Metal-ceramic crowns on the front teeth are the best solution for a dazzling smile. Prosthetics on front teeth

Prosthetics of the front teeth is a complex and multi-stage process, a great responsibility and painstaking work for the dentist, orthodontist and laboratory. What crowns do dentists recommend for front teeth?

The installation of a crown on the front tooth is carried out according to indications:

a severely damaged incisor. With a preserved root, a pin is used as the basis for the crown or
if it is necessary to prosthetize two adjacent teeth, they often use (several crowns interconnected), which is attached to adjacent pre-prepared teeth,
gaps, defects, developmental anomalies,
in the absence of a tooth, the crown is fixed on a previously implanted implant.

The main feature of smile line prosthetics is that the installed products will be visible to the interlocutor during a conversation. If you save on materials, the patient's appearance will suffer, as the prostheses will stand out against the background of natural ones.

Therefore, prosthetics of the front teeth should be taken seriously: prostheses should fully restore both the aesthetic and functional purpose of damaged teeth. The smile line can be restored using two types of crowns: metal-ceramic and.

cermet

Metal-ceramic crowns do not always look aesthetically pleasing.

Metal-free ceramics are ideal for anterior teeth prosthetics.

An ideal option for prosthetics of the front teeth are products made of zirconium dioxide. A zirconium crown consists of several layers: the first is a framework-base made of zirconium dioxide, the subsequent layers are ceramics. Properties of zirconium dioxide (oxide):

colorless crystals,
the material has the ability to transmit light in much the same way as enamel,
high strength, the material does not give chips and cracks,
a zirconium frame is much lighter than a metal one,
the material does not interact with other materials, does not cause allergies and irritation of the mucous membrane,
high aesthetic qualities due to the property of transmitting light,
the possibility of manufacturing a bridge prosthesis for the anterior teeth without the use of metal,
the manufacturing process of the structure is fully automated, so any inaccuracies and errors are excluded,
a thin frame allows you to grind a minimum layer of hard tissues in preparation for prosthetics.

Metal-free ceramics is not a cheap pleasure, but the high aesthetic performance and strength of prostheses justify the high cost of prosthetics. Indications for the installation of zirconia crowns:

it is necessary to restore 2-3 damaged front teeth. In such cases, a bridge is made,
to protect a tooth with a bulk filling,
strengthening in case of chips, cracks and other defects,
if it is necessary to restore a tooth with a preserved root based on a pin,
when it is contraindicated for the patient to install cermet.

Non-metal prostheses are contraindicated in patients with a deep bite and those who suffer from bruxism.

Why is metal-free ceramic better?

If funds allow, give your preference to metal-free ceramics for prosthetics of the front teeth and here's why:

Zirconia is a unique material that transmits light. Such a prosthesis is almost impossible to distinguish from a natural tooth,
the prosthesis fits as tightly as possible with the gingival margin, which is impossible with metal-ceramic prosthetics,
the material is resistant to high loads, the formation of cracks and chips, with proper care, such crowns last from 15 to 20 years,
minimal turning of hard tissues in preparation for prosthetics,
the design is made using computer technology, all calculations are accurate, so the crown sits as tightly as possible on the stump.

Which crown to choose?

What is the best crown to put on a front tooth? This question is asked by all patients who are going to have a smile line prosthesis. To answer the question, let's compare the main characteristics of these two types of crowns:

Criterion	Zirconium dioxide	cermet
Aesthetic indicators	The designs are devoid of aesthetic flaws, the prosthesis cannot be distinguished from a real tooth.	Blueness at the junction of the prosthesis with the gum, the metal base is visible through the ceramics.
Strength	High due to the crystal structure.	High thanks to the metal frame.
Health safety	Dentures are absolutely safe for the body, suitable even for allergy sufferers.	They have a number of contraindications for installation.
Price	High.	Available.
Turning hard fabrics	Minimum.	A significant layer of hard tissue is ground off.

As you can see, it is preferable to use metal-free ceramics for the smile line. But if funds do not allow you, cermet is also a good option. The main condition is to find a good clinic and an intelligent specialist.

Restoration of the anterior teeth requires a special approach due to their location in the high visibility zone. In the absence of one or more elements of the row, the impossibility of using alternative methods (fillings, veneers), prosthetics are used. In dentistry, the restoration of anterior teeth using metal-ceramic crowns is common, due to their high aesthetics, sufficient strength and affordability.

Description of the method

Ceramic-metal prosthetics is the use of a special design for the restoration - a crown. This denture consists of two elements:

metal base, made in the form of a tooth turned under the crown;
the outer part, made of ceramic, as close as possible in color to the natural shade of tooth enamel. As a result of using an extensive palette of coatings, the ceramic-metal prosthesis becomes outwardly identical to a real tooth.

To make a crown, the outer part is applied to a metal orthopedic base, which is made of various metal alloys. The most popular is an alloy of nickel (or cobalt) with chromium. This is due to its strength, good biocompatibility with tissues and optimal cost. However, in some cases, there may be an allergy to this type of alloy.

Reference! Crowns on gold-platinum and gold-palladium alloys are considered the most durable, but their cost is much higher.

Based on the technique for making metal-ceramic crowns, they can be:

stamped - with this technique, the base is stamped. It is considered an unreliable method due to the presence of inaccuracies in the manufacture;
milled - in this case, there is a clearer match with the patient's dental elements;
prostheses with a shoulder (ceramic) mass - in this case, the metal volume of the base is reduced, the ceramic part, on the contrary, is increased. It is considered the most optimal type of prostheses.

To fix the ceramic-metal crown, a dental material is used - cement. In this case, the prosthesis, like a cover, covers the damaged tooth. The use of this type of crowns provides a long-term and high-quality restoration result, due to the strength of the metal and the aesthetic qualities of ceramics.

Advantages

The widespread use of metal-ceramic crowns in dentistry, including for the area of the anterior teeth, is due to the advantages of this type of prosthetics. The benefits include:

Reference! The choice of shade with special care is carried out by the dentist on a special Vita scale.

