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14 September 2021
A dental crown is a prosthetic solution that allows the restoration of severely damaged teeth in situations where reconstruction cannot be performed with a composite material. Crowns can be made of metal ceramics, solid ceramics or zirconium (the most popular options). But they have one thing in common: a properly made crown can serve patients as long as a natural tooth. And the basis of proper manufacturing is proper preparation for prosthetics.
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Prosthetics on “living” teeth
However, with a sufficiently preserved volume of the coronal part of the tooth and an intact nerve, if it is necessary to make a bridge structure, as well as if it is necessary to correct the shape of the tooth, it is possible and necessary to keep the teeth vital (alive).
The classic metal-ceramic crown, widely used in practice by orthopedic dentists, is a combined two-part crown - the frame (cap) of the crown consists of a metal alloy, onto which ceramic mass is applied layer by layer. The technology requires abrasion of a sufficient amount of hard tissue, which is an extremely invasive technique.
Currently, all-zirconium crowns, the so-called, have become widespread. prettau technology (one-piece, without ceramic lining). The advantages of such crowns over classic metal-ceramic crowns are that during preparation a minimum amount of hard tooth tissue is ground off, which, in turn, allows the orthopedic dentist to carry out minimally invasive intervention, does not take the patient out of the comfort zone, and also allows the tooth to be kept vital ( alive).
Doctor of Medical Sciences orthopedist dentist Leonid Yakovlevich Koussevitzky
Sources:
- Samoilenko L. A. Depulpation of teeth in some diseases of the dental system, 1970
- Federal Agency for Technical Regulation and Metrology. Patient management protocol. Partial absence of teeth (partial secondary adentia), 2009
Expert author:
Avdeeva Tatyana Dmitrievna
Dentist-therapist
The information presented in this article is provided for reference purposes and does not replace the advice of a qualified specialist.
At the first signs of illness, you should consult a doctor.
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Cost of tooth depulpation (depulpation)
How much does it cost to depulp an upper front or lower back tooth?
The cost of tooth removal in Moscow on a turnkey basis depends on the following factors:
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- dentist qualifications
- pricing policy of the dental clinic.
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Is it worth putting a crown on a dead tooth?
Sometimes a diseased tooth has to be depulped, which is due to the ineffectiveness of therapeutic treatment of pulpitis. Whether it is worth doing depulpation before installing a crown on a tooth, only the doctor decides based on clinical indications.
The tooth receives all nutrition through the neurovascular bundle, so after its removal only dentin and enamel remain. Dead dentin tissue begins to darken, the tooth becomes fragile and gradually carious deposits form in it, which can spread to neighboring units.
Installing a prosthesis solves two problems at once - maintaining aesthetics and preventing the destruction of a pulpless tooth.
Installing a crown on the sixth tooth
Contrary to popular belief, the first permanent teeth that emerge in humans are molars (we call them sixes). They bear the main chewing load. Due to some reasons: poor hygiene or lack of it at all, untimely treatment, and so on, caries forms and, as a result, tooth decay.
Filling a tooth with a high functional load is not cost-effective and ineffective. Chewing hard foods can cause fillings and tooth walls to crack. Therefore, the best option is to install a crown. It will completely restore the chewing function of the tooth and protect it from further destruction.
The method of prosthetics for the sixth tooth depends on the clinical picture, and the decision is made by the orthopedist. If the tooth decay is severe, then I usually recommend removing the molar and then installing a pin onto which the crown is attached.
If the tooth can be saved, then prosthetics occurs according to the following algorithm:
- Inspection and diagnostics.
- Complete sanitation of the oral cavity is a mandatory procedure, the implementation of which determines the quality of prosthetics. The slightest presence of infection in the patient’s mouth can provoke the emergence of infectious foci in the prosthetic area.
- Tooth preparation, impression taking.
- Fixation of a permanent crown.
Some people think that it is possible to expect the production of a prosthesis with grinded teeth without temporary plastic crowns - such as as long as it takes, if you do not eat too hard food. No and no again! The ground tooth/teeth must be covered with temporary crowns! Typically, the waiting time for permanent crowns and wearing temporary ones is one to two weeks.
When choosing a material for a prosthesis, you need to take into account: where you want to place the crown and the functional feature of the tooth, therefore, to create a crown for the sixth tooth, it is better to use a material with high strength values.
Knowledge and experience of orthopedists
Of great importance in the issue of prosthetics without depulpation is the knowledge of orthopedic doctors about the safety zones of the crown parts of teeth. Safety zones are those areas of the tooth within which you can safely grind the tooth tissue without damaging the pulp.
The canines have slightly more such tissue than the lateral incisors. The age of the patient is also important: the older the person, the less likely the pulp is to be damaged.
Contact our clinic for a consultation on prosthetics without depulpation, and we will definitely find the right solution for you!
Dental prosthetics in our clinic. Types of dental crowns and methods of their manufacture
Do no harm
A patient consulted a doctor with one missing tooth and nearby intact teeth with a high crown.
Upon completion of prosthetics, the patient received a metal-ceramic prosthesis and two pulpless, heavily ground teeth. Such cases come across often. There is another way, the right way - do not depulpate the supporting teeth unnecessarily. This path is more complex, requiring more accuracy, caution, additional materials and a more respectful attitude towards the patient and his teeth. Often patients have the question “Why is it necessary to remove nerves from healthy teeth before prosthetics?” To tell the truth, this is not a mandatory procedure at all. When a patient comes without any complaints and is offered to turn “living” teeth into “dead” ones, deliberately changing their status from “healthy” to “previously treated”, this cannot but cause bewilderment in the patient.
On the other hand, why should the patient pay for such work? And in general, how to justify the need for such “treatment”? What “diagnosis” should be made before performing endodontic treatment on a healthy tooth?
And where is the guarantee that dental treatment will be successful and the doctor will not have to accept claims in the near future? Even with an arsenal of modern endodontic instruments, materials, ultrasonic devices, and sufficient practical skills, it is not always possible to achieve the desired effect.
It is also known that teeth without nerves, called “dead”, become fragile, more susceptible to destructive processes of hard tissues, their shock-absorbing function changes, especially after the widely used resorcinol-formalin method, and this does not bode well for patients.
For dental prosthetics without depulpation, we provide an extended 3-fold guarantee.
