What to do if there are gaps between the crowns?

In recent years, new technologies and materials have constantly appeared in dentistry. This, of course, also applies to the procedure for installing crowns on teeth. But even if the patient chooses the most advanced of these technologies and turns to a highly qualified dentist, this still does not guarantee 100% that the crown will remain in place forever.

Content

• Causes
• What to do if a crown falls out
• What can't you do?
• What to do if you can’t see a doctor right away
• What will the doctor do?
• How to prevent hair loss

The use of modern high-quality and high-tech materials does not make the service life of crowns unlimited. A dental crown has a specific lifespan of 12 years. Sometimes it happens that the crown falls out. Immediately after this trouble, increased sensitivity of the stump may appear. Contact your doctor without delay. If this is not possible, follow your doctor’s recommendations to save the tooth and reduce discomfort as much as possible.

What to do if a tooth crown falls out?

If you notice that the crown your dentist inserted has come off, the first thing to do is not panic.

• Reduce the load on the problematic tooth to a minimum (do not eat, do not chew gum, etc.)
• Do not try to attach it yourself,
• Contact your dentist at Dental Brothers as soon as possible.

During your visit, your doctor will evaluate the crown, perform any necessary diagnostic tests, and determine whether it can be re-cemented. The dentist will determine the reason why the dental crown fell out and take appropriate measures.

Why is this happening

The following reasons for loss are possible:

• The service life of the cement has expired, the composition has lost its fastening properties - the crown has decemented;
• The patient put too much stress on the crown by including hard foods in the menu;
• During installation, temporary cement was used, which had to be replaced at the appointed time;
• A destructive process was underway under the crown - caries developed, as a result, the tightness of the connection was broken;
• The person often consumed chewing candies and toffees - the viscous consistency of the products contributed to the tearing of the crown from the tooth;
• The crown was placed on a tooth that was too small, and the insufficient tooth height reduced the bond;
• The size of the crown exceeded the size of the stump;
• The tooth stump turned out to be pointed, so the crown was weakly fixed;
• The material used to make the prosthesis was not strong enough.

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Reasons for detaching the crown from the implant

The implant system consists of several components. In particular, it includes a titanium rod-screw and an abutment - an adapter on which the crown is fixed. All these elements of an artificial tooth are securely connected to each other and are normally motionless. But sometimes the prosthetic structure first begins to wobble and then falls out. It also happens that the crown suddenly falls off, exposing the metal element underneath. The reasons for this incident could be:

• Poor quality fixation of the prosthesis. The crown is attached to the abutment using a special cement composition. Violations of technology can lead to detachment of the prosthesis.
• Unscrewing the crown-abutment connection. If screw fixation of the prosthesis was used, over time it may become loose and become mobile or fly off.
• Incorrect installation. When choosing an abutment and making a prosthesis, the anatomical features of the patient’s oral cavity must be taken into account. If this is not the case, problems will appear over time.
• Excessive load on the prosthesis. Frequent chewing of too hard and sticky foods, cracking nuts, and the habit of gnawing on hard objects can also lead to disruption of the connection between the crown and the implant.

What to do if it is not possible to see a doctor immediately

• Apply clove oil to the tooth and the pain will decrease.
• Wash the crown and install it on the tooth using cement, which is sold in the pharmacy chain. It is not advisable to do this, but if you contact your dentist and get the go-ahead, you can fix the product temporarily, according to the recommendations of a specialist. You should first rinse your mouth with an antiseptic.
• If necessary, you can take painkillers.
• If the crown falls off and cannot be found, you can simply lubricate the tooth with pharmaceutical cement - this technique will somewhat reduce the discomfort.

Prevention of prosthesis installed on an implant falling out

For the normal service of the implant and crown, it is important to follow the dentist’s prescriptions and recommendations after surgery, as well as follow the rules for using the structures. Correct and sufficient oral hygiene is of great importance. You should not neglect brushing your teeth in the mornings and evenings. After every meal you need to rinse your mouth. You can eat anything, but the side of the implant should be protected from too much stress. It is better not to eat foods that need to be chewed, chewed, or chewed with force.

Possible options

If the old crown can be used, it will be reinstalled using fresh temporary dental cement. The patient will have the opportunity to wear the crown again for some time; if discomfort does not arise, the fixation will be performed with permanent cement. If wearing it is impossible, the dentist will offer to make a new crown and give reasons for his recommendations.

Minor damage to the crown (chips) can be repaired. Significant damage cannot be repaired. A new product will need to be manufactured.

Inlay or pin: which is better?

The choice of support element depends on the specific clinical case. Both the pin and the core tab perform similar functions. However, each solution has its own advantages and disadvantages.

The stump tab is considered a more reliable option for chewing teeth and if it is necessary to install bridges. It is important to understand that this significantly increases the cost of treatment (the price per tab can reach up to 10,000 rubles). In addition, the manufacture of a stump insert requires an additional laboratory stage and appropriate manipulations.

Placing a crown on a pin can be recommended if the tooth does not have serious damage and there is no risk of pin breakage and root canal injury under the influence of chewing load. However, not all pins are suitable for the restoration of anterior teeth, especially if metal-free crowns are used. The crown and post on the front tooth should not contain metal if you want good aesthetics.

When installing a ceramic crown on a front tooth, the core inlay should also be made of ceramic.