Attention! The most common cause of an artificial tooth falling out is secondary caries that has developed under it. It is possible to avoid such an outcome by undergoing regular examinations at the dentist for preventive purposes.

Flaws

The negative aspects of the use of metal-ceramic crowns for the restoration of teeth include:

increased strength of prostheses can contribute to damage to the teeth in contact with them, leading to their excessive abrasion;
in some cases, immediately after prosthetics or after some time, a bluish tint of the gingival margin may appear, which violates the aesthetic appearance of the front teeth. The reason is the metal from which the base of the prosthesis is made;
the need for traumatization of hard tissues when turning teeth (removal up to 2 mm on each side). Often there is an inflammatory process due to pulp burns and its necrosis. As a result, the crown is removed and the prosthesis is carried out again after the treatment;
in the vast majority of cases, in order to avoid inflammation, depulpation of the teeth is required, which reduces their strength;
allergic manifestations. Ceramics in this case is hypoallergenic, hypersensitivity reactions (burning in the mouth, swelling in the area of the prosthesis, metallic taste) are caused by the metal of the base of the prosthesis. It should be noted that a frame made of gold or platinum excludes the occurrence of allergies due to their biocompatibility with tissues;

Important! If you have signs of an allergy, you should visit a dentist. It may be necessary to replace the prosthesis with a different type of crown.

Indications and contraindications

The amount of intervention required for the restoration of teeth is determined by the dentist when examining the patient. Indications for metal-ceramic prosthetics are:

mechanical damage to dental tissue (chips, cracks) with significant destruction;
advanced form of carious lesions of the tooth;
a strong degree of abrasion of dental tissue;
when splinting teeth in case of damage to the supporting part of the tooth of a mild and moderate degree of flow (periodontal disease);
the absence of one or more elements of the dentition;
congenital anomalies.

Contraindications to the use of metal-ceramic crowns are:

The process of prosthetics

Installation of metal-ceramic prostheses occurs in several stages. First of all, the doctor examines the patient, if necessary, treats concomitant dental pathologies: caries, gum disease, extraction of teeth with a severe degree of damage, and so on. Next, the method of installing crowns is determined, based on the condition of the tooth.

Preparation

This stage includes the obligatory turning of the abutment teeth to fit the thickness of the crown for its reliable fixation. Removal of dense dental tissues on each side is not carried out by more than 2 mm. When turning for a more durable fixation of the prosthesis, some roughness of the stump is formed. Be sure to prepare the lower edge with a ledge for the correct location of the crown.

To prevent the occurrence of inflammation, the pulp is removed and the dental canals are filled.

In case of severe damage and destruction of dental elements, the following methods of prosthetics are used.

Tooth condition	Method of prosthetics
The root system of the tooth is preserved	A pin is used, with the help of which the required volume of the crown region of the tooth is achieved, after which the prosthesis is installed. The use of a stump tab, the creation with its use of a support on which the crown is fixed.
Severe defects up to adentia	on the implant. One of the new methods in orthodontics. In this case, the crown is fixed on an implant - a screw installed in the jaw bone tissue. The structure is highly durable.

Production of metal-ceramic crowns

The quality of the prosthesis, the accuracy of its fit to the tooth surface depends on this stage. The technology is complex and labor intensive.

Reference! Temporary dentures are placed on the turned teeth during the period of crowns manufacturing. They protect dental tissues and maintain an aesthetic appearance.

Installation of prostheses

To ensure the good quality of the crown, its functionality and convenience, fixation is carried out on temporary cement for a certain period of time (up to 3 months).

With the successful functioning of the prosthesis, it is removed, cleaned and the final installation is carried out.

Rules for the care of crowns

Caring for metal-ceramic prostheses is not difficult. It includes standard hygiene routines such as brushing your teeth twice a day. The movements of the toothbrush in this case should be carried out in the direction from the gum to the edge. The paste is used as usual, the gaps between the teeth can be cleaned with dental floss or an irrigator.

If you experience discomfort, pain under the prosthesis, you should contact your dentist. This symptom may indicate the development of secondary caries under the crown. In this case, its treatment and the implementation of repeated prosthetics are required.

If there is damage to the crown, you should also consult a doctor. With a slight chip without exposing the metal base, restoration using composite materials is possible. If the base has become visible, the crown cannot be restored. In this case, the prosthesis is removed and a new one needs to be installed in its place.

Video - How to remove a crown from a tooth

Important! It is necessary to remember about the service life of metal-ceramic crowns, their untimely replacement can contribute to the development of dental pathologies up to tooth loss.

A preventive examination by a dentist should be carried out every six months, regular professional hygiene of both artificial and real teeth is recommended.

From this article you will learn:

Metal-ceramic crowns are the most successful compromise between strength, aesthetics and cost in dental prosthetics today. Metal-ceramic crowns got their name because they:

Metal-ceramic crowns: photo

Metal ceramics on the front teeth: photo

Metal ceramics on chewing teeth: photo

Advantages of metal-ceramic crowns

Fairly acceptable aesthetics
if metal-ceramic crowns are made with high quality, they will largely match the appearance of your natural teeth. However, metal-ceramic will undoubtedly be inferior in aesthetics to metal-free ceramic crowns. We will raise this issue a little later in the section “Alternatives to metal-ceramic crowns”.
Durability and Strength -
the cast metal frame provides structural strength, the ceramic cladding is not subject to caries or abrasion. Sometimes only small chips of the ceramic mass are possible, but this does not happen very often. In addition, there is the possibility of repairing ceramic chips directly in the oral cavity.

Disadvantages of metal-ceramic crowns

How does the process of prosthetics work?

1. Therapeutic preparation of the tooth -

2. Stages of prosthetics -

After the tooth has been prepared for prosthetics, the process of prosthetics begins. Firstly, the tooth is turned from all sides to the thickness of the future crown (Fig. 16-17). As a result of grinding the hard tissues of the tooth, a stump is obtained. Next, the dentist takes an impression, according to which a metal-ceramic crown is made in the dental laboratory.

