Is it possible to restore a crown or do I need to make a new one?

One of the most common methods of dental restoration is the installation of crowns. This process is called prosthetics, and with its help it is possible to restore not only the functions of the dentition, but also restore their former aesthetics. After installing crowns, patients often forget to check with a specialist for information about their service life, because they have a certain resource. It depends on various factors, and therefore it is very important to thoroughly understand the question of when dental crowns should be replaced, as well as for what. After all, not only comfortable eating, but also the general condition of the oral cavity depends on this.

Dental crowns in our clinic

Specialists from the Beryozka clinic will help you place strong dental crowns based on an individual impression. Our doctors work according to the most modern treatment protocols, which ensures maximum similarity of the artificial crown with the real one. High-tech materials ensure long-lasting wear even with intensive use of the crown.

Making a crown based on an individual impression ensures the most comfortable use. And budget prices allow you to restore the beauty and functionality of the jaws to a person with any income.

Free consultation!

You can get acquainted with the specialists of the Beryozka clinic and decide on the need to install a crown at a free consultation. Our doctors are confident that the patient, once in their hands, will definitely return for treatment. This is facilitated by the beautiful and comfortable environment in the offices, friendly and polite staff, as well as the high professionalism of the dentists.

Contraindications

Like any medical procedure, the installation of crowns has contraindications. Cases in which the procedure is not performed:

• advanced periodontitis;
• bruxism - teeth grinding;
• fragile enamel;
• teeth are small and poorly positioned;
• pathological bite, when the incisors overlap one another.

Sometimes the age of the patient may be a contraindication to installing a crown made of a certain material. Then he is offered another way to restore the integrity of the dentition.

What are they: materials

Crowns are made from different materials: some are more durable, others are only suitable as a temporary measure. Their cost, complexity of manufacturing and installation also depend on this.

Metal ceramics

The product has a metal frame and is covered with ceramics on top.

Metal-ceramic crowns are suitable for installation only in adult patients.

Metal composite

The crown frame is made of an alloy of chromium and cobalt. From above it is covered with a photopolymer composite: while it is soft, it is given a shape, after which it is fixed with UV rays.

People with metal-composite crowns need to follow a diet to prevent artificial teeth from changing color. It is not recommended to consume drinks with dyes and foods with a high pigment content.

Golden

The oldest material for making crowns is gold.

It is best to install gold crowns on the back teeth, where they will be almost invisible.

Zirconium dioxide

Modern material for crowns is zirconium dioxide. It is durable, aesthetic, does not cause allergies and lasts a long time. But it has a fairly high cost, so it’s not suitable for everyone’s budget.

Metal-free

Modern synthetic materials can completely replace metal in the composition of the crown. They are no less durable, and look as close as possible to natural teeth.

Ceramic

The best way to choose the color of a crown is when it is made of ceramic. They do not look artificial, as they are quite transparent.

They are great for replacing incisors. But for chewing teeth, ceramic crowns are too fragile and cannot withstand such a load.

Porcelain

Porcelain crowns are not so popular, but are gradually becoming more and more in demand. They are easily and firmly fixed, which reduces the risk of loosening. Porcelain products last a long time, do not deteriorate due to temperature changes and are not stained by food. In this case, the crown can be made in an anatomical shape, repeating the relief of the tooth as accurately as possible, which ensures comfortable wearing. They look very aesthetically pleasing and are also hypoallergenic.

One of the disadvantages is their loose fit to the tooth, which can cause cervical caries. Crowns are quite fragile and can destroy adjacent healthy teeth. The product is not suitable for patients with thin enamel. In addition, the cost of such crowns is quite high, which is not affordable for everyone.

Combined

By combining several materials, it is possible to create crowns that combine their best properties. The product is suitable for use on front and back teeth: they look aesthetically pleasing and can withstand chewing loads. But such crowns are short-lived because they quickly wear out and sometimes become deformed. But their installation does not cause a blow to the budget.

Plastic

Plastic crowns are used as a temporary measure. They are manufactured on site and installed on the same day in place of the extracted or treated tooth. The cost of such crowns is low. But it is impossible to use them as permanent ones, since they cannot withstand prolonged chewing load.

Pros of ceramics

Engineers and chemists of large concerns for the production of dental materials (mostly German) are very hardworking and purposeful people. This is not a common stamp - I was convinced of this from my own experience, watching the evolution of ceramic crowns from Ivoclar Vivadent for 15 years. This is not an advertisement - this name means little to the average person, and dentists do not trust advertising. Over the years, the company has come a long way from really fragile crowns in the 2000s (the instructions said so - only for front teeth, with a bunch of contraindications) to the modern material e.Max (Imax, emphasis on the letter I), which in most cases regions is crowding out the former grandee - zirconium dioxide.

