Dental crowns are permanent prostheses that restore damaged teeth or replace lost ones. Experts recommend using crowns for prosthetics if the tooth is significantly damaged - no less than 70%. If it is necessary to correct damage that is smaller in volume, fillings or dental inlays are used.
The crown restores the anatomical shape of the tooth and its functionality.
The crown resembles a cap in appearance; the design is made in a dental laboratory using individual impressions. The product can be used as an independent prosthesis, or can be used as a support for fixing clasp and bridge prostheses. The structures are widely used in the implantation process.
For prosthetic restoration of damaged and lost teeth, crowns are used as follows: indications:
- restoration of a tooth with significant destruction of its coronal part by more than half,
- pathological abrasion of enamel,
- implantation,
- restoration of the anatomical shape of the tooth,
- fluorosis,
- restoration of a tooth that has suffered from chips and cracks,
- anomalies in the shape and arrangement of teeth in a row,
- to support and protect against tooth decay with a bulk filling.
Crowns are also used in pediatric dentistry to protect teeth that are severely damaged by caries, when it is impossible to install a filling.
Contraindications for installation of dental crowns:
- tooth mobility in advanced stages of periodontal disease,
- allergy to construction materials,
- thin walls of the tooth,
- periodontal tissue diseases,
- low crown part of the tooth,
- abnormal bite.
Types of prostheses
There are several types of crowns depending on the materials and manufacturing technology:
Metal-ceramics is still the most popular type of dentures due to its optimal price-quality ratio. High strength indicators make metal-ceramics an ideal option for restoration chewing teeth.
Here you see metal ceramics on the front teeth.
A ceramic-metal product consists of a metal frame, on top of which a ceramic lining is applied. The design is bulky and heavy. Before installing the prosthesis, the tooth is depulped and ground on all sides, this is necessary for a tight fit of the crown.
Metal-ceramics can be used for the restoration of anterior teeth, but some nuances should be taken into account:
- the metal base is illuminated,
- a dark rim may appear at the junction with the gum,
- a single crown will stand out noticeably against the background of the patient’s natural teeth.
- Ceramics
This modern look crowns that do not have metal elements. made according to individual prints. The product has high aesthetic qualities and is excellent for smile line prosthetics.
- Metal-free ceramics
This is the most durable and expensive type of dental crown. For their production, zirconium dioxide is used - a material unique in its properties, which in appearance and structure is identical to natural enamel. They refract light in the same way as the natural enamel of the tooth, so often even dentists cannot distinguish a crown from a tooth. Metal-free crowns are produced according to innovative technologies and on modern equipment.
- Metal-plastic
The frame of the structure is made of metal, the cladding is made of composite plastic. Is not the best option for prosthetics, since plastic absorbs odors, quickly darkens and cracks.
- Plastic crowns (temporary)
Such crowns have their own purpose - they cover and protect the ground tooth for the period while a permanent crown or other prosthesis is being made. Temporary crowns are lightweight, aesthetic, and help the patient avoid discomfort and get used to the prosthesis. oral cavity.
- Hardware
Metal crowns are rarely used now, but gold products remain popular, despite the development of technology and the introduction of new high-quality materials. Gold crowns are durable, they do not cause allergies and can withstand high chewing loads.
What are the advantages and disadvantages of crowns?
We offer you a comparison table showing the advantages and disadvantages different types crowns:
| Product type | Advantages | Flaws |
| Metal ceramics | · Affordable price. · Durability, strength. · Good aesthetic indicators. |
· Before installation, a significant layer of hard tooth tissue is ground down. · The product is heavy. · The metal frame is translucent, so it is not advisable to place metal ceramics on the front teeth. |
| Ceramics | · High aesthetic performance. · The material transmits light, very similar in structure to enamel. · Can be installed without removing the nerve. |
· Not recommended for use on bridges. · High price. |
| Metal-free ceramics (oxide, zirconium dioxide) | · The product is durable and lightweight. · Ideal appearance, cannot be distinguished from a real tooth. · Maximum tight fit to the tooth and gum line. · Long service life. Can be installed on both front and rear chewing teeth. |
The most expensive type of crowns. |
| Metal-plastic | · Affordable price. · Fast production. |
· Outdated technology. · Service life is about 2 years. · Plastic changes color and cracks. |
| Metal crowns | · Durability, reliability. · Service life - up to 5 years. · Affordable price. |
Due to its unaesthetic appearance, it is rarely used for front teeth. Not suitable for patients with metal allergies. |
What crowns are best for chewing teeth?
