What is better - a filling, an inlay or a crown to restore a tooth?

Dental inlays

have been used in dental treatment for a long time, but many people still have not even heard of this technology for tooth restoration.
Meanwhile, a dental inlay is better than a large filling or crown. We decided to talk about microprosthetics with dental inlays with maxillofacial surgeon, dentist Tamara Kazbekovna Alakaeva
.

Tamara Kazbekovna, what is a dental inlay?

A dental inlay is a microprosthetic tooth that completely imitates its missing parts (anatomical and functional). The dentist prepares the tooth, takes an impression and sends it to the dental laboratory, after which the dental technician makes an inlay.

Is a dental inlay an alternative to a filling or crown?

Yes, today a dental inlay is a modern alternative to both a filling and a crown.
The inlay is more durable than a regular filling, since the filling contains various micropores, from which caries develops over time (microflora gradually accumulates in microcracks and micropores, causing the development of carious lesions). The inlay fits more tightly to the tooth, so nothing accumulates under it. In addition, the use of a dental inlay provides a more uniform and correct load on the tooth. Unlike fillings, ceramic inlays do not wear out over time and do not change in color or volume. All of the above qualities of dental inlays are their advantages over fillings and crowns.

The only disadvantages of dental inlays include, perhaps, the higher cost and the longer amount of time required for their manufacture. If a regular filling is installed for the patient directly on the day of the appointment, then the manufacture and installation of the inlay requires at least two visits with an interval of at least 7 days, since the dental inlay is made in a dental laboratory.

But the patient must understand that if the tooth is significantly damaged, then the installed filling will not last long. An inlay costs more than a filling, but it lasts about ten years, and with good hygiene – even longer. Many people change their fillings once a year or even every six months. Therefore, the tab is actually cheaper than several fillings that will have to be installed in its place.

How much does it cost to install one tab?

The price of the inlay consists of the cost of the material from which it is made and the work of the doctor and dental technician. In Moscow, a ceramic inlay for one tooth costs on average from 25 to 35 thousand rubles. In addition to ceramic, metal, plastic, composite, and zirconium inlays are installed. The insert can even be made from noble metals (gold).

It turns out that noble metals are still actively used in dental prosthetics?

Not really. Gold inlays

Usually installed on patients who are allergic to metal.
Such patients do not suspect that they have such an allergy and find out about it after the installation of the structure. Therefore, if a person has never had any artificial structure in the oral cavity, he needs to do an allergy test. Ceramic materials
, which are more expensive than metal, are not allergenic. This is their important advantage.

Composite

- this is a material used to make fillings; dental inlays are also made from it; they are about 30% cheaper than ceramic ones.

Made of plastic

Temporary structures are usually made. If the patient’s tooth is fully prepared for the installation of an inlay, and it is impossible to make a temporary filling, he can be given a temporary plastic inlay.

When is a filling needed?

If less than a third of the tooth is damaged, then in most cases the doctor restores it using filling materials. Modern photopolymer fillings
allow you to recreate the shape and color of a natural crown, add aesthetics to the surface, and adjust the position of the unit.

But in case of serious damage, a large filling is often (!) placed in the cavity, which will not withstand long-term significant loads. If a tooth has been depulped, then over time its walls become fragile and further destruction occurs. When the carious cavity is large, restoring the destroyed tooth crown with a regular filling is acceptable, but does not guarantee long-term preservation.

Design differences

Composite

• Installed in one visit.
• The structure is looser, so over time the shade changes under the influence of food and drinks that have a coloring effect (tea, coffee, red wine, products containing dyes).
• It is necessary to polish systematically (at least once a year).
• The service life is 5-7 years, then an update is required.

Ceramic:

• Installation will require at least 2 visits to the doctor.
• Retains original color and shine throughout the entire period of use.
• Does not require professional care.
• The service life is 10-15 years.

Composite orthopedic plates are 2-3 times cheaper than porcelain ones.

What is a tab

Veneers are used to restore the beauty of the front teeth and strengthen them.

Stump tab

used to strengthen molars. More often it is a mini-prosthesis that completely repeats the shape of the internal destroyed part of the crown. It is inserted into the tooth and secured with a special dental compound.

Such structures are a good way to restore a tooth. The inlay is used when the destruction of the natural crown exceeds 30% and there is a healthy root.

Their service life is 20 years or more, the materials tolerate chewing loads and correspond to the anatomical structure of the tooth. Their shade remains unchanged under the influence of food coloring. There are options:

• Restorative
  , their role is close to the function of a filling. They are attached to the top of the unit without touching the channels.
• Stump mini-prostheses
  . Such a frame is fixed in the channel. Then the tooth is covered with a crown. A post-core inlay can help if the visible part of the tooth has crumbled and only the root remains.

Metal-free tab

– restoration of the dental crown, which is orthopedically justified and aesthetically pleasing. The surface wears out synchronously with the enamel, without any discomfort.

