How to place a crown on a tooth: a detailed overview of all stages of treatment


A crown is the name in dentistry for a prosthesis that is placed on a tooth, on an implanted implant, or included in the structure of a dental bridge. With the help of dental crowns, you can restore severely damaged or lost teeth, the restoration of which must be carried out urgently and for this you must contact a dentist.

How the crown will be installed, whether it hurts to put a crown on a tooth - we will answer all these questions in detail in our article.

When is it necessary to put a crown on a tooth: indications for restoring teeth with a crown

The need to place a crown on a tooth may arise in the following situations:

  • The tooth is severely damaged by caries. If the natural crown of a tooth is damaged by more than 50% by caries, then it would be more correct to put a crown on the tooth rather than restore it with a filling. Large fillings do not withstand the chewing load well and may fall out or break, and the tooth may break along with the filling. If the root of the tooth is damaged, then it will have to be removed. By placing a crown on a decayed tooth, you have the opportunity to save it;
  • The tooth is destroyed as a result of trauma. If the roots of a tooth were not affected by injury, it is possible to restore the tooth - it will be enough to put a crown on it;
  • You can also put a crown on a tooth for aesthetic restoration: for example, if a tooth is chipped or its enamel has changed color, becoming gray or yellow, and this defect cannot be eliminated by classic whitening.

Doctors recommend placing temporary crowns to preserve teeth for patients with periodontitis. In this case, crowns prevent teeth from becoming loose and falling out.

In your case, do you need to put a crown on your tooth or is it possible to use another restoration method? The doctors of our dental clinic in Moscow, “Firadent,” can help you find the answer to this question. To make an appointment with our specialists, you just need to dial our dental clinic’s phone number!

Restoration method - one-stage implantation immediately after root removal

Single-stage implantation of a front tooth involves immediately installing an implant into the socket after tooth extraction. For this type of implantation, special dental implants with aggressive threading and a high degree of primary stabilization are used. On the same day, immediately after implantation, a temporary plastic crown is installed. This implantation allows you to solve two problems - removing a broken tooth root and closing a cosmetic defect. In addition, the method allows you to save a little, because... Some manipulations are not performed (for example, the gum former is not installed).

After 3-4 months, when osseointegration of the implant is complete, permanent crowns are installed. Just as in the case of conventional crowns, from an aesthetic point of view, the best solution for the front teeth is the use of ceramic crowns and, accordingly, abutments. It is preferable to install the crown on a zirconium dioxide abutment, then in any type of lighting the crown will not stand out from the general row of teeth. In our opinion, this option for restoring a broken front tooth is the most optimal.

I need to put a crown on a tooth: is the treatment painful?

Statistics show that most people, knowing that they need to put a crown on a tooth, still postpone their treatment for fear of visiting the dentist and the pain that supposedly cannot be avoided with dental prosthetics. Does it really hurt to put a crown on a tooth? Let's look at this issue together.

So is it painful to put a crown on a tooth or not? The most painful stage in the process of installing a crown on a tooth will be the preparation, during which the teeth are treated for caries, depulped (if necessary), and also ground down to the thickness of the future crown. All these procedures are not performed without anesthesia, as they can cause quite severe pain to the person.

Before you begin to treat and prepare the tooth for placing a crown on it, the doctor will definitely perform an anesthesia procedure using a local anesthetic. The type and amount of the drug are selected individually for each patient. The use of anesthesia makes the process of preparing the tooth for crown installation painless.

If the patient experiences a literally panicky fear of dentists, in our dental clinic “Firadent” he may be offered dental treatment in his sleep[/anchor], under sedation. Sedation should not be confused with general anesthesia; it is a light medicated sleep in which the patient will remain during treatment. Sedation allows you to relieve the patient not only from pain when preparing teeth for prosthetics, but also from psychological discomfort and stress! Moreover, after sedation there are no negative side effects, which are not uncommon after general anesthesia.

