Teeth perform several functions in our body at once; it is impossible to overestimate the importance of the chewing and aesthetic function. Modern dentistry can restore a tooth from which only the root remains, or even nothing at all. And the question of what is wiser to install – a crown or an implant – will not be entirely correct. The situation itself is important; a lot depends on the condition of the neighboring teeth, on the place where the tooth is lost or very damaged.
Implant: what kind of design is it?
An implant is an artificial root of a tooth, which is made from high-quality, durable materials. It is implanted into the bone tissue exactly in the place where the tooth previously was. After the titanium artificial root has taken root, the doctor will put a denture on it. The coronal part of the implant is fixed with special cement.
Pros of implants:
- they not only repeat the shape of the tooth root, but are also stimulators of those processes in which healthy teeth participate;
- reliable and durable;
- have no food restrictions;
- in 90% of cases, modern implants will last a lifetime.
But, unfortunately, this technology is not without its drawbacks. And one of them is the high cost of the procedure. There is a possibility that the structure will be rejected by body tissues. And although the materials are selected for biocompatibility, no doctor will give a guarantee of non-rejection. The procedure is quite long, there is a so-called postoperative period. It is also worth considering some contraindications to implantation.
When can implants be installed?
Theoretically, as many implants can be installed in a patient’s mouth as there are missing teeth. If there are no contraindications, then all lost teeth can be replaced with structures on implants. It also happens that the patient does not mind installing a bridge, but this is not possible: there is simply nothing to hook it to, the condition of the teeth does not allow it. Then a crown on an implant is the only possible solution.
If, on the contrary, the patient is offered to install a bridge, but he does not want to do this due to the need to prepare adjacent teeth, implantation becomes an alternative. In most cases, prosthetics on implants is done using single crowns; bridges on implants are a rare option.
To install an implant, you need to make sure that the condition of the gums allows this: the gums do not bleed, are not inflamed, and surgical intervention is possible. It is recommended to treat all adjacent teeth before placing an implant. The doctor must also make sure that there is enough bone tissue for implantation. Sometimes you have to undergo surgery to build up bone tissue, which is also done in almost all modern clinics today.
Is implantation fraught with complications?
Complications, of course, need to be avoided, and the doctor will tell you how to do this. But they are still not excluded. Most often they occur in the postoperative period, but sometimes they appear later.
Complications after implantation include:
- injury to the mandibular nerve;
- injury to the maxillary sinus (if there is insufficient bone tissue);
- divergence of surgical sutures;
- inflammation of the wound tissue, complicated by infection (may be fraught with implant rejection);
- incorrect position of the implant in the bone itself, which will lead to problems with further prosthetics.
In rare situations, the patient begins to bleed due to bleeding disorders. You need to warn your doctor about this pathology in advance. Pain after surgery is also considered a complication. Normally, it cannot last several days or more.
Crown: what kind of design is it?
The crown is the outer, visible part of the teeth, one might say, its shell. The crown is fixed to the damaged tooth or to the adjacent teeth (if we are talking about a bridge). Crowns can be temporary or permanent. Temporary crowns, usually plastic, are offered to the patient for the period while permanent dentures are being made.
The most popular type of crowns are metal-ceramic. Metal crowns are almost never installed, but if they are made, they are usually made of gold. Ceramic crowns can be made of porcelain or zirconium; these are very expensive designs, but aesthetically perfect.
Crowns have many advantages: they are made quickly (about 7-10 days), they are also fixed quickly, and the price is affordable. There are also some disadvantages to prosthetic crowns - you need to grind down your teeth in order to put on a crown, and often neighboring, possibly healthy teeth also have to be ground down.
Complications can also arise after the installation of crowns:
- sometimes food gets under the bridge, since a small flushing area between the gum and the bridge itself still remains;
- the neck of the tooth may become exposed due to receding gums;
- You may feel discomfort in your mouth for a few days after the crowns are installed.
Crowns are not installed forever: usually their service life is 5-10 years, after which the dentures will have to be replaced. They can serve longer, but the aesthetic indicators of crowns (especially metal-ceramic) are reduced.