Metal crowns can be placed on chewing teeth - they are reliable and durable.
What type of crown is best for prosthetic restoration of chewing teeth? Before making a choice, the dentist will take into account a number of factors:
- Metal-free ceramics will help restore and protect a damaged tooth,
- if the tooth walls are thin, in this case it is advisable to use metal ceramics,
- if the patient is limited in finances, the doctor may offer him a metal structure.
The main purpose of chewing teeth is to grind food, so when making prosthetics, the dentist’s main task is to restore this function. The ideal option in this case is metal ceramics, since the ratio of aesthetics and functionality is optimal here.
Of course, if the patient has in cash, it can supply metal-free ceramics. Anyway final decision is taken by your doctor.
Restoration of anterior teeth
It is possible to fix a crown on a front tooth provided that its root remains intact. If a tooth is missing, the product is fixed to the implant. You can still save money on the restoration of chewing teeth, but this option will not work with the front teeth, since they are visible when smiling and talking.
Of course, the ideal option in this case would be ceramics, or better yet, metal-free ceramics. It is durable and aesthetic. If the patient cannot afford a ceramic crown, the dentist will offer the classic – metal ceramics. This is also a good option, as they are well-made and correctly installed metal ceramic crowns They look very good on the front teeth.
No, it doesn’t hurt, since all manipulations are carried out under the influence local anesthetic, the type and quantity of which is selected individually. So that you understand what the doctor will do at each stage of prosthetics, we will introduce you to the procedure for installing crowns in more detail:
- Preparation
This is the first and very important stage on which the quality of prosthetics depends. At the first visit, the specialist will examine your oral cavity and also send you for an X-ray. Based on the results of the examination and the image, the doctor will determine the condition of the mucous membrane and teeth and, if necessary, prescribe treatment. IN mandatory plaque and stone are removed.
To prepare a tooth for a crown, proceed as follows:
Turning – required condition during prosthetics with crowns, and more hard tissue is removed for metal-ceramics than for ceramics.
- Laboratory stage
An impression is taken from the ground tooth; it is needed by a dental technician, who uses it to make a crown. During the production of the prosthesis, the patient is fitted with a temporary plastic crown on the ground stump, which protects the ground tooth and hides the defect.
- Direct installation of a crown
First, the crown is tried on and fixed with temporary cement. If the patient feels comfortable, the product does not interfere with him or disturb the overall bite, it is fixed with permanent cement.
Why a tooth under a crown may hurt: possible complications
Pain under the crown is a common complaint of patients. But one thing is discomfort immediately after installation and several days after it, when the anesthesia wears off and one gets used to the crown. But if a patient’s tooth begins to hurt a few months, and sometimes years after the installation of a crown, this indicates the development of complications:
- Poor preparation for prosthetics (poorly disinfected instruments, poorly filled root canals). As a result, an infection begins to multiply in the canals, which becomes the cause of the development of the inflammatory process.
- The dentist perforated the canal walls during treatment. This can happen either due to the doctor’s fault or due to pathological curvature of the root canals. Perforation may also occur during installation in the pin channels.
- Tool breakage. Yes, and such troubles sometimes happen in dental practice. Most often, the reason is the same curvature of the root canals. A piece of the instrument remains in the canal, and if the dentist does not notice this immediately and leaves it there, inflammation will occur over time. The tooth will have to be treated again.
Not all patients know that they can be safe from such troubles if, after installing the crown, X-ray. When poor quality treatment everything will be visible in the picture: not completely filled root canals and the same broken piece of the instrument. In this case, the clinic must pay you re-treatment tooth If a complication appears after some time, you will have to treat the tooth at your own expense.
Price and service life
We suggest you familiarize yourself with the average cost of different types of crowns and their service life:
What determines the cost of a crown, what does the price consist of? Factors that influence pricing:
- clinic pricing policy: each dental clinic focuses on a specific segment of consumers,
- qualifications of the personnel: an orthopedic doctor (his payment is 20% of the cost of the prosthesis), a dental technician (his payment is about 25% of the cost of the prosthesis),
- type of materials (the most expensive is zirconium dioxide),
- the presence of a dental laboratory in the clinic (if it does not exist, the clinic will have to enter into an agreement and cooperate with a third-party laboratory, which will affect the formation of the price).