You can read all the details on dental treatment during sleep in a separate article on our website, which is devoted to sedation, or find out during a consultation with the doctors of our clinic - “Firadent”.

An alternative to implantation is autotransplantation of wisdom teeth

Don't rush to remove your wisdom teeth. Firstly

, there must be clear indicators for their removal.
Secondly
, you don’t need to follow fashion, trends and delete eights just because “a girlfriend or friend deleted them and it’s cool.” There are a number of moments in life when wisdom teeth come to our aid.

It is not for nothing that nature has created a number of organs that duplicate each other in our body, for example, we have two lungs, two kidneys, which in case of problems with one lung/kidney come to our aid. Also with wisdom teeth: if a person (for some reason) has problems with the chewing group of teeth, for example, caries has destroyed the sixth or seventh tooth, then eights can come to the rescue. How so? After all, wisdom teeth are not involved in the chewing process. Yes, you are right here. But a wisdom tooth can serve as a donor, and it can be transplanted into place of a tooth with destroyed roots. Fantastic? No, advanced technologies in dentistry. This is called autotransplantation.

In the following video we show in detail the dental transplant surgery. The roots of two sixths of the patient's teeth had just been destroyed, and they were replaced by the patient's own wisdom teeth. And, by the way, this patient at the end of the video gives a detailed review after 1 year after the operation. Look, this is useful:

Initial examination and diagnosis

The decision that a crown needs to be placed on a tooth is made by an orthopedic dentist after examining the patient’s oral cavity and teeth, as well as performing a number of diagnostic measures. Based on the data obtained, the orthopedist will develop a treatment plan, which may include not only the installation procedure itself, but also a number of additional measures:

  • Professional oral hygiene, which allows you to clean your teeth from plaque and tartar;
  • Removal of severely damaged teeth that cannot be properly treated and restored with a filling;
  • Treatment of caries and any other diseases of the teeth and gums diagnosed during examination;
  • Tooth removal, treatment and filling of canals.

Note that depulping a tooth before placing a crown on it is not always done. The depulpation procedure involves removing the dental nerve, after which the tooth becomes more fragile and vulnerable to external factors. If a tooth has more than one root and is in good condition, doctors prefer not to remove the dental nerve and put a crown on a living tooth.

When drawing up a treatment plan, the question of what kind of crown will be placed on the tooth is also decided. Modern dental crowns are made from different materials and there is always the opportunity to choose the version of the prosthesis that will most suit the patient in terms of aesthetics, price and durability.

The drawn up treatment plan is agreed with the patient and after agreement the treatment process begins. The first step is to prepare the tooth for the installation of a crown.

Is it painful to install a metal-ceramic crown?

Installing a metal-ceramic crown is a completely painless process.
The only unpleasant moment may be taking impressions with impression material, especially if you have an increased gag reflex. In this case, it is better to resort to 3D prosthetics CEREC.

Preparing to install a dental crown

Preparing for a dental crown may include the following procedures:

  1. Professional teeth cleaning. Removing tartar and plaque from the surfaces of teeth will help you accurately select the color of the future crown, as well as identify primary caries and other diseases that are important to cure before placing a crown on the tooth.
  1. Treatment of caries, pulpitis, periodontitis, and gum inflammation. You can’t put a crown on sick teeth!
  1. Treatment of the tooth on which a crown will be placed. During this process, the doctor will drill out the tooth and remove all tissue affected by caries. If necessary, tooth depulpation is carried out, as well as treatment and filling of dental canals.

IMPORTANT: Dental canal treatment must be of high quality! If during the treatment of the canals the doctor makes a mistake, does not remove all the tissues affected by inflammation, or fills the canals incorrectly, the tooth may begin to hurt already under the crown, and then it will have to be removed and treated again! In our dental clinic “Firadent” in Moscow, treatment of tooth canals is carried out under a microscope with an optical device, which allows the doctor not to act at random, but to accurately see the length and internal space of the dental canals, and therefore carry out the procedure with impeccable quality.