What to choose: implants or crowns
When choosing one or another type of structure to replace teeth, you need to trust your doctor. He will assess the condition of your teeth and gums and recommend the best option. The doctor has no right to impose his opinion, and if you doubt his recommendations, visit another doctor. Both prosthetics and implantation are expensive procedures, so no one should be surprised by the patient’s suspiciousness and his desire to understand the situation in detail.
Table. Comparison of types of dental structures
| Type of design | Restoration of tooth functions | Durability | Features of care |
|---|---|---|---|
| Overloading dental structures is unacceptable (no need to crack nuts, chew seeds, etc.) | On average 7-8 years | There is no special care. Regular toothpastes are used; mouth rinsing is required after every meal. |
| Functions are restored to 100% | 20 or more years | They do not require special care. Eliminate the possibility of infection by pathogenic organisms. |
You need to understand that implantation is not a one-day operation. An implant is inserted into the patient's bone, and after the procedure is completed, you have to wait for some time to continue the action. Sometimes it is less than a month, and sometimes you have to wait six months. Time is needed for the implant to fuse with the bone.
It often happens that the tooth was lost a long time ago, and the bone atrophied without chewing load. The doctor must first perform a bone grafting operation, which means that the implantation process will take some more time.
Classic implantation takes a lot of time, but it is believed that all the work and expectations are worth it. If implantation is successful, the structure will last a lifetime, and if the crown that is placed on the implant fails, it can be replaced with another without replacing the implant itself.
Dental implantation in one stage
Such a scenario is possible, but it requires certain conditions. The procedure is minimally invasive, the recovery period is not so long, the tooth is already installed in the prepared socket. Implants that are implanted simultaneously can serve as both a base for bridges and a base for single crowns.
Are there any disadvantages to immediate implantation?
- After removing a tooth, there should be plenty of space in the gum.
- There should be healthy teeth next to the extracted tooth that will take the load and allow the implant to settle in painlessly.
- There is a certain risk of rejection of the structure.
- Such an implant is not fixed with one hundred percent reliability, therefore there is a risk of its displacement during chewing processes.
Unfortunately, with any type of implantation there is such a threat as peri-implantitis. This is an inflammatory process of the mucosa that involves the bone around the installed implant. Usually the process begins due to infection. Smokers, as well as those people who do not adhere to oral hygiene, are at risk of getting this complication.
Those patients whose situation with dental implantation or prosthetics is burdened by chronic diseases (especially in the acute stage) should discuss the possibility of solving problems individually with a doctor. He will tell you when and how teeth can be restored, whether there are risks, what points need to be taken into account, etc.
The good news is that modern dentistry can cope even with complex cases that require a huge range of work. Today, a person can hope to have beautiful, fully functioning teeth at any age. Replacement structures last a long time, look natural, and are becoming increasingly available.
Video - Prosthetics or implantation
Anastasia Vorontsova
It's no secret that having healthy and beautiful teeth is real happiness!
They not only give a beautiful smile, but also help maintain health. People who have lost teeth for one reason or another very often think about restoring them.
After all, missing teeth is not only discomfort, but also a direct path to disease.
An artificial crown is a type of prosthesis. It is installed when it is not possible to restore a damaged tooth using any restorations.
In addition, a timely installed dental crown allows you to maintain the correct bite and restore the aesthetic appearance.
Dental crowns are used in all types of prosthetics.
The advantage of crowns is that they help strengthen the tooth and protect it from destructive factors. To install a crown on a tooth, it must first be prepared.
Kinds
According to the purpose of crowns there are:
- Restorative. Used to restore damaged teeth.
- Supporting. Used for bridge prosthetics.
By time of use:
- Long-lasting crowns for teeth. They are installed for an indefinite period. They are made from durable, wear-resistant materials.
- Temporary structures. They are used to protect prepared teeth from infection and exposure to external factors. They are fixed to ground teeth while permanent crowns are being installed. If crowns intended for temporary use have a plastic base, then with prolonged use, an inflammatory process may develop in the area of contact with the soft tissues.
Depending on the fixation method:
- Fixed structures. These include single crowns. They are fixed with special dental cement onto a pre-prepared tooth. Such structures can be used even in cases of severe loss of tooth tissue and even in cases where only the root or its tissues are preserved.
- Removable crowns. For example, a removable clasp denture in which a dental crown is mounted.
The structures can be installed both on the front teeth and on the chewing teeth.