During the manufacture of permanent crowns (1-2 weeks) - temporary plastic crowns are made to the patient. Temporary crowns are necessary: firstly, in order to protect the turned teeth from the aggressive environment of the oral cavity, and secondly, for aesthetics, because. if you have prosthetic front teeth, then smiling with turned teeth (especially at work) will be very unpleasant.

Metal-ceramic crowns: photos of the main stages of prosthetics

Metal-ceramic crown and its alternatives -

If you are prosthetics of the posterior teeth:

The main alternative may be the manufacture of solid metal crowns (Fig. 19). In terms of reliability, they even surpass cermets, are much cheaper, but not very aesthetically pleasing, because. look like polished steel, gold plating is still possible. However, if you are prosthetizing the distant 6-7-8 teeth, then this may not be important.
There is also a combined option (Fig. 20) -
for example, you need to make a bridge from the 5th to the 7th tooth. At the same time, 5-6 teeth fall into the smile line. In this case, it is possible to make a bridge in such a way that teeth 5-6 will be lined with ceramics, and tooth 7 will be without ceramics, i.e. look like a cast crown. The savings for replacing only one metal-ceramic crown with a cast one will be from 2.5 thousand rubles.

If you are prosthetic front teeth:

The main alternative in this case would be metal-free ceramics made of porcelain or zirconium dioxide (Fig. 21). If aesthetics are most important for you, then before choosing metal-ceramics, read a visual article with a photo comparing metal-ceramics with metal-free ceramics: “Which crowns to prefer for front teeth”

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Metal-ceramic crown: price

So, how much does a ceramic-metal crown cost in a mid-price clinic…

The cost of a metal-ceramic crown made of ceramics from a German or Japanese manufacturer (for example, IPS) and a cobalt-chromium alloy of good quality, and at the same time made by a highly qualified dental technician and orthopedist, will be at least 6 thousand rubles per 1 Unit.
However, if cheaper materials of Russian and Belarusian production are used, then in some clinics you can find a price of 4.5 thousand rubles for 1 crown.
The cost of a metal-ceramic crown on a gold-palladium or gold-platinum alloy will cost 9 thousand rubles + the cost of gold (about 65 euros per gram). Together with the cost of gold, 1 crown will cost approximately -
at 17 thousand rubles for one Unit (1 crown).
If temporary plastic crowns were made to the patient in the process of prosthetics with metal-ceramic, then the cost of a metal-ceramic crown automatically increases by another 900-1200 rubles. (for each crown).

Metal ceramics - the price of even one crown may seem too high to many people, but in fact it is a compromise (not to mention metal ceramics on gold). To understand this, it is necessary to compare the cost of metal-ceramic crowns with the cost of prosthetics with metal-free ceramics.

Metal-ceramic crowns: reviews

Positive feedback from patients after prosthetics with ceramic-metal will be made up of the following factors:

High-quality tooth preparation for prosthetics–
→ the main trouble that patients with crowns have to face is poorly sealed root canals. Over time, inflammation occurs at the top of the root of such a tooth, which leads to pain, swelling of the gums, and, accordingly, to the need to remove the crown, retreat the tooth and the need for new prosthetics. Sometimes this leads to the need for tooth extraction.
→ the second trouble is breaking off the crown from the root of the tooth. This occurs again when the tooth is not properly prepared for prosthetics. For example, if the patient has only the root of the tooth left, then the crown part (on which the artificial crown will be fixed) should be restored not with a pin and filling material, but with the help of a stump tab.
Professionalism of an orthopedic dentist (prosthetist)–
a lot depends on how well the doctor prepared the teeth for crowns (grinded the hard tissues of the tooth) or took impressions of the teeth. Violation of the technology of turning teeth and (or) taking impressions will lead to the fact that the crown will not fit snugly to the tooth tissues. This means that saliva will leak under the crown, microorganisms will get in, which will cause decay of the tooth tissues under the crown, the appearance of an unpleasant odor from under the crown. Over time, this will cause the crown to break off.
Professionalism of the dental technician–
The impressions taken by the prosthetist are sent to the dental laboratory. There, the dental technician, using casts, first makes plaster models of the patient's teeth, on which future crowns are already being modeled. It depends on the technician how the shape of the crowns, their color, transparency will correspond to the patient's own teeth.

Conclusion: if all participants in the process of manufacturing such crowns approached their business competently, then you will surely be satisfied. However, finding such competent specialists can be very difficult. And your feedback will directly depend on the quality of work of specific general practitioners and orthopedists, as well as a specific dental technician.

Metal-ceramic: the service life of crowns

In dental clinics, the guarantee for prosthetics is usually 1 year. The service life of metal-ceramic crowns is about 8-10 years. However, the latter is true only if the work was carried out qualitatively.

Advice to patients: Before the end of the warranty period for crowns, always take control X-rays of the teeth on which they are installed. Even if nothing bothers you! Very often, in the area of the roots of the teeth, on which the crowns were fixed, inflammatory processes occur, associated with shortcomings in the treatment and prosthetics. This will automatically necessitate retreatment of the tooth.

If such a defect is found before the end of the warranty period, then by law you will be required to treat the tooth completely free of charge and make a new crown on it. If you apply after the end of the warranty period, then there will be no chance to heal something for free. It is very important to fix the claim before the end of the warranty period! And not only in the clinic, but also in the Society for the Protection of Consumer Rights.

I advise you to take x-rays not in the clinic where you were treated, but in any other, and consult an orthopedic doctor there about the quality of prosthetics. Very often, doctors, not wanting to redo their own poor-quality work, hide the true situation from patients. We hope that our article on the topic: Metal-ceramic crowns price reviews - turned out to be useful to you!

24stoma.ru

Types and materials of crowns

Teeth 6 to 8 are not included in the concept of “smile zone”, and therefore doctors believe that they should be the last thing to worry about their aesthetics. Many people put on the simplest, stamped metal crowns. Not only do they look creepy, but also the surface does not fit the rest of the teeth at all. That is, it's just a "metal piece" in your mouth. The cheaper it is, the less anatomically correct it is made and the worse the condition of the turned tooth under it will be later. Therefore, most experts recommend installing cermets.