After filling the canals, the tooth is restored with a filling and the next stage in prosthetics begins - turning the tooth under a crown.

Installation cost

Prices for installing crowns vary greatly. The variation is due to the materials of the prostheses, their quality, the pricing policy of clinics and the skill of the doctor. In Moscow the cost is as follows:

  • temporary plastic: minimum 800 rubles, maximum 7,500 rubles, average – 1,500 rubles;
  • metal: for alloys of cobalt with chromium or nickel 1,500-4,000 rubles, the price of a titanium structure reaches 20,000 rubles, gold products will cost 10-15 thousand rubles.
  • metal-ceramic: minimum 5,000 rubles, on average – 10-12 thousand rubles;
  • metal-ceramic of improved aesthetics with shoulder mass: 12-16 thousand rubles;
  • all-ceramic: from 12,000 rubles, on average – 25,000 rubles, in some clinics the cost reaches 50-70 thousand rubles;
  • zirconium: minimum 15,000 rubles, on average – 25-30 thousand rubles, in a number of dentists the price of the service reaches 40-55 thousand rubles.

Some dentists include in their price list turnkey prices for the preparation, production and installation of crowns. The latter indicate only the cost of the prosthesis itself. And preliminary treatment is always calculated separately for each patient.

Grinding a tooth for a crown

Before placing a crown on a tooth, the tooth must be ground to the thickness of the future prosthesis. This procedure in professional dentistry is called “preparation”. The enamel of the tooth is ground down with a drill and during the treatment the doctor will give the tooth a shape that will allow the crown to be placed firmly and tightly.

IMPORTANT: Grinding of live teeth can be quite painful, so local anesthesia must be administered before performing this procedure. If the tooth was depulped before grinding, local anesthesia may not be used, the procedure will not cause pain.

When preparing teeth, a layer of tissue is removed from the tooth before placing a crown. The thickness of the layer will depend on how thick the crown will be. A minimal layer of tissue is removed from the teeth for cast crowns; a significant layer of tissue must be removed from the tooth if it is decided to install ceramic or metal-ceramic crowns. On average, during the grinding process, about 2.5 mm of tissue is removed from a tooth on each side.

As a result of tooth preparation, a core base (stump) is obtained, on which the doctor will place a crown.

Types of materials for stump inlays

According to their structure, stump inlays in dentistry are divided into cast stump inlays and collapsible stump inlays. Non-separable stump inlays consist of a stump part and 1 - 2 pins, therefore they are used for prosthetics of teeth that have no more than two channels. Collapsible stump pin inlays differ from cast stump pin inlays in that they are used for teeth that have 3-4 canals, and are equipped with a corresponding number of root pins, which are specially made removable, since otherwise it will be impossible to insert them into the root canals. Depending on the materials of the stump inlays, the following types of these microprostheses are distinguished, described in the table below.

Metal stump inlayThe metal stump inlay can be made of an alloy of chromium and cobalt; there are also silver stump inlays and gold stump inlays. They are reliable, but not aesthetic, therefore, in modern dentistry, gold core inlays and silver microprostheses are used quite rarely and only for prosthetics of chewing teeth.
Metal-ceramic core inlayA core inlay made of metal-ceramics is quite strong, but its quality is worse than that of inlays made from other materials due to the difference in thermal expansion of metal and ceramics. Therefore, such microprostheses often fall out.
Ceramic core inlayA ceramic core inlay best preserves the aesthetics of a smile, since ceramics in its properties and appearance are as close as possible to natural tooth enamel. In this regard, the stump inlay for the front tooth is made from this material.
Zirconium core inlayThe advantage of such structures is not only their high strength, but also the white color of the stump inlay made of zirconium dioxide, which does not show through the crown. Therefore, as an answer to the question “Which stump inlays are better?” Along with a ceramic inlay, we can safely call a pin-stump inlay made of zirconium oxide or dioxide. Thus, the stump inlay for the front tooth can also be made from zirconium.
Composite stump inlayA type of core inlay with a pin that adheres to the tooth tissue better than others, but is not strong enough compared to inlays made from other materials.