In order to choose the right dental crowns for prosthetics, you need to understand which ones are better for the chewing group and which ones are better for the front teeth.
- Crowns for the anterior group of teeth must have excellent aesthetic characteristics. Alternatively, these can be structures made of metal ceramics or metal-free ceramics.
- Crowns for chewing teeth. There are several options for prosthetics of chewing teeth. To restore them, structures made of metal-ceramics, metal-free ceramics, metal, and combinations can be successfully used.
Materials
Dental crowns can be made from various materials, depending on the indications and wishes of the patient.
The presence of a large selection of materials ensures a successful solution to any clinical situation, as well as the reliability of the dental structure.
The functionality and aesthetics of future teeth depends on the material chosen.
Dental structures can be made from materials such as:
- Plastic.
- Ceramics.
- Metal ceramics.
- Metal alloys.
Metal crowns
Structures made of metal are one of the oldest methods of prosthetics.
In recent times, stamped crowns were used, which were made from special blanks.
- Such designs were not distinguished by functionality and good aesthetics.
- To imitate gold, crowns were often coated with titanium nitride, resulting in a yellow color.
- The stamped structures were not fixed onto the tooth accurately enough, resulting in injury to the gums.
The relative advantage of a stamped crown is its low cost and ease of removal.
In modern conditions, metal dental crowns are made at a higher quality level.
- Currently, structures are made by casting or machined from solid metal blocks using computerized equipment.
- Features of such designs are precise fit and long service life.
- The finished crown is fixed using a special adhesive for dental crowns, which is characterized by increased strength.
Considering the low aesthetic properties of metal structures, it is advisable to install them on the chewing teeth.
Ideal for those teeth whose lifespan is limited, but there is no indication for their immediate removal.
Gold dental crowns
Gold is a metal that has a beneficial effect on the human body and is highly biocompatible with its tissues.
For this reason, the use of gold for the manufacture of prostheses remains relevant.
Solid crowns are made from gold alloys, and they are also used to create the frame of metal-ceramic crowns.
The cost of gold structures is quite high, but this price is justified by the combination of advantages.
Metal-ceramic crowns
Structures made of metal-ceramics have become widespread.
- These are crowns that are characterized by the best price-quality ratio.
- The metal-ceramic structure consists of a metal frame lined with ceramics. The metal frame gives the crown strength, and the ceramic coating gives it an aesthetic appearance.
- Metal-ceramic crowns can be installed on both the front and chewing teeth.
- Metal-ceramic structures provide excellent aesthetics, are quite strong and durable, but since the crown contains metal, they can cause allergies in some patients.
Since the metal frame does not transmit light, a metal-ceramic crown on the front teeth may look unnatural.
In this regard, in dental practice, crowns made of metal-free ceramics are used for prosthetic restoration of teeth in the smile zone.
Metal-free ceramic crowns
All-ceramic crowns are an alternative to metal ceramics. Such structures are made from porcelain or zirconium dioxide.
- They are practically indistinguishable from natural teeth, but porcelain crowns have one significant drawback. This is increased fragility.
- For this reason, it is recommended to use prosthetics only on the front teeth, which bear the least load.
- And since the highest aesthetic demands are placed on this group of teeth, installing porcelain ceramics will be the best solution.
- Recently, ceramic crowns based on zirconium are made by casting, so it has become possible to install them on chewing teeth.
- Porcelain crowns can only be installed on a single tooth, and bridge structures can be made using zirconium dioxide.
The disadvantage of ceramic crowns is their rather high cost, since the manufacture of such structures is a labor-intensive process.
The cost of porcelain structures is very high for the reason that only a highly qualified specialist can make them.
Video: “Metal-free ceramics”
Plastic crowns
This type of crown is used as temporary.
Fixation of plastic structures is carried out before prosthetics with permanent crowns.
Plastic crowns perform a protective role and provide a comfortable state after grinding the teeth.
The service life of plastic structures is short and is limited by the time spent on making permanent crowns.
Crowns made of plastic have many disadvantages:
- There is a high probability of gum injury.
- Acrylic plastic is a strong allergen.
- The material has a porous structure, which allows bacteria to quickly multiply in the oral cavity.
- The appearance of spots and darkening of the crown.