A crown can be for one tooth or several. Sometimes, when you need a prosthesis for 2-4 teeth, a whole bridge is placed on special fasteners that hold on to healthy teeth.

First of all, we will talk about restoration crowns. They are used in order to return a person the ability to chew normally. There are several main types.

Full crown. It replaces the destroyed natural completely.
Stump- recessed type. If the tooth is almost completely destroyed, this option is the most convenient and aesthetic.
with pin. Option for heavily damaged teeth.
half-crowns. Close all sides except the inner (lingual). They are often used to mount bridges and other types of prostheses.

In any case, the crown for the chewing tooth is selected taking into account the increased load.

If the patient insists that the tooth should look as natural as possible, prosthetics using crowns on a zirconium frame are recommended.

Zirconium dioxide has an important advantage over conventional metals and alloys. It has a natural translucency close to that of a real tooth.
The second big plus is the strength of such products, which is greater than that of standard ceramic-metal. It is indicated up to 600-700 MPa.
Long service life (a well-placed crown will last up to 20 years).
Light weight.
Low thermal conductivity.
High precision custom fit.
It is easy to achieve the correct shape, anatomical accuracy of chewing surfaces, match the color to the enamel of adjacent teeth.

The high accuracy of fitting such crowns is ensured by the fact that this is done using computer simulation. Therefore, the errors are hundredths of a millimeter. When it comes to getting an exact replica of the tooth you are going to chew on, it is important that it has the right height and shape. Otherwise, the load on the maxillotemporal joint will be uneven, which can lead to various disorders.

A pin tab made of fiberglass or titanium can also be used. In the first case, we get transparency - the base is not visible through the crown. In the second case - increased strength.

For example, you have a damaged tooth and you want to stop the process of its destruction. In this case, you can install a completely aesthetic metal-free crown. They are made of ceramic, very similar to real teeth, but are expensive. Therefore, it can be expensive to put them on a chewing tooth.

If you need to combine reliability with a certain level of aesthetics, it is recommended to use cermets. The frame of such products is made of nickel-chromium and cobalt-chromium alloys. For "distant" teeth, metal crowns can also be used.

The most important point is the preparation of the tooth for the installation of such structures. Indeed, in order to put a crown, the tooth is ground, the nerve is removed from it, the root canals are cleaned and sealed. If the filling is not carried out with sufficient quality, an inflammatory process may begin. The most unpleasant moment in this story is that inflammations begin late, when the guarantee for the artificial tooth installed to you expires. In the CIS, they rarely give a guarantee for more than a year. For comparison, in Germany, high-quality crowns are given up to five years of warranty. You say we don't have such specialists? Yes, but they still don't risk promising that your crown will last that long.

How is a crown selected?

The choice of crown type in most cases depends on the degree of tooth decay. In some situations, the doctor can perform the restoration with filling materials, which will be cheaper and faster. In others, if the rest of the tooth cannot withstand the stress, a crown is recommended. Sometimes it is placed on an implant made of titanium, which can be screwed into the root of a tooth or into the jawbone.

Prices

For many people, the question of which type / material to choose rests on the financial moment. That is why there are so many people with "iron" teeth in our country. After all, a beautiful metal-free crown for a chewing tooth can be quite expensive.

I just entered prices in the search engine and was surprised at the spread. For example, in St. Petersburg, they ask for 35 thousand rubles for one zirconium crown. At the time of this writing, that was $533. But, having scrolled through several offers from clinics in other cities (both in the Russian Federation and in Ukraine, Belarus), I was convinced that there are much cheaper options. For example, the people of Kiev offer the same service for $149. The Moscow clinic asks for 25 thousand rubles. (379 USD).

But this is all according to zirconium dioxide prices. Ordinary cermet is cheaper, metal costs a penny at all relative to these prices. So it's up to you to choose - to put less aesthetic, average in terms of parameters or almost perfect, but more expensive.

For example, at the above-mentioned Muscovites, you will pay around $ 200 per tooth for high-quality cermet. A metal-plastic crown will cost $73.

How long will a crown last?

Only a person who foresees the future can answer this question accurately. Because no doctor can predict how much you will load the tooth, whether the destruction of the “residues” on which the crown is attached, etc. will begin.

Crowns can wear out over time. The cheaper option chosen, the sooner this process will begin and replacement will be needed.

Features of caring for dental crowns

If you have a simple single crown installed on your tooth, then a toothbrush, paste and floss for care will be enough. But if you have a bridge installed (or, as it is also called, a bridge), then hygiene is likely to have certain difficulties. The fact is that such prostheses have an intermediate part (it is she who restores the lost tooth), food remains accumulate under it, which is sometimes very difficult to remove.

But regular hygiene is not everything. I also recommend using irrigators that allow you to clean the most inaccessible parts of the oral cavity (for example, under the same bridge) from soft plaque and food debris. Irrigators form a pulsating water jet under pressure and deliver it through a special nozzle.

Can there be any problems?

Metal-ceramic crowns are very durable, this is the best material for prosthetics, even for front teeth, not like chewing ones, but there is one unpleasant nuance that you should be aware of. This is a darkening of the edge of the gums. Moreover, this can be observed both immediately after installation, and after a certain time.

What is the reason for such a phenomenon? The darkened gum is a metal frame that protrudes through the mucous membrane. In this case, everything depends on the characteristics of the smile: if the gums are visible during it, then the defect described above will also be noticeable.

Reviews about crowns

What do people themselves say about installed crowns made of various materials? I'll start again with expensive, zirconium. That's what's really good about them - doctors for such money try much more. After all, their mistakes will lead to customer dissatisfaction and the need to redo everything. And this work is very difficult. Therefore, they strive to do everything right and efficiently at once.

Prices have risen markedly in recent years. If in 2013 a Russian could put two zirconium crowns for 35,000 rubles, by 2016 there was only one. People complain only about the cost. For many people, it is simply unbearable. After all, many people live on a salary / pension of 15-20 thousand. Save a year? An option, but it does not suit everyone.