Let's list what makes Emax so remarkable:

• Strength. Allows you to make not only crowns, but also bridges. Not only for front teeth, but for any teeth. There is enough strength to spare.
• A huge selection of colors, transparency options , the possibility of individualization either by simple painting or by applying additional layers of ceramics (this is the finest work on the verge of craft and art, in some cases up to 15 layers of ceramics are used, achieving incredible naturalness).
• Possibility of manufacturing individual implant abutments. The abutment is the outer part of the implant; the crown rests on it. There are two options for their use - standard titanium abutments manufactured at the factory (there is no time for aesthetics here, the strength or complexity of the design is important) or individual abutments. If you make such an abutment from Imax material, the crown on the implant (by the way, it can also be Imax) will be more aesthetically pleasing.
• Emax has brought digital technology directly to the dental chair. Now the doctor can make crowns on his own and in one visit . The aesthetics and strength are the same, the accuracy is higher - the human factor is reduced to a minimum. This technology is called CEREC (Cerek, emphasis on the first syllable), in conjunction with modern ceramic materials, it is incredibly convenient for both the doctor and the patient.
• The crown is bonded to the tooth (dentists call this bonding) by creating a chemical bond between the ceramic, adhesive luting cement and the tooth tissue. This connection is absolutely sealed and durable.

Types of crowns

The number of missing teeth, the presence of dentures and other individual characteristics of the patient determine what type of crown is suitable for him. It is impossible to determine this in absentia, since it requires an examination by a specialist.

Bridges

Suitable for people who have lost more than one tooth. The prosthesis is made for all missing units, and its parts are connected by a metal bridge. To secure the crowns, you need healthy chewing teeth. Only complex prosthetics are performed in this way.

Implant supported crowns

If the patient has implants, the crown can be secured to them. This will prevent the destruction of healthy teeth, which can occur due to excess stress. But the method is only suitable for those who already have implants installed.

Crown for one tooth

If one tooth is destroyed, a crown can be installed only on it. This usually happens after deep caries or injuries. Before installing a crown, the condition of the periodontium, jaw and gum tissue is assessed. Sometimes additional operations are performed to build up the bone plate.

Fixation with a pin

The rarest method of prosthetics is installing a crown on a pin. It is quite traumatic and carries a risk of complications, so it is almost never used. If other methods of prosthetics are not available to the patient, the crown is installed on a pin, but this is done in several stages under the supervision of specialists at each of them.

Dental clinic No. 2

According to dentists, owners of crowns installed ten or more years ago need to seriously think about

what impact they have on health. The metals that were used in those days to make crowns oxidize in the oral cavity and provoke associated diseases - from stomach ulcers to oncology. It is not surprising that many diseases supposedly arise without a reason and cannot be completely cured. Few doctors pay attention to the composition of the crowns in the patient’s mouth. Therefore, dentists urge you to take this issue more seriously. Orthopedic dentist Rafael Aleksandrovich Shakhnazarov tells more about the composition of crowns and the reasons for their replacement.

Why can old crowns be harmful to health?

Very often in my clinical practice there are cases when patients come with a complaint about the inadequacy or unaestheticness of bridge-like prosthetic crowns on teeth made earlier: either many years ago, or recently made. Crowns, which were manufactured more than 10-15 years ago in our country, did not always meet the requirements of orthopedic dentistry.

What metals are old crowns made of?

The composition of the crowns, in particular the metal of these crowns, often did not even meet the technical standards for the manufacture of crowns. These are nickel-chrome, nickel-palladium. Accordingly, nickel is a cheap metal, but it has many disadvantages. Its main disadvantage is very strong oxidation. In the oral cavity, oxidation occurs excessively. The oral cavity is the beginning of the digestive tract, and all ions and metal oxides will travel further along the digestive tract, ending up in the stomach and intestines. Several years ago, the Ministry of Health adopted a resolution to extract this metal from dentistry. Nickel has a very strong destructive effect on the gastrointestinal tract, which leads to the formation of ulcers in the stomach. Accordingly, stomach ulcers may occur. And what is important, nickel has a very strong effect on the development of cancer.

What materials are used in modern crowns?