Find out more on the topic

We have collected more useful information about why a tooth crown falls out:

• Microprosthetics
• Stamped crowns
• Ceramic crowns

Literature used for the article:

1. Orthopedic treatment of dental crown defects with artificial crowns / S.A. Naumovich. ― Minsk: BSMU, 2011.
2. Method for clinical production of temporary crowns / V.I., Shemonaev, A.A., Maloletkova, O.Yu. Pavlova ― Volgograd scientific and medical journal, 2012
3. Orthopedic treatment with fixed prostheses / Stefan F. Rosenstiel, Martin F. Land, Yunhai Fujimoto. ― Moscow “MEDpress-inform”, 2010

Stages of installing a crown on a pin

1. Initial consultation, determination of indications and contraindications for treatment.
2. Preparation of tooth tissues and depulpation of root canals.
3. Installation of the pin.
4. Taking impressions or 3D modeling. Sending the results to the laboratory to make a permanent crown. Immediately after the procedure, the patient is offered a temporary crown.
5. Trying on the finished product and fixing the crown with a pin.

Dentist's fault and inflammatory processes in the oral cavity

One of the most common reasons for a large gap to appear is a medical error. This can happen due to the crown fitting too tightly to the soft tissue or, conversely, if the installation of the structure is insufficiently strong.

However, a large gap does not always appear due to the doctor’s fault. Sometimes the reason for this is the presence of serious inflammatory processes, for example on the interdental papillae, in the gums or in the tissues that surround the tooth itself. Quite often, complications appear against the background of a general deterioration in a person’s health and when the functioning of his immune system is disrupted.

Other reasons: insufficient oral hygiene, as well as allergic reactions to the drugs and materials used in the work of the master. If the tightness is broken and the strength of the crown fixation decreases, visible gaps may also form over time. In any case, the situation requires immediate intervention by qualified medical personnel.

Temporary crowns

The implantation process involves a fairly long (depending on the protocol) waiting period for the artificial root to take root. During this time, the patient is fitted with temporary prostheses.

Temporary crowns are made from inexpensive materials that do not have sufficient rigidity. If you don't take good care of them, infection can easily get to the tooth. Therefore, in most cases, the reason why a temporary crown on an implant becomes loose is non-compliance with the rules of care and excessive chewing load.

What you can't do on your own

When a crown falls off a tooth, many people think about how to glue it back in place. There can be only one answer - nothing. There is no need to glue it with superglue, BF-6 glue, or special cement for crowns purchased at the pharmacy. You should also not use chewing gum (chewing gum). That is, you need to follow the algorithm described in the section above. There is no need to stick a crown on the tooth even temporarily.

The thing is that there is a high probability of damaging the stump or gum, or even breaking the support. The prosthesis itself can also be damaged. Don't forget that it fits onto the tooth very tightly - and you need to know how to turn it correctly for a perfect fit.

Reasons for release

Prosthetics is a process that involves 3 people: an orthopedic dentist, a dental technician and a patient. Each of them determines how long the restoration will last.

The dentist is responsible for ensuring that the tooth is prepared correctly. The main reasons for loosening as a result of improper tooth grinding:

• The taper of the stump exceeds 30 degrees
  (it is too sharp)
• The height of the prepared tooth is very small ( less than 4 mm
  for molars and 3 mm for other teeth). Metal-ceramic crowns consist of 2 layers: metal and ceramic. They are thick, and the teeth need to be sharpened to fit them. This is especially true for the front teeth, which are already small. Metal-ceramic restorations fall off most often. Preparations for ceramics and zirconium are more gentle. The stump manages to maintain the required height. There are fewer cases of a crown falling off.
• There are no retention elements: stripes and grooves that contribute to better fixation.

The dentist's responsibility to ensure that the crown does not fall out increases if preparation for prosthetics includes the use of pins and inlays. In second place are iatrogenic (medical) reasons for release of fixation are violations of stump restoration protocols.

• Incorrect pin installation
• Incorrect use of tab

The doctor’s qualifications play a role in depulpation (removal of a nerve), taking impressions, and determining central occlusion (the position of the teeth when closing).

The crown manufacturing process takes place in a dental laboratory. This is where a technician can make mistakes:

• Errors in the manufacture of restorations. The workpiece from the inside must exactly repeat the shape of the stump. If this does not happen, the structure will not hold.
• Violation of the finished product processing protocol. The finished restoration is sandblasted from the inside. This is done to create roughness for better adhesion of the surface to the cement. If the technician has done the treatment poorly, the adhesion factor will be low.

After installation, responsibility for the restoration falls on the patient. To prevent the crown from falling off the tooth, you need to follow the doctor’s recommendations:

• Avoid sticky, chewy foods (nougat, toffee, chewing gum). Velcro pulls the restoration along with it, breaking the adhesion between the cement and the surface. This happens gradually, until one fine day we discover that the crown of our tooth has fallen off.
• Do not expose dentures to excessive stress (candy, nuts). If too much pressure is applied, the grip may be damaged or the stump may break.
• Carry out regular care, use dental floss. Insufficient hygiene leads to the development of caries under the denture. In pulpless teeth, this process is painless, so it will be an unpleasant surprise to discover that the crown has fallen off because the tooth has been consumed by caries.
• Carry out professional teeth cleaning. Plaque removal is a standard preventative measure to prevent dental caries. Crowns last much longer on healthy teeth.

In some cases, the crown falls out simply because its service life has expired. There are 2 reasons for this:

1. Over time, dental cement loses its properties
   and can no longer hold the restoration.
2. With age, the contour of the gums changes
   and it sags. A gap forms between the denture and the gum, into which bacteria penetrate. They destroy hard tooth tissue. There is nothing to hold the restoration on; the crown falls out. This is why dentures need to be changed regularly.