Depending on the extent and nature of the tooth loss, there are different solutions available to restore the health of your teeth. Our available solutions include bridges, crowns, inlays, and full dentures.
Crowns
Crowns wrap around the entire surface of a damaged or decayed tooth. They require the entire outer surface of the tooth to be ground down, and the crown placed on top protects and restores the damaged tooth.
Types
Crowns can be divided into two categories, depending on the material they are made of and a distinction is made between temporary and permanent crowns.
Temporary crowns are made for temporary wear only, to protect the tooth stump or for aesthetic replacement. It is usually made of acrylate plastic.
Types of permanent crowns
Metal crowns: can be made of gold or some kind of dental metal – this is rarely used nowadays because of its aesthetic disadvantages.
Metal-ceramic crowns: the crown frame in contact with the tooth surface is made of metal (gold, titanium, or dental metal) and the veneer is porcelain, so that the result is similar or more beautiful than the original tooth structure.
Zirconium porcelain crowns are among the most aesthetically pleasing solutions. In this case, the part of the crown in contact with the tooth surface is made of zirconium and the porcelain veneer is placed on top.
Porcelain crowns (pressed ceramic) are among the most aesthetically pleasing solutions. It is made of pure porcelain. Its disadvantage is that it is more fragile than other types of crowns.
In the case of pure zirconium crowns (“full zirconium” crowns), the crown is made only of zirconium without a porcelain veneer. It is aesthetically preferable and less fragile than crowns with porcelain cladding. The disadvantage is that the unique color shades are less easily achieved than with porcelain veneering.
Tooth preparation:
Teeth can be prepared in the following ways:
Tangential preparation, where only the crown portion of the tooth is thinned at the tooth-gum interface, ensuring an aesthetic gingival seal of the crown being made. This method is easier to perform but can cause gingivitis if the crown surface is not driven under the gingival margin to the correct depth.
shoulder preparation: in this procedure, the dentist forms a thin rim at the level of the gumline. It has the advantage of providing a more precise tooth edge seal, on which the crown will fit accurately, and less risk of inflammation. This method is a more complex procedure and requires a higher level of skill on the part of the technician.
The process of making a dental crown
Step 1:
Grinding the tooth to the correct shape. After preparing the tooth surface, an impression of the tooth is taken in two phases, the relationship between the upper and lower teeth is recorded. This is necessary so that the technician can create a crown of the correct height and color to harmonizes with the opposing teeth. Based on the impression, the technician will make the framework of the crown in two to three days. This can be made of zirconium, medical metal, gold, or titanium.
Step 2:
try-in of the finished framework, during which the dentist checks its accuracy, the relationship between the crown and the prepared tooth, the closure of the framework at the edges and the correct bite height.
Step 3:
the so-called lightless or matte trial is performed on the 2-3rd day after the skeleton trial. At this stage, the crown is almost complete, the technician has already built up the porcelain veneer on the metal frame, but the final layer of porcelain has not yet been applied. At this step, it is checked that the size, shape, and color of the porcelain crown fits harmoniously with the existing teeth. At this stage, the restoration can be modified if the patient wishes.
Step 4:
takes place one day after the matte trial, when the crown, finalized according to the criteria checked in the previous trial, is glued by the dentist to the polished bone. The bonding can be permanent or with a temporary adhesive. In the case of permanent bonding, the crown can only be removed at the cost of mechanical damage. Temporary bonding is used if the patient or dentist is likely to require modification in the future.
Bridges
A technique for filling gaps between teeth, in which the teeth bordering the gap are ground down to hold the bridge they support as a pillar. Bridges, like crowns, are made of porcelain fired onto a zirconium or metal frame.
A technique for filling gaps between teeth, in which the teeth bordering the gap are ground down to hold the bridge that is fixed to them as a pillar. Through these pillars, the crowns are connected by means of the framework, thus creating the bridge, as it is called. Bridges, like crowns, are made of porcelain fired onto a zirconium or metal frame.
The process of treatment
The first step in making the bridge is to grind down the teeth bordering the gap. This is done under local anesthesia.
The subsequent steps of the bridge are the same as for the crowns.
Denture/prosthesis
A convenient, removable, simple solution for the replacement of large and complete tooth gaps.
Complete removable dentures
Complete removable dentures are used when a complete tooth loss has occurred in one or both jaws. The dentist takes an impression as a first step in the process of making the denture, and then, through repeated rehearsals, forms an aesthetically acceptable, high-quality replacement that matches the original bite. A complete removable denture has two parts, a base plate that rests on the jawbone, in contact with the mucosa. The base plate can be made of metal or plastic, or a combination of both. The other part is the teeth, which are in the base plate. In the case of a full removable denture on the maxilla, the palate is covered by the base plate, which often causes discomfort for patients and can take several weeks to get used to. Wearing it involves changes in taste and speech, but after a few weeks of use, patients become fully accustomed to it. If anatomical conditions do not allow the removable denture to fit snugly against the mucous membrane of the jawbone, it may move around the jawbone. In such cases, the use of a prosthetic adhesive is necessary to hold the denture in place while eating or speaking.
Partial removable dentures
Partial removable dentures are not used in cases of complete tooth loss. In this case, a porcelain crown is made on the retained natural teeth, which are then fitted with precision, invisible fixation elements, through which the removable part that replaces the missing teeth can be fixed. This version is more comfortable because we use a smaller and thinner base plate, which is easier to clean and comfortable to wear. In the case of partial removable restorations, the fixation site between the crown and the denture is not visible. A simpler version of partial removable dentures is when the technician does not use a hidden anchoring solution, but instead uses what are called metal gum clips to secure the denture to the tooth or crown. This is a simpler, cheaper solution, but it is aesthetically disadvantageous as the anchors are visible.
Root-retained dentures
In a root canal restoration, the crown that fills the tooth gap is fixed with a screw that is inserted into the root canal. It is used in cases where the upper part of the gum is badly damaged or damaged, but the root is healthy and in good condition.
Treatment procedure
The first step in such cases is root canal treatment of the affected tooth, after which the dentist makes a hole in the root, takes an impression and the technician uses this impression to make the missing part of the tooth in metal or zirconium. The pin has two parts: a long projection that extends into the root to hold it in place, and a cap shaped like a ground tooth to replace the missing crown part of the tooth. The crown is made on the cap, replacing the missing tooth. This technique can be used to save broken, badly damaged teeth with crowns so that they do not have to be removed.
For more information on the root canal procedure, please visit the Aesthetic Dentistry section.
Procedures in tooth replacement
Individual bite adjustment
In the case of larger tooth replacements (bridges, dentures), it is recommended to set the bite individually. By using suitable special instruments (customized articulators), we can determine the optimal bite conditions for the patient and the optimal load on the jaw joint.
Go to
Step 1:
we record the patient’s bite conditions using appropriate instruments.
Step 2:
record the upper and lower bite ratios in individually rated articulators.
Step 3:
according to the recorded values, the technician prepares the prosthesis to restore the optimal bite.
Advantage: a more accurate, more comfortable prosthesis can be made. The procedure minimizes the risk of developing jaw joint problems after the prosthesis has been made. Disadvantages: it increases the time needed to prepare a prosthesis, requires multiple visits and is more expensive.