made of various metals are classic version prosthetics and have been used for many decades. The most common option is gold teeth.

The advantages of gold crowns are their durability, strength and reliability. Such elements do not undergo oxidation, and their abrasion coefficient is as close as possible to natural enamel, which does not cause damage to antagonist teeth during chewing. The disadvantage of such structures is one - an extremely unaesthetic appearance, so they are often installed in an area invisible to outsiders.

Metal-ceramic

The cermet combines positive properties both metals and porcelain materials. These crowns are durable, strong and have good aesthetic performance. Their cost is an order of magnitude lower than that of all-ceramic prostheses. The disadvantages are the need to prepare a large volume of natural dental tissues before installation, as well as the risk of increasing the enamel abrasion coefficient on antagonist teeth. In addition, when the gum edge is lowered or the crown itself is inaccurately made, a visible strip of ferrous metal may appear.

Ceramic or porcelain

All-ceramic metal-free crowns are the most aesthetic. They imitate natural teeth as accurately as possible and do not lose their properties even after long time. But ceramics are quite fragile and may not withstand a large chewing load. Therefore, they are most often installed on the front teeth. The disadvantage is their high cost.

Preparation for prosthetics

The process of preparing for prosthetics with a dental crown consists of several stages.

1. Grade clinical picture and the patient's oral health. At this stage, the volume of future intervention is discussed, the type of crown is determined and a treatment plan is drawn up.
2. If there is a need, then treatment is carried out for inflammatory diseases of the gums, periodontal disease, caries. All old fillings on abutment teeth must be replaced with new ones.
3. If metal-ceramics are to be used, then most often tooth depulpation is performed in order to prevent inflammatory lesions.
4. Tooth preparation is the removal of hard tissues of a certain thickness with instruments. For metal structures, the removal of 0.3 mm of enamel and dentin is sufficient, and when using cermets, the grinded layer can reach 2 mm. In addition, for a more reliable fixation of the prosthesis, it is necessary to prepare the teeth with an indent.
5. After the teeth have been treated and prepared, impressions are made using a special paste, on the basis of which dental crowns are made in the dental laboratory.
6. After the manufacture of the prosthesis, several fittings are carried out, which determine the accuracy of the manufacture of the structure, its convenience and compliance in color and structure with the rest of the teeth. Very often, the finished crown is fixed on temporary cement for up to 3 months. This is necessary so that the patient is finally convinced of its comfort and proper restoration of chewing function.

In the photo: the process of installing a crown on a tooth

How to put a crown on a tooth: stages and installation technology

Installation and fixation of the crown is the final stage in prosthetics.

1. After removing the crown from the temporary cement, it is thoroughly cleaned.
2. The prepared tooth stump is treated with a sandblaster to give its surface a microroughness.
3. The final fitting is carried out, and the doctor makes sure that the denture is positioned correctly, does not interfere with the free closing of the teeth.
4. A special dental cement is applied to the inner surface of the crown, and it is put on the tooth. After that, the structure is irradiated with a special lamp, which accelerates the hardening process.
5. All excess cementing composition is carefully removed, since even a small amount of it can cause severe irritation and inflammation of the gums.

An hour later, a chewing load can be given to the installed crown. And the maximum pressure can be exerted on it in a day.

Lock fastening

One of the promising areas in prosthetics is the fastening of crowns with the help of special locks. This method allows you to grind the abutment teeth minimally, it facilitates the process of installation and removal of structures. The fixation of such prostheses begins with the fixation of locks on the teeth with the help of cements, which perform the function of a support, followed by the installation and fixation of the crown.

Mounting on implants

Such prosthetics do not require processing of neighboring teeth. The design itself can be installed in two ways:

• Screw fixation when the crown is connected to the abutment adapter outside the mouth. After that, the entire structure is screwed to the implant using a screw that passes through the hole in the prosthesis. After that, the channel is closed with a special filling material. This method is more suitable for single crowns.
• cement fixation when the abutment is first fixed to the implanted root, after which the crown is fixed on it with cement. This method is preferable when several teeth are being replaced at the same time.

How crowns are removed from teeth

Removing dental crowns is not a simple act, especially when it comes to the complete preservation of the prosthesis in order to subsequently install it back in its original place.

If it is necessary to remove the crown due to its breakage, when repair is not in question, then it is sawn with dental instruments and removed in parts from the dental stump.

To save the prosthesis when removing the crown from the tooth, there are special tools:

• Crown Removers(the most common tool model is the Kopp hook) - they are flat hooks with an automatic or manual mechanism that, after fixing on the border of the crown with the tooth, apply a certain force and remove the crown.
• Forceps- tools that allow you to securely fix the crown between the branches and remove it from the base.

In modern dentistry, crowns are removed using ultrasonic devices. When the tip passes around the junction of the prosthesis with the stump, ultrasound causes crumbling and cracking in the cement, after which it is removed without much difficulty.

Another sparing technique for removing crowns is the use of pneumatic tools, under the action of which the cement is also destroyed and the structure moves away from the support.

Complications after prosthetics

After the installation of crowns on the teeth, complications may occur:

1. Prosthetic stomatitis resulting from excessive pressure of the prosthesis on the soft tissues of the gums. This causes a violation of blood circulation and the formation of bedsores and the death of the mucous membrane at the border of contact with the crown. Prevention this complication consists in the formation of a "flushing channel" - a small gap along the edge of the gum.
2. Caries of abutment teeth. This problem can occur in the case of an untreated disease at the preparation stage, or with poor oral hygiene, when plaque and food debris accumulate under the prosthesis, which serve as a breeding ground for carious microorganisms.
3. Allergic reactions to materials used in prosthetics. The first symptoms of it can appear both immediately after the installation of the prosthesis, and after some time. The main manifestations of allergies: dryness and burning sensation in the mouth, rashes on the mucous membranes and skin.
4. galvanic syndrome- occurs when there are prostheses using various metals in the oral cavity. This leads to the appearance of a galvanic current that stimulates the oxidation processes. The main manifestations of the complication: an unpleasant metallic taste in saliva, malaise, chronic headache, discoloration of crowns and adjacent teeth.

The appearance of any of the complications, especially when the tooth hurts under the crown, requires an urgent appeal to the attending physician. Delay is fraught with the loss of the abutment tooth. Most often, complications require removal and re-prosthetics after treatment of all negative reactions.

When carrying out prosthetics, it is up to the patient to decide which crowns to install and on which teeth. But at the same time, it is imperative to listen to the opinion of the attending physician and thoroughly follow all his recommendations.