- Rapid abrasion of the structure due to the thin coating.
Metal-plastic structures
- Such crowns are much cheaper than porcelain or metal-ceramic crowns.
- However, they are less durable and subject to rapid wear.
- In addition, as a result of plastic corrosion, the color of the teeth will soon change and bad breath will appear.
Titanium dental crowns
Structures made of titanium dioxide are a thing of the past, but nevertheless have a right to exist, if only because of their low cost and the absence of the need to remove a large amount of dental tissue during the preparation process.
Disadvantages of the material:
- Lack of wear resistance.
- The presence of a flat chewing surface of the tooth.
- Insufficiently tight fit to the gum and neck of the tooth.
- Lack of aesthetics.
What to choose?
If we talk about the choice of material, the main factor is the financial capabilities of the patient.
When choosing, it is also worth considering some advantages and disadvantages of designs.
| Metal ceramics | Ceramics | |
| Pros: |
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| Minuses: |
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Price
Video: “Metal-ceramic crowns. Some features"
Metal crowns are distinguished by their affordable cost, high strength, reliability and durability. With high-quality installation, they will last at least 10 years and will fully correspond to the shape of the tooth, maintaining its normal chewing function. Prosthetics of such a crown do not require strong grinding of the tooth, which prolongs its service life.
The main disadvantage of such orthopedic structures is their low aesthetics, or rather its complete absence, since a metal crown will stand out noticeably against the background of natural teeth. It is for this reason that it is most often installed on the chewing area, which is not so noticeable when smiling. Designs made from such material are not suitable for those who are allergic to metal. In addition, the high hardness of this crown over time can lead to damage to the top layer of teeth on the opposite side.
Constructions based on a metal frame 0.3-0.5 mm thick, lined with ceramic mass, will be somewhat more expensive. They have a more aesthetic appearance, so they can be installed not only on the chewing area, but also on the frontal area. In this case, metal-ceramic crowns are the optimal combination of affordable price and aesthetics. The main disadvantage of such dentures is the need to grind off a large amount of dental tissue, and, consequently, depulpation of the tooth, which is necessary to protect it from thermal burns. Well, a “dead” tooth usually lasts less. In addition, due to the metal frame, the edge of the gum may acquire a bluish tint, which does not look very attractive on the front teeth. In terms of strength, such crowns are not inferior to metal ones.
Advantages and disadvantages of all-ceramic crowns
– ideal for front teeth. Such structures are much more expensive, not inferior to the same strength and reliability as metal ones, but their aesthetic properties remain at the highest level. Modern materials and technologies used in dentistry make it possible to install ceramic crowns that almost completely imitate the shade and structure of natural teeth, so even one crown will not stand out when you smile.
Due to the absence of a metal frame, the gums under such dentures do not change color, and the structure itself is not only quite strong, but also lightweight. Ceramics does not absorb foreign odors and does not pigment, which is especially important for front teeth. In addition, such material does not contribute to the development of bacteria in the oral cavity, therefore it is considered the most hygienic.
Ceramic ones are made from dental porcelain or zirconium dioxide. The latter is characterized by higher strength and a degree of imitation of the natural color and transparency of the tooth - it becomes almost impossible to distinguish the crown. Accordingly, they are more expensive. Both of them can also be installed on the chewing area of the jaw, but the advantage in this case is on the side of zinc dioxide.
Stump tab or crown - which is better and why?
The question of which restoration method will best restore a damaged tooth is inlay, crown or traditional, worries many patients. However, a final choice in favor of any method can be made only after a preliminary assessment of the condition of the problem tooth, its antagonists, tissues surrounding the tooth, etc., that is, the general conditions for. Without this, discussions about the benefits of inlays or crowns are similar to an argument about what tastes better: honey or black caviar. Indications for installation inlays and crowns are different, so it is incorrect to compare them ─ it is better to simply become more familiar with the features and scope of application of these methods.
When does a ceramic inlay help?
A tooth that is destroyed due to injury or complications of caries can be removed and replaced with an implant-supported denture. But if the tooth tissue is partially preserved, the best solution to the problem is tooth restoration─ this ceramic inlay.