In modern dentistry, slightly different materials are used. The most common metal in modern dentistry is cobalt, which is used together with chromium, cobalt-chromium alloys, from which modern metal-ceramic crowns are made. Very often patients come, as I said, with the desire to replace old crowns. It happens that there is a fairly large number of old crowns in the oral cavity. And we always tell patients: if you want to change the crowns in the oral cavity, if you have crowns made of nickel-chromium alloy in the oral cavity, then it is necessary to remove all the crowns with a one-time replacement with permanent modern crowns or with periodic replacement, respectively, with the production of a temporary one designs.

Why do you need to change all the crowns at once?

Sometimes in my practice there were cases when doctors changed only part of the crowns, and left part of the old ones. Very often, the patient experienced cases of the effect of galvanization of different ionic metals, when the patient feels constant or periodic tingling in the oral cavity, which does not go away by any means: neither ointments, nor mouth rinsing. These complaints went away only after either the old crowns were removed, or all the crowns in the oral cavity were completely changed and all the crowns were made from the same material.

Recommendations for patients

Our oral cavity is a biosystem in which all components must be compatible. This means that any orthopedic intervention, any other dental treatment must be biocompatible and not cause harm to the body. Crowns must be made of the same metal.

Methods for making a crown

Orthodontic products can be manufactured using several methods. Each of them has its own advantages and disadvantages.

Cast products

Strong and durable crowns are made using casting. For this, a single piece of metal is used. The method is not suitable for all materials.

Stamped

More affordable, but less durable prostheses are made by stamping:

• a mold is placed into the dental anvil;
• using rubber rings a stamp is obtained;
• the crown is made using special hammers that differ in shape and size;
• The product is given its final shape using small tongs.

Such crowns last less than cast ones, but are much cheaper to produce.

Why do you need to change crowns or dentures?

Installing a crown is one of the ways to restore a tooth in case of its destruction. A “cap” is placed on a support (for example, on the preserved part of the root), repeating the shape and size of a healthy tooth. Thanks to such a prosthesis, it is possible to restore the functions and aesthetics of the dentition. However, crowns have their own service life, depending on the material and workmanship.

Over time, the product loses strength and changes shape, which can lead to irritation of the gums and a constant feeling of discomfort in the oral cavity. In addition, the surface of the crown absorbs dyes contained in food and drinks and gradually darkens, standing out against the background of the dentition.

When should crowns be replaced?

Dentists recommend replacing outdated crowns every 5-7 years, but in some cases replacement may be required earlier. You should not postpone a visit to a specialist “for later” if:

• the support on which the prosthesis is attached is destroyed. This is usually caused by the development of caries. The remaining part of the tooth gradually dies, and the crowns lose their fixation strength.
• soft tissues in contact with the crown become inflamed. The gums become red and swollen and become painful when touched. This is often due to a gradual change in the shape of the prosthesis and its wear.
• The roots are exposed and pieces of food begin to get stuck under the crown. This situation not only causes discomfort, but can also cause gum infection and tissue inflammation.
• the prosthesis has chipped or changed color. This situation occurs when using low-quality dental products.

The need for early replacement of a prosthesis can also be caused by individual intolerance to the materials used in its manufacture or a violation of prosthetic technology. Therefore, before carrying out the procedure, it is necessary to take a responsible approach to choosing a crown and entrust its installation to an experienced and qualified specialist.

Materials for making crowns

The service life of dentures depends on the materials used. If a few years ago most patients chose gold or steel products, now many prefer ceramics and metal ceramics.

Ceramic (or “porcelain”) crowns do not differ from “their” teeth, do not darken over time and do not require special care. It is also worth knowing that they are quite fragile, so they are usually used for the restoration of incisors, which are subject to less stress compared to molars. Metal ceramics are a more practical solution. The ceramic layer in metal-ceramic dentures is applied to a steel frame, thereby achieving the necessary strength and attractiveness of the product.

What should I replace the crowns with?

Most often, the patient is faced with the need to replace the existing prosthesis due to partial or complete destruction of the support, which makes further fastening of the crown impossible. In this case, several options are offered for replacing lost dental tissue:

• removable prosthetics. Thanks to this technology, the lack of both one tooth and a whole row is compensated, while the cost of the procedure remains relatively low. But a removable prosthesis causes significant discomfort to its owner: it can rub the tissues of the prosthetic bed and fit poorly, and its service life rarely exceeds 3–5 years.
• fixed bridge prosthetics. The “bridge” rests on two living or implanted teeth and returns lost functionality and aesthetics to the dentition. The prosthesis does not cause any discomfort to the owner (if the fixation technology is followed) and does not require special care.
• implantation. One of the most reliable, but also expensive options. The implant is indistinguishable from a regular tooth and lasts twice as long as bridges.