Making crowns

Crowns are made from an impression that is taken from the prepared teeth. To obtain this impression, the orthodontist will use a special plastic mass. Based on the impression taken, the laboratory will first make a plaster model of the prosthesis, and then a crown, which will be placed on the tooth.

Modern dental crowns are made from different materials: metal, ceramic, metal-ceramic and zirconium. The timing of the production of the prosthesis will depend on what kind of crown it is decided to place on the tooth. Crowns made of ceramics and metal-ceramics take the longest to produce. So that a person does not have to walk without a tooth during the entire time of making the crowns, a temporary plastic prosthesis is put on the tooth.

IMPORTANT: Temporary plastic crowns help hide a defect in the dentition; a person will not have to be embarrassed by the absence of a tooth and experience stress for this reason. Also, temporary dentures help protect a ground and therefore weakened tooth from the negative effects of environmental factors and bacteria.

What is the difference between a pin and a stump inlay?

The fundamental difference between a pin and a stump inlay is that it is placed under a filling. Previously, a similar technique was used to treat severely damaged teeth when it was not possible to install a crown. Subsequently, this method discredited itself with a large number of complications in the form of secondary caries. Moreover, detecting a carious process under an extensive filling on a pin was quite problematic. Often, such treatment led to severe damage to the tooth by caries and, as a consequence, to its removal.

Let's compare the disadvantages and advantages of the pin stump insert and the pin presented below:

Pros and cons of the stump Pros and cons of the pin

tabs

  • a tight fit protects the tooth from pathogenic bacteria and the development of secondary caries;
  • withstands significant chewing loads;
  • has a long service life;
  • does not require replacement in case of wear of the artificial crown.
  • established in two visits to the doctor;
  • involves significant grinding of living tooth tissue;
  • costs more than a regular pin.
  • costs less than stump inlays;
  • installed in one visit;
  • involves a smaller volume of preparation of living tooth tissue;
  • unable to withstand the usual chewing load, over time the seal on the pin begins to collapse;
  • the pin can be installed in only one dental canal;
  • a loose fit allows bacteria access into the dental cavity, which provokes the appearance of secondary caries;
  • lasts no more than 2-3 years.

Answering the question “Which is better - a stump inlay or a fiberglass pin,” most experts are inclined to favor dental inlays. Considering the unreliability of installing a filling on a pin, such a service can be found extremely rarely in modern dentistry. The most correct option would be to use a stump tab and then install a crown on it. The choice is due to the fact that this microprosthesis not only strengthens the crown, but also protects the tooth from further destruction throughout life.

Try-on, temporary and permanent fixation of the crown

Before placing a crown on a tooth, it must be tried on. For this purpose, the patient is invited to the clinic. During the fitting, the accuracy of the crown's manufacturing and the tightness of its fit on the stump base are assessed. If the fitting does not reveal manufacturing inaccuracies, the patient does not feel discomfort and is satisfied with the aesthetics of the finished product - a temporary fixation of the crown is performed on the tooth.

What is temporary fixation? This is a kind of “test drive” of the crown. With a crown placed on a temporary basis, the patient will walk for a certain period of time (usually up to 4 weeks). If during this time no defects or inaccuracies are identified in the manufacture of the crowns, the patient comes to the clinic and the crown is placed and fixed with permanent dental cement.

At this point, the crown installation process can be considered complete.

If the crown comes off a tooth...

This also does not mean that the tooth will have to be removed. After all, even crowns with a zirconium frame, an expensive and high-quality material, can fall out. Parting with it is an unaffordable luxury if you have the opportunity to install it again. By the way, if the crown falls out on its own, this is a guarantee that it will not be sawed. Whatever materials are used to make crowns, it is almost always possible to re-attach them to the tooth, only with new cement. The main thing is not to lose the crown and bring it to the doctor.