Teeth are normal Dental prosthetics Review various types crowns and their advantages with prices for installation in Moscow
A crown is one of the oldest types of dental structures used to restore the aesthetics and functionality of teeth. Unlike other orthopedic products, it not only hides visual imperfections, but also helps restore teeth that have been destroyed by more than 50%. This article will help you understand the nuances of dentures and decide which tooth crown is better in different situations.
Indications for prosthetics
Classification is carried out according to two criteria: the type of material from which they are made and design features. Dental restoration with a crown is not recommended for everyone. clinical case. Indications for their manufacture and installation the following problems arise:
Concerning contraindications, then there are very few of them. Cases in which prosthetics will have to be postponed or canceled altogether include:
- severe nervous system disorders,
- diseases of the oral mucosa - periodontal disease, periodontitis, stomatitis and others,
- periods of exacerbation of any chronic diseases,
- individual reactions of the body: intolerance to anesthesia and/or materials from which the prosthesis is made,
- blood diseases.
It is also advisable for women to refrain from prosthetics and other dental procedures during menstrual cycle– these days they experience a significant decrease in the pain threshold and worsening blood clotting.
Types of crowns, review of materials
The materials from which dental structures are made differ from one another not only in external characteristics, but also in technical characteristics.
The task of a dental crown is to return damaged teeth to their original functional, anatomical and aesthetic usefulness. Nowadays, modern dental technologies and materials help doctors successfully solve the problems of dental prosthetics with crowns, taking into account aesthetic and strength requirements. After reading the article "Dental crowns: which are better?" you will learn what kinds of crowns there are on teeth, which crowns are best to place, how much it costs to put a crown on one tooth, the difference between the types and purposes of dental crowns, and you will also understand which crown is better for the chewing tooth and which for the front one.
What is a dental crown?
So, what is it - a crown for a tooth? A dental crown is a cap that fits onto a prepared tooth and has maximum anatomical and functional similarity to the human tooth it replaces (for example, as part of a metal-ceramic bridge).
Due to the fact that in the final stage of prosthetics, the dental crown is attached to the prepared (ground) abutment tooth with permanent fixing cement, and cannot be removed by the patient, dental crown refers to fixed dentures. Such dentures are made by dental technicians in dental laboratories.
The degree of destruction of the coronal part of the tooth, at which a dental crown is necessary, is more than two thirds (66% or more). In addition to restoring your own damaged teeth, dental crowns are used for fixed prosthetics on implants, and can also be made for abutment teeth to which removable dentures (clasp or plate) cling. Due to the high degree of destruction (more than 66%), such teeth cannot be restored with ceramic inlays, because there is a high probability of tooth fracture or chipping of part of the tooth, therefore only a crown on a tooth can prolong its full life.
- The most commonly used crown, combining aesthetics and strength. A ceramic lining is applied to the metal cap, almost identical in color and shape neighboring teeth. Among the disadvantages of metal-ceramics, one can note the not ideal color compatibility with the enamel of living human teeth; with gum atrophy, the end metal rim of the crown can be visible. If the dental technician applies shoulder porcelain and the prosthodontist grinds the shouldered tooth, the latter complication can be avoided.
Ceramic crowns
- In the last 15-20 years, these have been the most progressive and biocompatible crowns, with an ideal aesthetic surface. Their only drawback is strength limitations, which do not always allow the use of all-ceramic crowns for prosthetic restoration of chewing teeth. Thus, answering the question: “Which crowns better ceramics or zirconium?", we can safely say that zirconium is more suitable for back teeth. The cost of zirconium crowns is higher than that of ceramics.
The final choice of crowns is made by the patient together with the dentist, taking into account the clinical situation and financial capabilities.
Implant supported dental crowns
After complete engraftment of the implant, within a period of 3 to 7 months, a supragingival support (abutment), which looks like a prepared (shaped) tooth, is screwed into it and fixed with a screw. The dental crown is fixed to this supragingival support. In order to achieve ideal aesthetic compatibility with natural teeth, both the abutment and the crown should be made of metal-free ceramics or zirconium dioxide ceramics. As a compromise option for implant prosthetics, metal-ceramic crowns and metal abutments are quite acceptable, especially for the group of posterior, chewing teeth.