The advantages of such an inlay over a filling are undeniable: the inlay is much stronger, more durable, and more resistant to external influences. Avoiding depulpation of a healthy tooth is usually only possible inlay, crown however, it requires deep preparation, after which the tooth becomes “dead”. However, if the tooth requires endodontic treatment, or has already been subjected to endodontic treatment, it may be advisable to undergo prosthetics with an artificial crown, under which a core tab on a pin base.
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Tooth restoration with a ceramic inlay
In what cases is a crown necessary?
A tooth with very thinned walls is unlikely to be saved by a type of restoration such as a ceramic inlay; a crown in this case is a much more effective method that strengthens the coronal part of the tooth, while the chewing functions of the tooth are preserved in full. A crown will provide a particularly strong and durable restoration if the tooth underneath is not simply filled, but reinforced using a structure such as a core inlay. To restore multi-rooted teeth, the inlay design can be collapsible.
What is a stump tab and what is it for?
Artificially formed stump, or crown inlay, is not independent, but an auxiliary basis for prosthetics. In restoration structures stump pin insert plays the same role as a simple pin, but its reinforcing properties are significantly higher. If the doctor believes that a crown should be installed stump inlay, manufacturing it may take longer than a simple filling on pins and then covering the tooth with a crown. However crown and core inlay form a truly reliable restoration structure, while the risk of destruction under the crown of a tooth with a massive filling is invariably high.
Stump pin inlays Teeth before restoration with stump inlays
Fixation of core inlays Final restoration of inlay + crown
Depending on the possible conditions of prosthetics, the pin stump insert can be made of various materials. Titanium and zirconium, which have good biocompatibility with teeth, are not always a justified choice for making inlays: in the event of a breakage, the stump inlay made of titanium or zirconium oxide is removed from the canal with considerable difficulty. For the restoration of chewing teeth, a cast gold core inlay is considered the best quality option, but many patients are stopped by its high cost.
More acceptable for most patients in need of prosthetics is a cobalt-chromium stump insert, the cost of which is much lower than gold. In addition, cobalt-chromium alloy is successfully used for the manufacture of frameworks for metal-ceramic crowns, which avoids the antagonism of metals in the oral cavity. As for restorations in the frontal area, the use of metal inlays is undesirable from an aesthetic point of view. A ceramic pin inlay (ceramic core inlay) is more appropriate for prosthetics of anterior teeth. If there are increased demands on aesthetics, a metal-ceramic stump inlay is also used, the price of which is slightly lower than that of an inlay made of solid ceramics.
In this article we will look at which ones are better to choose and from what materials they are made.
When choosing prostheses, the following factors are taken into account:
- price;
- the patient's wishes;
- clinical indications.
For prosthetics of the front teeth, you need to use the following dental products:
- metal-free ceramics (or porcelain);
- metal ceramics.
And also crowns are classified by design:
- Jackets.
- Designs with . As a rule, this option is used to restore a damaged tooth.
- Telescopic. The dentist has the opportunity to choose the height of the crown on the tooth.
- Half-crowns. Application: for ; as a support for bridges; as a support for cantilever dentures. Such dental structures cover the tooth from all sides.
- Stump (buried). Such products are used to restore damaged crowns.
- Equatorial. As a rule, such products are used for splinting. They are placed around the diseased tooth.
- Full.
Approximate prices
What does the cost depend on:
- Having our own laboratory. Dental products are manufactured in special laboratories. If the clinic does not have its own laboratory, then it is forced to cooperate with private laboratories. Accordingly, the cost of services provided will increase.
- Cost and quality of materials used.
- Qualifications of the attending physician.
- Pricing policy of the clinic.
Price:
- zirconium costs 30–40 thousand rubles.
- metal-ceramic costs from 12 to 16 thousand rubles.
- metal-plastic costs from 6 thousand rubles.
- solid cast costs from 5 thousand rubles.
- made from zirconium oxide costs from 20 thousand rubles.
- made of porcelain costs from 16 thousand rubles.
Life time
The service life of the product depends on the materials used.
Life time:
- Metal ceramics are 7–10 years old.
- Gold products are 15–20 years old.
- Zirconium oxide products are more than 20 years old.
The period is set by the manufacturer.
What determines the service life:
- individual physiological characteristics of the patient;
- compliance with the rules of care;
- quality of construction;
- the quality of the procedure performed;
- mechanical impact.
- rules of care