How to place a crown on an implant?

A crown can be placed not only on a tooth, but also on an implant. This allows you to restore lost teeth without grinding down healthy units in the rows. Crowns on implants are durable, aesthetic, and visually indistinguishable from natural teeth.

Before placing a crown on an implant, an artificial root implantation procedure is performed. As soon as the implant takes root, an abutment is placed on it, and then a crown. Putting a crown on an implant will be more expensive than conventional prosthetics, but the price of the service is fully compensated by the impeccable aesthetics and long service life of both the implant and the crown.

Color selection

Based on the color of neighboring teeth, antagonists and characteristics: shade, brightness, intensity, the required tone for the future crown is selected. It will be uneven, like a natural one. The neck has one undertone, the cutting edge has a slightly different one. By mixing different numbers of colors of ceramic powder, the technician achieves the desired result.

The Vita scale is used in dental practice

, where red, brown, yellow, gray lead the groups, and the tones of each of them are indicated by numbers. 1 - the lightest tone and then darker in increasing order.

Lighting in the office is no less important when determining the color of future artificial teeth. All these points are always taken into account by experienced specialists.

Crown service life

Patients who plan to get a crown are often interested in its useful lifespan. The service life of a crown placed on a tooth will depend on a number of factors:

  • Crown material and technology;
  • The patient’s compliance with all doctor’s recommendations for crown care;
  • Quality of preparation of teeth for prosthetics.

The last factor is of fundamental importance: if mistakes are made during the preparation and manufacturing of the crown, the crown will not last long, and undesirable complications may arise, due to which the crown will have to be removed and re-installed on the tooth. For these reasons, you need to very carefully choose the clinic where you plan to treat and restore your teeth! Remember that the worst type of saving is saving on your own health!

The crown must be placed in a well-equipped dental clinic, staffed by experienced orthopedic doctors and dental technicians. The clinic must use the most modern technologies for diagnostics, treatment and dental prosthetics; only this approach to the choice of dentistry guarantees high quality treatment!

Which dentistry in Zvenigorod is best to choose for prosthetic crowns?

There are many dental clinics in Zvenigorod.
One of them is the dental department of the Istok Health Clinic. The dental clinic has been operating in Zvenigorod since 1992. There are 7 dental offices equipped with the most modern equipment, its own dental laboratory, X-ray room, and sterilization department. Here you can receive a full range of dental services, and you can get an appointment at virtually any convenient time. The Clinic's management closely monitors the quality of services provided and materials used.

How much does it cost to put a crown on a tooth?

How much does it cost to put a crown on a tooth? It is difficult to give a definite and precise answer to this question, because the cost of installing a crown may include various additional but necessary procedures. For example, professional teeth cleaning, treatment of caries or pulpitis, treatment and filling of canals.

The cost of installing a crown will be influenced by both the material and the production technology of the prosthesis. The most expensive options are ceramic and zirconium crowns produced using CAD/CAM technology. But such crowns fully pay for their cost due to their high strength, reliability and aesthetics.

Also, the cost of installing a crown will depend on how it will be placed - on an abutment tooth or on an implant.

The best way to find out how much it costs to put a crown on a tooth is to come to an appointment with orthopedic doctors at our dental clinic in Moscow - “Firadent”. Experienced specialists of our dentistry will conduct an examination and diagnosis and draw up a treatment plan, which will indicate the exact price of the service.

Prices at Doctor Zhuravlev Clinic

Plastic crown (temporary)PC.1000 rub.
Solid crownPC.3600 rub.
Metal-ceramic crownPC.6000 rub.
Metal-ceramic crown on an implantPC.15,000 rub.
Zirconium oxide crown for implantPC.16,000 rub.
Crown based on zirconium oxidePC.13000 rub.
EndocrownPC.12000 rub.
Pressed ceramic crownPC.14,000 rub.
Stump tabPC.3600 rub.
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