Color of dental crowns
The color that artificial dental crowns have is determined by the veneering of the crown. If you have given yourself a metal crown, everything is clear, but if your goal is to have dental crowns that completely match the color of your natural, human teeth, then it is the type of lining of your dental crown that will determine how great this similarity is. To select the color of teeth, dentists use the “Vita” color scale. Let's figure out what determines the light identity of a natural human tooth and an artificial dental crown.
Maximum transparency and similarity in sunlight or artificial lighting, natural and man-made dental crowns, is ensured by the depth of penetration and reflection of light from the surface of the tooth. In natural human teeth, tooth enamel, due to its structure ((the enamel consists of hydroxylapatite, light-conducting mineral prisms)) is similar to a transparent lens, (the thicker the enamel, the more transparent the tooth, the thinner the enamel, the duller the tooth appears), it allows and reflects light in both directions: inside the tooth - towards the dentin, and from the tooth - out towards the observer's eye. The color of a natural tooth is ensured by the dentin of the tooth, and the thickness of the tooth enamel ensures its brightness and transparency.
In dentures, the task of the dental technician is to ensure the deepest possible penetration of light into the lining of the dental crown, and its even reflection to the eye of the observer.
In a metal-ceramic crown(as in metal-plastic), the depth of penetration and reflection of light is not great, and the opaque layer of ceramic cladding, masking the metallic shine of the crown frame, looks like a neon color (at a disco or laser show) dark spot, which creates a feeling of discomfort for a person who has anterior metal-ceramic crowns.
In an all-ceramic or zirconia crown, opaque ceramic is not required to mask the metallic sheen of the crown frame, and dentin-mimicking ceramic light-detecting layers and enamel ceramic layers provide light transmittance and reflectance 90% identical to natural dentin and enamel. Therefore, the aesthetic parameters of a metal-free ceramic crown are considered the best.
Toothache under a crown
If the tooth under the crown hurts and at the same time it is depulped (the nerve in the tooth was removed and root canals were treated), the following reasons are most likely:
- A granuloma or cyst has formed under the root of the tooth. It is necessary to take an x-ray, remove the ceramic or metal-ceramic crown from the tooth and treat the root canals of the tooth.
- Overload of the tooth on which the crown is fixed. You need to contact an orthopedic prosthetist, determine the points of overbite on the crown using occlusal foil and grind off these points.
- Bruxism (involuntary clenching of the jaws and grinding of teeth, mainly at night, during sleep). It is necessary to consult a gnathologist.
- Decementation of the root stump tab or fiberglass pin in the root of the tooth or decementation of the crown itself fixed to the prepared tooth. It is necessary to contact an orthopedist, remove the tooth crown or stump inlay or anchor pin, and install a new inlay, pin or metal-ceramic crown.
- A root fracture or perforation of the tooth wall, which ends very sadly, causes a fracture of the tooth crown. Most often, the tooth has to be removed. Less commonly, it is possible to use tooth-preserving surgery, hemisection of the tooth, or restoration of the tooth with a metal core insert.
- Formation of secondary tooth root caries with destruction of the tooth root. Most often, the tooth is removed and a dental implant is placed.
- Sometimes the tooth hurts under the crown due to progressive periodontitis in the area of the tooth replaced with a crown, with loss bone tissue around the tooth and the formation of periodontal pockets. It is necessary to take a targeted X-ray and treat periodontitis.
If pain appears under the crown of a tooth, you should contact your dentist as soon as possible, this increases the chances of saving the tooth on which the dental crown is fixed.
Price for dental crowns
How much does a crown cost for one tooth?
The cost of a dental crown is determined by:
- qualified doctor and dental technician
- type of crown
- crown material and technology.
The most expensive are ceramic crowns on an implant, followed by all-ceramic crowns, made in one visit, on CAD-CAM devices, then gold-ceramic crowns, zirconium dioxide and all-ceramic crowns, followed by metal-ceramic crowns, then metal-plastic, then metal, and the cheapest plastic crowns . The most aesthetic and high-quality tooth crown, the price of which corresponds to its aesthetics and strength, is made from zirconium dioxide. Moscow and others big cities Russia offers the largest selection of dental clinics where such work can be done.