Next, let's move on to cermets. The biggest problem is finding good specialists who will carry out the procedure correctly so that you do not have problems in the future and do not have to remove the tooth on which the crown is placed. In general, for chewing teeth, crowns of this type are optimal in terms of price and quality.

The most negative comments fell on metal-plastic and cast metal crowns. Metal-plastic crowns have one unpleasant property - the plastic coating will peel off over time, exposing the metal base. The view is not the most pleasant. Also, often under cheap crowns, the gums begin to become inflamed, and gingivitis has to be treated.

Nevertheless, 90% of negative reviews are not related to the materials, but to the incompetence of doctors. Therefore, I can recommend that you study the opinions about the clinic you have chosen, and then trust its employees with your teeth and money.

Summing up, I want to say - you should not save on dental health. I wish you good luck in choosing a clinic and crowns. I look forward to your comments and subscriptions to news site.

expertdent.net

Advantages and disadvantages

Metal-ceramic is a metal frame on which ceramic mass is applied in layers. Unlike previously produced composite materials, cermets are able to reproduce the structure of a natural tooth, while not changing color when interacting with coloring agents.
The high strength of the material allows for prosthetics, both anterior and posterior teeth. Porcelain fused to posterior teeth are preferred, while zirconia or ceramic crowns are suitable for teeth in the smile zone. At the same time, the high strength of metal-ceramic teeth can have a negative effect on the surface of opposing teeth and cause their increased abrasion.
Ceramic metal does not contain toxic substances, and therefore, it is absolutely safe. However, it must be remembered that different types of cermets may behave differently in the oral cavity. If the denture framework contains nickel, this may cause an allergic reaction in the patient. Some metals. The crowns that are part of the framework can oxidize under the influence of saliva.
The disadvantages of cermets are the possibility of exposure of the metal frame of the crown when the gums are lowered and the need for strong grinding of tooth tissues and depulpation.
Prostheses made of metal-ceramics have a long service life, however, even structures made of gold-platinum alloy are not eternal and will last more than 15 years to their owner. The warranty for cermet is 1-3 years, depending on the composition of the frame of the product.

For prosthetics of the anterior teeth, the most preferred option would be structures made of zirconium dioxide or ceramic.

However, it must be borne in mind that ceramic structures are very expensive.

Photo: Metal-ceramic crowns on a gold frame

When restoring chewing teeth, ceramic-metal is quite acceptable, because. the shortcomings of her aesthetics are invisible on the side teeth.

In addition, zirconia and cermet are not inferior to each other in terms of strength, and aesthetics in the lateral section are not as important as functionality.

The most popular metal ceramics on a frame made of gold or its alloys with palladium or platinum due to the fact that gold is not rejected by the body, being a biocompatible material, and is not oxidized by saliva.

When using alloys on gold, crowns have a more natural shade due to the yellowness of the metal.

Video: "Metal-ceramic crowns, some features"

How to install

When installing cermet, the patient undergoes diagnostics.
If necessary, the dentist treats and seals the root canals.
Depulpation of teeth is performed. If the condition of the supporting teeth is satisfactory, they are left alive.
The cermet is installed on the tooth with a ledge. When grinding the hard tissues of the tooth, along its lower edge, the dentist forms a ledge to avoid contact between the metal frame of the crown and gums. This eliminates the appearance of bleeding, allergies, irritation and swelling.

Price

The price of ceramic-metal dentures is much lower than all-ceramic ones. The price includes the preparation of the tooth for prosthetics (turning and depulpation), the manufacture of the dental structure in the laboratory, as well as the fixation of the finished dental crown.

Depending on the status of the dental institution, the material used as the frame of the denture, the price of metal-ceramic varies within from 6000 to 40000 rubles.

Metal ceramics on a frame made of cobalt-chromium alloy of a Japanese or German manufacturer will be from 6000 rubles, Belarusian or Russian - from 4500 rubles for the crown
A metal-ceramic crown on an alloy of gold with platinum or palladium will cost from 9,000 rubles (excluding the cost of gold). The total cost of the crown will be at least 18,000 rubles.

Metal ceramics and its alternatives

When prosthetics of distant chewing teeth, solid metal crowns can be the main alternative. In terms of reliability, they are significantly superior to cermets, much cheaper, but not aesthetically pleasing enough. However, with prosthetics of 6, 7, 8 teeth, this is not important.
Another combined option: for example, it is required to make a bridge of 5 - 7 teeth. At the same time, teeth 5 and 6 fall into the smile line. In this case, the 5th and 6th teeth should be made of metal-ceramic, and the 7th - without facing. Savings in this case will be at least 2500 rubles.

Reviews

The results of prosthetics with ceramic-metal depend on the quality of the preparation of the teeth for the fixation of crowns and the absence of defects in the fabricated prosthesis. Feedback from patients can be very different: both positive and negative.

A few years ago, a metal-ceramic bridge prosthesis on a cobalt-chromium alloy was installed on the lower chewing teeth. I quickly got used to my new teeth. Comfortable to chew and talk. When I smile, others do not notice that my teeth are not real.
My lower sixth tooth collapsed. The dentist advised to put metal-ceramic, as when smiling, the tooth will be noticeable. The doctor installed a pin, which was fixed with a filling material. A metal-ceramic crown was placed on top. At first, it did not differ from my real teeth, but now it has become a little dull and yellowed.
I have been walking with metal ceramics on chewing teeth for five years. At first, all the teeth were the same, and about a year ago, the dentures slightly changed color. But this is not so important, since they are not visible at all during a conversation.

Photo: before and after

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Cost of services

The installation of dental bridges is a procedure that has been used for about three decades and has proven itself in the orthodontic services market among patients who have lost one or more teeth in a row. A dental bridge helps not only to restore the appearance of teeth and return a smile to the patient, but also chewing function, practically without disturbing taste, temperature, tactile sensations and allowing you to enjoy the taste of your favorite dishes without limiting yourself in anything.

What is a dental bridge?