Sign up for installation of dental inlays at a discount:

What is a tooth core?

Stump inlays are structures that enter one third of the tooth canal, restoring the lost part of the tooth from above. A crown is installed on top of the stump inlay, which is made from the material chosen by the patient.

Often there are teeth restored with “extended” fillings on pins. It should be noted here that some dentists install huge fillings on their patients’ posts instead of crowns. Such fillings do not last very long, and they fall out even if you do not chew anything hard. As a result of chewing, this huge filling, together with the pin, goes sideways and breaks the root of the tooth in which the pin was installed. Such a root usually has to be removed. In rare cases, it is possible to install a crown on a broken tooth. This usually happens in cases where the crack is not below the level of the gum.

How long have dental inlays been used on the Russian dental market?

Quite a long time ago, more than 10 years. It’s just that not all patients agree to visit the doctor several times. They want to do everything in one day, so they choose large fillings, fillings on pins (“extended”). Some doctors make concessions to such patients and do as the patients want, but this is wrong. A healed tooth with a large filling will simply chip quickly, and there is a chance of losing the tooth altogether, so it is better to put an inlay on it.

How many tabs have you installed as a specialist?

Hard to say. I've been working with tabs for about five years. We install 10-15 tabs per month. There are patients who need to install several inlays at once, for example, due to increased tooth wear.

Let's summarize our conversation. What is better - an inlay, a crown or a filling?

Everything is done according to indications, but, of course, a ceramic dental inlay is best.

Let me give you an example: I had patients who had a ceramic inlay installed on one side and a metal-ceramic crown on the other. And according to reviews, the inlay is much better, since most often food gets under metal-ceramic crowns and accumulates under them. This may cause an unpleasant odor.

If metal-ceramic crowns were installed, the metal edge may be exposed, which does not add aesthetics.

Patients also do not like large fillings, which shrink after a certain time, and there is a high probability of chipping the tooth wall or caries.

In these cases, tabs are the best option.

Doctor, thank you for the detailed story!

When salvation is a crown

A dental inlay is a way to save a tooth when it is not possible to fill it. If the damage is significant, then a filling or inlay will not help; more reliable protection will be required - a crown

.
Modern designs are durable and help maintain quality of life when 50% or more
of tooth tissue is lost.

Restoring a tooth with a crown (the price is calculated depending on the chosen material) is reliable protection against recurrent caries. Microparticles of food do not get under the crown, pathogenic microflora do not penetrate, and there is no violation of the marginal seal.

Ceramic, metal-ceramic or zirconium crowns on a tooth will become a reliable covering for the thinned, fragile walls of a natural tooth and will protect them from chipping or breaking.

Modern dentistry makes it possible to bring the shade of the crown as close as possible to the natural shade of the enamel, so the presence of the structure is almost invisible. Installing crowns on chewing teeth is an opportunity not to limit your diet, to eat familiar foods without fear of destruction of the teeth.

The main pros and cons of ceramic inlays for teeth

Modern technologies allow us to achieve unique solutions in dentistry. When considering the possibilities, ceramic inlays have the following number of advantages:

• high compatibility – the restoration method may not be suitable only due to a certain number of diseases;
• the surfaces have excellent wear resistance, the coating does not wear out even under the influence of increased loads;
• high similarity to natural tooth enamel, photos of ceramic inlays for teeth can be seen on our website;
• structural strength ensures long service life;
• the procedure can serve as a preparatory step for installing crowns;
• the original shade does not darken or turn yellow, including when eating with coloring substances;
• structures do not shrink and are not subject to polymerization;
• the load is distributed evenly, which also affects the condition of neighboring teeth.

If we talk about the disadvantages, we can highlight the relatively high cost of a ceramic inlay per tooth when compared with a conventional filling, and the restoration course is carried out over several sessions. First, a full examination of the oral cavity is performed, after which an impression is made and a temporary filling is installed. The whole process takes about a week, but the result exceeds all expectations.

Restoring teeth using root veneers

In orthopedics, there are unique possibilities for restoring teeth in cases where only one root remains of a tooth. You must immediately understand that the root tissue of the teeth must be healthy - this is the main condition for 100% tooth restoration. Look at the photo to see what we are talking about - caries-affected tissues are removed and ground down to healthy tooth tissues:

In such cases, veneers with the root part

:

And this is how beautifully, and most importantly, you can reliably restore your teeth:

Patients who encounter such technologies for the first time experience a wow effect, and their smile is not only restored, but becomes incredibly beautiful:

By the way, this clinical example can be viewed in more detail HERE

How stump inlays are made: an overview of the main stages

Stump inlays are made individually for each patient. Treatment begins with an examination of the patient and consultation with two specialists – a general dentist and an orthopedic dentist.