Each option has its own benefits, so it is recommended that you consult with your doctor before making a decision. The specialist will take into account not only the features of a specific procedure, but also the patient’s health condition and select the optimal technology and materials.

How a tooth crown is made

Before starting to make the prosthesis, the size and shape of the product are determined. To do this, the patient undergoes:

• examination by a doctor;
• general and targeted x-ray diagnostics;
• 3D - visualization on a computer screen of the entire jaw and a specific tooth.

Then the doctor selects the material from which the crown will be made. It depends on which tooth needs to be replaced, the age of the patient and his financial capabilities.

To accurately manufacture the prosthesis, an impression of the jaw is taken. For this, gypsum or a similar synthetic material is used. The resulting model is sent to the laboratory.

Preparing for installation

A crown cannot be placed on an unprepared tooth. He must be completely healthy. If you have inflammatory diseases of the oral cavity, they need to be cured before installing a crown.

Then the teeth are ground down. It is performed under anesthesia, so the patient does not experience any discomfort. This procedure is carried out to ensure that the denture fits perfectly and no food remains get stuck under it. It also allows you to equalize the width of the neck and middle of the tooth. This way the prosthesis will be firmly fixed, which will prevent loosening.

Only 1-2 mm of enamel is removed. The depth of treatment depends on the selected crown material: metal-ceramics require more space, and ceramics are quite thin; a very thin layer is removed to install it.

In some cases, depulpation is performed. The patient is warned about its need in advance.

If the tooth is severely damaged, a core inlay is installed. It separates the internal tissues from the crown, allowing you to avoid pain while wearing it.

Upon completion of all manipulations, a temporary crown is installed on the tooth. It is made in the dentist's chair. The design protects the prepared area and restores its aesthetic appearance.

Alarm bells

The Achilles heel of all fixed dentures is the area of ​​contact between their edge and the gum. This is where the pathological process most often begins. Pieces of food penetrate into the gap formed after cement dissolution, causing rotting and proliferation of microorganisms.

By the way, experts still do not have a common opinion on how best to constructively design this place. When grinding a tooth, is it necessary to make a circular ledge where the lining of the combined structure should end - at the level of the gum edge or slightly into the space between it and the neck of the tooth?

An experienced doctor only needs one look at the crown to understand whether it is time to replace it or not. But to find out the condition of the tooth root, an x-ray is needed.

In general, the following factors are considered when assessing the condition of a product and deciding to replace it:

• Patient complaints of discomfort and pain.
• Long service life.
• Loose fit to the tooth stump, destruction of the cement connecting them.
• A large amount of dental plaque.
• Hyperemia (redness) of the gums at the site of contact, swelling, exposure of the root, painful reaction to pressure.
• Violation of the occlusal relationship with the antagonist tooth.
• The presence of perforations on the occlusal surface.
• Poor condition of the periodontium and tooth root according to the results of radiography.

In addition, replacement may be necessary when adjacent teeth are destroyed, when it becomes advisable to install a bridge prosthesis on the entire group.

First signs

When going to the doctor, the patient usually already has a definite opinion about the condition of his crown and assumes one or another action from the doctor. At the same time, his self-diagnosis may be erroneous. What should you pay attention to first of all, what signs may indicate that it is time to change the crown?

• Discomfort or pain in the tooth when biting.
• Constant food getting stuck under the product.
• Mobility of the structure.
• Bleeding when brushing teeth.
• Bad breath.
• Change in gum color (darkening).

Any of these symptoms should be a reason to see a doctor, and the sooner this is done, the better.

Let's find out together whether it is possible to put a crown on a living tooth, and what experts think about this.

In this publication we will discuss which crowns are best placed on implants.

Here https://www.vash-dentist.ru/protezirovanie/nesemnyie-p/koronki-np/skol-keramiki-kak-ustranit-defekt.html we will tell you what materials are used to restore chipped ceramic crowns.

Installation process

The crown is installed in several stages. The number of visits to the doctor depends on the condition of the teeth and the chosen prosthetic method.

Laboratory stage

A cast of the patient's jaw is sent to the laboratory to create a plaster model of the jaw. After complete drying, the desired part is cut out. Using it, a wax prototype is made.

The model is fixed on the base and filled with a special mixture. It goes into the oven for 4-5 hours. The resulting mold is immediately filled with the alloy while it is hot. The future crown is left in this form until it hardens completely. The piece is then polished and sanded to achieve the perfect shape.