The installation of a bridge is one of the procedures that can save the remaining healthy teeth, since the distances that appear in the place of lost teeth lead to malocclusion and displacement of the dentition, because, as you know, nature does not tolerate emptiness.

A dental bridge is a system consisting of crowns on healthy (supporting) teeth and one or more artificial teeth attached to them. The bridge makes it possible to restore from 1 to 4 lost teeth and at the same time lead a familiar, full life, without feeling the presence of a prosthesis, and also not much different in appearance from the patient's "native" teeth.

There are several types of bridges:

Ceramic (made using zirconium dioxide);
Cast (cobalt-chromium alloy);
Metal ceramics (metal frame coated with ceramics);
Adhesive (made from reflective filling materials with the addition of fiberglass);
Metal-plastic (temporary, installed for the period of preparation of a permanent bridge - ceramic or metal-ceramic).

The intermediate part of the bridge can be connected to the mucosa in different ways:

Flushing - with the presence of space between the bridge and the mucous membrane, through which food can freely mix during meals. This method of connection is quite convenient in terms of oral hygiene;
Tangent - with this method, the bridge on one side is connected to the mucosa. This method is usually used for the front teeth, when the aesthetic component is important;
Saddle-shaped - this method involves the connection of the dental bridge with the mucosa on both sides. This method is less reliable and functional, but its use is justified for installing a bridge on the front teeth.

When choosing the type of bridge, the doctor takes into account the condition of the patient's teeth, his individual characteristics: bite, the presence of diseases such as periodontitis, the strength of the teeth themselves, how quickly they wear out, etc.

Dental bridge procedure

Installing a bridge is a rather complicated and responsible procedure, and it takes place in several stages:

Diagnostics for the condition of the oral cavity and whether the abutment teeth will be able to withstand the increased chewing load;
Preparation for the procedure of abutment teeth: depulpation, canal filling (if necessary), grinding for crowns, if necessary - strengthening with tabs;
Taking impressions;
Installation of temporary crowns;
Production in the laboratory of supporting crowns from casts and an intermediate section;
Fitting of crowns, revision if necessary;
Directly fixing the bridge with special cement.

The longest is usually the procedure for making a bridge in the laboratory - it can take from one to three weeks.

Contraindications when installing a bridge

The installation of a bridge is possible with the exception of a number of contraindications (in addition to the standard ones - allergies to anesthetics, problems with blood clotting, inflammatory diseases, etc.):

Diseases of the jawbone (osteomyelitis, osteoporosis, etc.);
Periodontitis, periodontal disease in acute form;
The presence of inflammatory processes in the oral cavity;
Absence of abutment teeth on both sides of the missing (or absent, if there are several of them), which will subsequently be able to withstand the chewing load;
Malocclusion;
Bruxism;
Predisposition to abrasion of the hard tissue of the teeth.

Rules for the care of a dental bridge

Dental bridges, like any other dentures, have a lifespan and can break or fall out over time. Proper care of them will help extend their life and keep them in "working" condition. The first and most important rule is to monitor oral hygiene and the condition of the teeth (all, and especially the supporting ones), visit the dentist in time for a preventive examination. Timely treatment of caries will protect against complications in the form of destruction of supporting teeth, gum disease, and inflammatory processes. Once every six months, it is necessary to undergo a professional cleaning procedure and regularly use an irrigator or rinse your mouth with water after each meal.

Periodic visits to the doctor will help identify the need to replace the bridge in time, without waiting until the patient feels discomfort and the bridge breaks off. In the clinic, the removal of a “worn out” bridge is carried out as carefully as possible, which cannot be said about the situation when it falls off by itself - the supporting teeth can be damaged and should not be left open, since they have been turned and are more vulnerable to caries and other diseases that are sensitive to external stimuli.

In case of pain under the bridge, you should immediately consult a doctor - this may be a signal of the occurrence of secondary caries. Also, pain may be present if the bridge was too deeply embedded, and in the process of eating, soft tissues are rubbed with its edge - this situation is fraught with the risk of bruising and, as a result, the development of inflammatory processes.

Installing a bridge has many obvious and undeniable advantages, but there are also disadvantages:

The need to prepare abutment teeth for a crown (even healthy ones);
Loss of bone tissue;
Increased load on the abutment teeth, which over time can lead to their "wear", and in the long term - loss.

Installing bridges is a fairly common and popular procedure. Implants are more gentle and safer in relation to healthy teeth, however, in cases where implant installation is not possible, a bridge is exactly the way that can preserve not only the functions, but also the aesthetic appearance of the patient's teeth.

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Basic concepts and classification of crowns used for chewing teeth

By time of use: temporary and permanent.
By appointment: restoration and support.
By type of construction: full, equatorial, stump, semi-crowns, telescopic, with a pin, fenestrated, jacket.
By type of raw materials for manufacturing: metal, non-metal and combined.

Metal - used to cover teeth that are subject to strong abrasion. Such crowns are very wear-resistant, which allows them to be used for 10-15 years. They can be made from noble and base metals. The most common products are nickel, gold and medical stainless steel. Also, an important point is the fact that for the installation of this design, the tooth is not sharpened much, and the cost of such dental prosthetics differs significantly from other methods.
Non-metal are divided into: cermet - a very durable construction, which consists of a metal frame covered with a special ceramic lining and plastic - which has not proven itself from the best side. Such prosthetics during tooth preparation provides severe damage to it and is an expensive dental service.
Combined are used when there is a need to restore both chewing teeth and those that come into view when smiling. In this case, strong metal crowns are applied to the chewing teeth, and cermets are applied to the front teeth. This method will significantly save financial costs.

How to choose the right dental crowns for chewing teeth: manufacturing and installation

Removable dentures as a method of prosthetics of chewing teeth

Clasp
Nylon
Acrylic
Sectors
Immediate dentures

Complete absence of chewing teeth.
The unstable condition of the teeth, which was formed as a result of the development of periodontal disease.
In case of impossibility of placing implants.
For temporary use in the manufacture of permanent crowns.