Due to the volatility of the ruble exchange rate, it is not entirely correct to provide absolute cost figures. To obtain a treatment plan and financial details, it would be best to contact dental institutions, having previously assessed their price list on the Internet.
What does a dental crown look like: photos of patients before and after prosthetics
Which dental crowns are best?
It is impossible to answer the question “Which crowns are better?” in the abstract. In dentistry, as in other branches of medicine, there are such concepts as indications for medical manipulation, contraindications, it is also necessary to take into account age, accompanying illnesses, the patient’s psychological expectations from dental prosthetics and much more, including the patient’s financial capabilities.
All other things being equal, zirconium dioxide and ceramic crowns are the most physiologically, aesthetically and functionally suitable for prosthetics of anterior teeth, and gold-ceramic crowns for posterior, chewing teeth. When making the final choice of crowns for dental prosthetics, the determining role is played by your orthopedic dentist and dental clinic, who will be responsible for your treatment plan and dental prosthetics. Financial capabilities are the second key factor, without which it is difficult to choose the best options for solving the problem of dental prosthetics.
Dental crowns, which are better, patient reviews
Klebanov Ilya Vladimirovich. Mytishchi.
Tsukanov Pavel. Moscow. 01/12/2016
I turned to Sergey Brodsky for prosthetics of the lower back teeth. Since November 2012 I have been using a dental bridge that he made. During this time, I came twice for an examination, and the bridge was cleaned and polished according to the bite. I am pleased with the result, I recommend the doctor and the clinic.
Sooner or later in the life of almost every person the question arises of replacing untreatable or lost teeth with artificial ones. In such a situation, it is not recommended to abandon the procedure for installing new teeth. After all, if a crown is not placed on a damaged tooth in time, its complete loss may occur. In this regard, for many people the relevant question is which dental crowns are better, since healthy and beautiful smile is a condition for a positive image.
Modern dental crowns
An artificial dental crown is a dental prosthesis that is installed on a partially or completely destroyed tooth. The purpose of this installation is restoration of chewing function and maintaining proper bite.
Dental prosthetics technologies are being improved, new materials are appearing for the manufacture of crowns and veneering of damaged teeth. Therefore, before choosing crowns for yourself, it is worth familiarizing yourself with the materials from which they are made.
Metal
Metal is the most well-known and economical material for making crowns. However metal crown from an aesthetic point of view, it has a disadvantage, since, despite its durability and strength, in the mouth it looks like it has been processed metal tooth. Such crowns are inexpensive, so they are usually installed on chewing teeth, which are not visible during communication. The lifespan of metal crowns is ten to twelve years.
Methods for manufacturing metal dental structures:
Non-metallic
- Manufactured made of porcelain or plastic, they are quite aesthetic, as they look natural. The disadvantage of such crowns is that they are not strong enough. Plastic structures are the cheapest option, however, this material absorbs food coloring. After two to three years, the color of the crowns becomes unpleasant, and it also differs from the color of the tooth enamel.
- Constructions made of metal-free ceramics based on zirconium oxide - one of the most popular. Many dentists believe that this best material. Since metal-free ceramics have aesthetic qualities, crowns made from it are best placed on the front teeth. The only drawback is the high price.
Indications for use:
- Restoration of damaged teeth.
- Manufacturing of artificial teeth on implants and structures on pins.
Metal-ceramic
Their frame, made of metal, is lined with ceramic mass. Due to this, such crowns strong, durable and natural looking. The shade of metal ceramics can be selected individually for each patient. You can place it in the most difficult cases. Metal ceramics are durable and cost two to three times less than products made from zirconium oxide. Therefore, metal-ceramic structures are considered the best and are very popular among the population.
Indications for use:
- Disturbances in the shape and color of dental structures that arose as a result of pathological processes.
- Injuries.
- Wedge-shaped defects.
- Increased abrasion of tooth enamel.
- Fluorosis.
- Caries.
- Hereditary anomalies of the position and shape of teeth.
- Allergy to plastics.
Minuses metal ceramics:
- The nerves need to be removed.