Removing the temporary structure

When the permanent crown is ready, the temporary structure is removed. It only takes a few minutes, after which prosthetics can be applied.

Installing a crown on a tooth

Before fixing the crown, a fitting is performed. If it is uncomfortable or the enamel color is not suitable, it is sent for revision. When the crown is perfect, it is secured with cement. The strength of the fixation must be checked after the material has hardened.

Monitoring the situation after installation

After fixing the crown, the doctor checks how correctly it is installed. To do this, an x-ray is taken. Only after his assessment can the patient go home. If you experience strange sensations, you should call your dentist to clarify your condition and the need for a second visit.

Our advantages

At the Beryozka clinic, the material for the crown and its type are selected individually. Each patient is given an approximate treatment estimate so that he can clearly see what he is paying for. A transparent work system, professionals, the latest equipment and materials ensure the ideal result of prosthetics at the Beryozka clinic. A polite attitude and the ability to quickly get an appointment are the key to pleasant emotions from visiting a dentist.

No. 8 Question and answer: Questions from patients about prosthetics and implantation

– How can you determine when it’s time to change the crown? The tooth is not bothering me yet, but I don’t remember how many years the crown has been in place!

– Only a doctor can tell you during an examination whether the crown needs to be changed or not.
For this purpose, we recommend preventive examinations every six months. The fact is that there is no exact service life of artificial crowns - there is data obtained from examinations of a large number of patients who come for appointments for prevention. These periods range from five to seven years, depending on the materials used in the manufacture of the crown, on the qualifications of the doctor and dental technician who performed the work, as well as on the load, care, daily hygiene, and bite of the patient. The need for replacement is explained by atrophy of the bone tissue of the alveolar process, which occurs with both natural teeth and crowns, which entails a change in the position of the marginal gum. As soon as the gum exposes the edge of the crown, the latter becomes not completely sealed, and salivary-gingival fluid begins to get under it. Further, the salivary-gingival fluid increasingly washes away the cement on which the crown is fixed. As a result, microbial flora begins to enter there, affecting hard tissues. The crown can remain in this condition for a long time, sometimes up to 15 years, but after it is removed, the unfavorable outcome of just such a long wearing or use of the crown invariably leads to tooth loss. Therefore, we ask patients to come regularly for preventive examinations of orthopedic structures. As soon as their failure is discovered, a replacement is proposed. This is not the loss of supporting teeth, but only the replacement of an orthopedic structure, which will again hermetically close the crown part of the tooth, which will make it possible to save it, and not go along the long path - removal, implantation, restoration with a crown. – I plan to replace my “ancient” bridge with implants, but I don’t want others to know about it.
Is it possible to cover the implants with a crown immediately after installation so that missing teeth are not visible when smiling? – It is extremely rare that when a patient wants to perform this manipulation, the doctor may refuse him. Nowadays, the technology for instant restoration of damaged crowns, bridges or natural teeth is so developed that they can always be restored in the shortest possible time. Most often this is done day after day while the patient is in the doctor's chair. This happens almost instantly: first, an impression is taken of the prosthesis that is in the mouth, then the bridge or crown is removed, then a bridge is restored from fast-hardening plastic, which can remain in the oral cavity for a short time, and then it is changed to a laboratory prosthesis and a temporary structure. Now we even insist that patients do not walk without temporary structures, since with their help the correct chewing load is restored. In the absence of temporary structures, increased load most often falls on the front teeth, which entails loss of bone tissue, exposure of roots, and ultimately weakening of teeth that were in the oral cavity under nonspecific pressure.

Pros and cons of crowns

All medical procedures have both pros and cons. Before you decide to install crowns, you should compare the pros and cons.

Advantages

The advantages of using this method of prosthetics are much greater than the disadvantages. The advantages of installing crowns include:

• preventing the destruction of pulpless teeth;
• preservation of a living tooth even with partial destruction;
• restoration of the ability to chew food normally;
• restoration of an aesthetic appearance while smiling;
• prevention of diseases of the gastrointestinal tract, which can be caused by insufficient chewing of food;
• restoration of the ability to speak clearly.

Due to the large number of advantages, the procedure has become so popular among patients.

Flaws

The procedure for installing crowns has its disadvantages. Flaws:

• the need to grind healthy parts of the tooth;
• limited period of wearing a prosthesis;
• inability to carry out the procedure with a damaged root;
• the need for regular visits to the dentist for monitoring.

The disadvantages of the procedure are offset by its advantages. Therefore, crowns remain the most popular way to restore the integrity of the dentition.