Simplicity and ease of use.
Aesthetic look.
Uniform load distribution throughout the structure.
Secure fixation.
No need to grind healthy teeth.
Possibility of removal if necessary.
Neutralize the deformation of the dentition.
Duration in use.
All parts of the prosthesis responsible for fastening are neatly hidden and not visible.
Availability and low cost of this service.
Easy to care for, allows you to monitor the sanitary condition of the structure and, accordingly, oral hygiene.

The design consists of a base and made teeth. It is fixed by clasps to the abutment teeth. This is a modern dental lock that provides a strong hold, while not damaging the tooth enamel. The only drawback is the visibility of this type of attachment when smiling and opening the mouth wide. There is also a method of attachment by suction of the structure to the hard palate.

Metal ceramics as the best type of crowns for chewing teeth

The material has increased strength.
The technology of creating an orthodontic overlay made of metal-ceramic allows you to outwardly resemble the natural bone tissue of the teeth
Does not stain with food colorings.
The absence of toxic substances ensures the complete safety of this type of product.
Long service life.

The period of operation and the cost of installing orthodontic overlays

Not a professional manufacturer.
Poor preparation for prosthetics.
The expiration of the service life of the structure.

Metal ceramics - 12 years
cast ceramics - 15 years
zirconium dioxide - 15 years.
Porcelain - 10 years.
Gold or medical steel - 15 years.
Solid plastic - 6 years.
Metal-plastic - the maximum term is 10 years.

Ceramic-metal on a frame made of foreign metals is over 8,000 rubles, and on a domestic one - from 4,000.
If the frame is based on precious metals - from 9,000 to 20,000 rubles.
Metal crowns in cost start from 700 rubles.

Crowns on the front teeth, of course, require a fairly high level of visual appeal.

Today, the medical industry has in its arsenal two suitable options for such dental structures that meet this requirement - these are metal-ceramic and metal-free ceramics.

This is the most common type of prosthesis for the restoration of anterior incisors. Its popularity is explained not only by the fact that it is the best, but because at an affordable price this species has quite acceptable external qualities.

The benefits of these crowns include:

decent visual characteristics;
long service life.

The price of such a product is the average between the cost of metal-ceramic and non-metal structures.

The disadvantages include:

the need for strong grinding of bone tissue and violation of enamel;
the need to most often remove the nerves and seal the canals for such prostheses.

Problematic moments when prosthetics with ceramic-metal:

Blueness of the gum margin- for the most part, immediately after installation or in the future, you can see the resulting blue gingival margin near the crowns. This has to do with the presence of a metal base. If you smile widely, then this shortcoming can be clearly visible.
The prosthesis can be seen against the background of other natural elements of the jaw- this is also due to the metal frame, due to which the product lacks the translucency characteristic of real teeth. Therefore, the crown looks rather unnatural in comparison with the natural bone tissue of the oral cavity.

This is extremely important for the anterior canines and incisors, because when talking and smiling, they always get natural light, which will emphasize the transparency of natural enamel and, at the same time, the opacity of prostheses.

Essential nuance:

If you simultaneously prosthetize several elements of the jaw region, for example, all the front incisors, then this unnaturalness will not stand out much, because only the teeth under the crowns will fall into the smile line.

If you insert only one or two prostheses, then be prepared for the fact that the crowns will definitely be partially visible.

This visibility will be especially pronounced if only one incisor is taken under the crown.

This is due to the fact that the human eye first pays attention to the differences in symmetrical objects.

Therefore, if you need absolute invisibility, then in this case only non-metal-based structures are required.

Metal-free ceramics

In this video, you will be able to install a ceramic-metal crown on an anterior incisor.

In dentistry, metal-free products are standard crowns for front teeth made of zirconium dioxide, plastic or porcelain.

At the same time, ceramic prostheses with the addition of plastic are considered the cheapest, but the most unreliable option, since they wear out quickly.

If it is necessary to create a reliable bridge, then the choice naturally falls on reinforced ceramics with zirconia.

Advantages of metal-free ceramics:

Zirconia, porcelain and plastic dentures can accurately reproduce the color as well as the translucency of natural teeth. In other words, it is extremely difficult to distinguish such substitutes from real teeth. This effect is due to the fact that the main component of such dental appliances - ceramics, completely coincides in optical properties with natural tooth enamel.
The high level of preservation of the appearance of solid ceramic prostheses on the incisors guarantees the preservation of the aesthetic appearance of the product for a long time, because the material is protected from staining in the color of coloring products and does not lose its luster over time.

Cons of non-metal products:

High price.
Fast erasing (only for plastic prostheses).

An example of metal-free crowns

In the manufacture of porcelain crowns, two methods can be applied:

Method of layer-by-layer application of porcelain material.
Injection molding method by means of pressure and high temperature.

This is important because dentures made from pressed porcelain are much stronger than those made from unpressed porcelain.

Pressing the material increases the reliability of prostheses and reduces the risk of ceramic chipping.

Therefore, it is better to know the production method before starting the installation.

Indications for placement on anterior incisors

Prosthetics is carried out in the following cases:

Normal tooth root. A broken, chipped incisor with a healthy root is an excellent option for a crown.

First, the root is thoroughly processed, the dark pigment is removed, then the doctor partially restores part of the bone tissue in order to later fix the artificial prosthesis.

Restoration of the element of the jaw row can be carried out by two methods:

Use of filling material and post. The root canal is first sealed, then a pin is installed in it, on the basis of which a part of the bone tissue is restored. Later, it is cut down, shaped to attach an artificial prosthesis.
The use of a tab, which is called a stump. It is produced in the laboratory by mold. It is similar to the natural part of the root. The doctor fixes it in the dental canal, after which he puts on a crown.
Absence of teeth. Modern medicine offers new ways of prosthetics. If one or more front incisors are missing, it is possible not to grind adjacent elements for crowns. The optimal solution is implants with subsequent fastening of prostheses.

It is possible to use either ceramic or metal-ceramic crowns.

Another way to restore the front teeth is to install bridge prostheses, consisting of several crowns.

Extreme crowns are attached to healthy molars, the gap between the teeth also fills the prosthesis.