- A large volume of hard fabrics is ground under the structure.
- Since the structure has a metal base, the gingival margin may appear blue.
- Due to the presence of a metal frame, the color of the crown may differ from tooth enamel, since it does not have the translucency that is inherent in natural enamel. Therefore, the designs may be a little noticeable, especially on the frontal group.
Porcelain
This a real work of art by highly qualified specialists. Porcelain crowns fully match the appearance of tooth enamel, and their service life is not inferior to ceramic products.
Disadvantages of such prosthetics:
- High cost of work and material.
- They can only be installed on a single tooth.
Combined
They consist of a metal frame lined with ceramics or any other material. This type of prosthetics allows not only to preserve the aesthetics of the oral cavity, but also save money. For the front teeth, the veneer can be chosen from among more expensive materials, and for the chewing teeth, a structure made of inexpensive metal can be installed.
Manufacturing stages
Installation steps
Contraindications
- Allergy to the materials from which crowns are made.
- Loose tooth.
- Malocclusion.
- Insufficient height of the crown of the tooth.
- Thin walls of the lower front teeth.
- Gum diseases.
- Age up to sixteen years.
Which crowns are best to place?
Having an idea about modern crowns, knowing their pros and cons, you can approach prosthetics competently and not make a mistake with optimal choice, manage your money correctly and not harm your health.
If teeth are severely damaged, crowns can help restore their appearance and function. Such structures will restore the normal ability of chewing food to chewing teeth. A high-quality crown replaces a real tooth if done right choice. What design options are preferable to place specifically on chewing teeth? What should patients know about their choices?
About the choice of designs
The chewing group of teeth is the beginning of the digestive system. Their function is important in that they grind food. For this reason, the loss or damage of one of the elements of the masticatory system necessitates its rapid restoration in order to avoid deterioration in the quality of chewing food. Crowns allow you to save tissue from complete destruction and reliably restore chewing function.
The patient and the doctor must take into account a number of conditions before choosing the material for the manufacture of the structure. So, for example, to preserve the masticatory organ from further destruction, it can be used.
If the walls of the teeth are thin and can break during grinding, then it is more advisable to opt for metal-ceramics. Then the load will be distributed over the metal frame, and this will protect the tooth from destruction.
If the patient is financially limited, the specialist may offer him a metal structure. These crowns are durable and very reliable.
Characteristics of crowns
To save chewing teeth, specialists place single crowns or bridges. Let's learn about the advantages and disadvantages of different types of such structures:
- Metal. In most cases, they are installed on those teeth that are worn out. The advantages of the structures are that they are durable, strong - their service life is more than 10 years; no need to grind hard tissues organ of mastication in contrast to . As for the shortcomings, the main one is the not entirely aesthetic appearance. For most, it is this minus that is an obstacle to choosing metal structures. Although, in fact, such a defect is not so visible on chewing teeth.
- Metal ceramics. The main advantage of this design is strength. This is achieved thanks to a metal frame. Equally important is the natural and aesthetic appearance of the structure, since it is covered with ceramic cladding. Such options have a significant drawback - the need to sand off a large volume of hard tissue before installation. The frame of such products can be made of gold, chromium, cobalt, nickel, and platinum. Often, in addition to pure metals, alloys are used, for example, nickel + chromium or cobalt + chromium. They have good compatibility with oral tissues and are financially available. Ceramic is applied in layers to the metal frame. In a special oven at high temperature The product is fired after each layer is applied. This is how it is created reliable connection between metal and ceramics.
- Metal-free ceramics- highly aesthetic, durable, reliable material. Its main feature is that it transmits light, because metal is not used in manufacturing. It is thanks to this that a metal-free crown is almost impossible to distinguish from a natural tooth. However, the main disadvantage of such products is their high cost. Therefore, in most cases, such structures are placed on the front teeth, which are always in sight. And chewing ones are covered with other types of structures. Metal-free structures are made of porcelain, ceramics, and zirconium dioxide. A budget-friendly and popular option are plastic crowns. They may be temporary. Porcelain options are used for single prosthetics. They are durable, with good aesthetic characteristics.
- Combined crowns. The method is used when there is a need to restore chewing teeth and those nearby in the smile area. Then expensive materials are used for the latter, and metal for chewing teeth.