Before an impression is taken from the tooth, according to which a stump insert will be made, high-quality sanitation of the oral cavity is carried out, and all diseases of the teeth and gums diagnosed during the examination are treated. The damaged tooth is treated: the nerve (pulp) is removed from it, and the canals are filled. This is where the work of the dentist-therapist ends and the orthopedist begins to care for the patient.

Further treatment will proceed according to the following scheme:

1. The prosthetist will correctly prepare the tooth for installation of the stump inlay and select its type.

1. When choosing the type of stump tab, the material of its manufacture and the type of tab (single-root or multi-root, cast or collapsible stump tab) are determined.

1. Then the doctor will make an impression of the patient’s jaws, which will be sent to the dental laboratory, where a stump inlay will be made from the impression taken.

1. Based on the impression, a model of the stump inlay is first made, and then a permanent structure is made from the selected material.

1. The dental technician passes the finished stump inlay to the orthopedist.

After the stump inlay is ready, the patient is invited to the prosthetist’s office and the doctor installs the stump inlay in the tooth canals. A temporary prosthesis is put on the tab and a break is taken in the treatment until the crown is made, which the doctor fixes on the stump tab.

Tooth restoration with a crown using metal-ceramics

An inexpensive solution is a one-piece tooth crown. It is durable and justified for molar prosthetics. The durable frame is covered with layers of ceramics. This design is aesthetic and convenient.

Tooth restoration with a metal-ceramic crown is a budget-friendly and reliable way to maintain the health of your teeth. The cost of a crown is 17,900 rubles per tooth. An impression is made that follows the contours of the natural crown, recording the characteristics of the bite, and a frame is created according to the obtained parameters. Each applied layer of porcelain coating is baked under high temperature.

If there is no healthy root, the tooth has long been removed, there are problems with the structure of soft and bone tissues, then the only way to return to your normal lifestyle and maintain health is implantation. Today there are methods for restoring a tooth crown, completely replacing a lost unit - in my clinic the cost of metal-free options is from 27,900 rubles

for a destroyed restored tooth (and
from 34,900 rubles
for a crown for an implant).

I, Dr. Samsakov, will produce ceramic tooth modules of any complexity, post-core and other types of inlays, “crown plus tooth root” modules using CEREC technology - cost from 27,900 rubles. per tooth The process will take about 1.5 hours.

Types of products

Experts distinguish between two main types of orthopedic structures: stump and restorative. A ceramic core inlay is required to restore the tooth core for subsequent fixation of the crown. Most often it is used for prosthetics of incisors. Restorative structures are used for chewing teeth when one or two surfaces are damaged. In addition to high aesthetics, they are characterized by reliability and durability. Also, the tabs are distinguished by the material used. Below are the most common materials from which products are made.

• pressed ceramics. Products are produced using porcelain injection molding. The procedure is carried out under conditions of high temperature and pressure. Compared to orthopedic structures made of metal or zirconium dioxide, they are not as durable, but are ideal from an aesthetic point of view;
• zirconium dioxide. They are made by grinding finished metal oxide blanks. Grinding is carried out automatically using a ready-made impression (plaster model) of a damaged molar or premolar. Thanks to computer control, finished structures are characterized by high quality. Upon completion, the workpiece is fired, fusing the porcelain mass. Zirconium dioxide is a high-tech material for orthopedic structures, and therefore is in special demand. From an aesthetic point of view, such inlays are in no way inferior to porcelain products, and in terms of strength they are not inferior to metal products;
• metal. The metal most often used is gold or a silver-palladium alloy. Such designs are reliable, but do not have high aesthetics;
• metal ceramics. This is the latest orthopedic design, which is distinguished by high aesthetics, but at the same time cannot boast of proper quality. Due to thermal exposure, such products often fall out of the mouth. Most experts advise installing a structure made of zirconium dioxide or pressed ceramics rather than metal ceramics.

Dental care after the installation of a core tab

Stump inlays do not require complex specific care. All you need to do is maintain oral hygiene, brush your teeth regularly and undergo periodic dental examinations and professional hygiene procedures.

To clean crowns installed on teeth with core inlays, it is best to use brushes with soft bristles; it will also be useful to rinse your mouth after each meal - with a special balm or just clean water. When brushing your teeth, it is important to clean them from all sides and be sure to thoroughly clean the interdental spaces. For this purpose, special brushes and dental floss are used.

Indications for dental restoration with inlays

Let's look at all the cases in which the use of tabs may be indicated. It is recommended to use tabs:

• If the tooth is destroyed by more than 1/3;
• With increased wear of chewing teeth;
• When restoring teeth that in the future will have to act as a support for a crown or installation of a bridge;
• For large carious cavities in the teeth, the elimination of which with conventional fillings is ineffective.

The need to use inlays is determined by the dentist during the examination of the patient. Based on the clinical situation, the specialist will choose the type of microprosthesis that is suitable for you, both in terms of functionality and material of manufacture.