Manufacturing cost

The cost of one metal-ceramic prosthesis is from 6 thousand rubles.

But in some cases, you can find a lower price.

Most often, in this case, institutions save on consumables, and it is to be expected that crowns will be made from lower quality materials.

The use of cheap material will imply a poorer appearance of the substitute and a higher risk of ceramic chipping.

The cost of metal-free ceramics is from 13 thousand rubles for 1 prosthesis.

The beautiful appearance and strength of ceramic crowns has a higher price, the need to attract more qualified and paid personnel, the need to purchase expensive equipment for the production of such structures.

And all this, of course, is included in the price.

The front teeth are critically valued in society because they are visible when talking, as well as when a person smiles.

Therefore, they require careful care. But various situations may arise in which they are damaged and lose their beauty.

In this case, measures should be taken to treat and eliminate the deficiencies. If the teeth have been destroyed and deformed, the installation of metal-ceramic crowns can save.

Advantages and disadvantages

Crowns for the front teeth are made from various materials, but the most popular are crowns made of metal-ceramic.

First of all, this is due to their relative cheapness in comparison with others.

Metal-free crowns are even more affordable, but metal-ceramic crowns are the golden mean in terms of quality and cost.

Their second advantage is their closeness to the natural look, because with proper creation and installation in appearance they are absolutely identical to the real ones. Thus, an aesthetic appearance is achieved, the teeth are neat, even and do not differ from the entire dentition.

Metal-framed ceramic crowns are strong and durable. The service life of such structures can be up to 15 years, subject to basic rules of personal hygiene.

However, in addition to the positive qualities of the design, it has certain disadvantages. In order to install a metal-ceramic crown, the tooth must be quite heavily polished. Up to 1.5-2 mm of hard tissue is removed along its edges.

Also, most often the tooth is subjected to depulpation. This procedure is necessary in order to prevent inflammation and subsequent diseases of the area under the installed crown.

During grinding, the pulp undergoes a burn, which causes its death. If you leave it in the tooth and install a metal-ceramic frame on top, it clogs, which allows inflammation to develop quickly. In this case, you have to remove the prosthesis and treat the tooth, and then put the structure back on.

Indications

absence of a tooth;
damage to half or more of the tooth;
physical defects (unevenness of the dentition, malocclusion, etc.);
front teeth are abutment teeth.

Of course, there are other factors that may necessitate such an operation. The final opinion on the installation of crowns is expressed by the dentist. First, he carefully examines the client's oral cavity and eliminates all problems in the available ways.

When the supply of other options has dried up, he advises prosthetics, and the client already makes a decision.

When placed on front teeth

Depending on the situation and the complexity of the position, not bridges, but single metal-ceramic crowns on the anterior teeth may be recommended. For example, only the tooth itself can be damaged, and the root can be completely intact.

If the root of the tooth is preserved

When the root can be saved, the specialist treats it first, if necessary.

After that, he creates an artificial crown, which is attached to the damaged tooth. Two types of setup can be used for this.

The first is that the canal, where the healthy root is located, is filled with filling material. Then a metal pin is placed there, which is carefully fixed. The crown part of the tooth is turned under the stump and after that a new crown (artificial) is attached to it.

Another method is that when restoring a dental crown, a stump tab is used. It has a root part, which is placed and fixed in the canal with the tooth root. Where it is visible, it is made identical to the stump, and after installation, a new crown is attached to it.

On implants

Due to the fact that there has been a sharp leap in the development of the dental field, today it is not necessary to change adjacent teeth when installing a metal-ceramic crown in the area of missing teeth.

Previously, it was necessary to grind the adjacent ones in order to attach an artificial crown to them. Implants are now implanted in an empty place, which are then covered with a new crown part.

When installing a ceramic-metal crown, a metal pin also plays the role of an implant, but gutta-percha can be used.

The nuance in the installation of ceramic-metal crowns is that over time, the gum may become somewhat smaller, which will open the metal frame. Then you need to make a correction to hide the metal.

Installation problems

The installation of metal-ceramic crowns is a rather complicated procedure, since it consists of several stages, some of which are painful. The main difficulty occurs at the stage of preparation, when the tooth is to be prepared.

If any diseases and problems were identified in advance, then before engaging in prosthetics, they are eliminated. But when turning a living tooth, pulp burns can occur. In this case, after the installation of the crown, inflammation may occur.

In some cases, after the ceramic-metal prosthesis is installed, over time, a negative reaction of the body may occur. This is due to individual intolerance. This happens extremely rarely, since cermets are absolutely biocompatible, and a tolerance test is done with any prosthetics.

In the process of attaching a ceramic-metal crown, accidental damage to the adjacent tooth could occur. This can happen when filling or turning. It might not have gone unnoticed right away, but over time it made itself felt.

It happens that a dental technician makes a mistake when preparing a prosthesis. Violation could occur both in the process of creating an X-ray image and taking a subsequent impression, and during the production of a crown. In this case, it does not fit perfectly, which causes discomfort when worn, as well as a number of other problems.

Preparation for prosthetics

At the first appointment with the dentist, first of all, there is a thorough examination of the condition of all teeth for any problems.

If ailments have been identified, they are urgently eliminated. After that, the area where the metal-ceramic crown will be installed is studied.

To begin with, the patient is sent for an x-ray to understand how things are with the tooth, which is being prepared for prosthetics. Based on the results, the doctor decides whether the installation will be on a living tooth or will have to be depulped (if the tooth is present at all).

Depulpation consists in the fact that the pulp is removed and a pin or gutta-percha is installed in its place. Then the root canal is sealed. If the crown of the tooth itself is more or less preserved, then it must be ground in order to attach a new artificial crown in the future.

When a tooth is prepared for a future crown or a post/implant is placed, an accurate impression of that part of the jaw is taken. It is sent to the laboratory, where a three-dimensional model is created from it. It is she who is used in the preparation of the future prosthesis.

Since it is made for a long time, and it is not worth walking with turned teeth, temporary crowns are installed on them, which are fastened with a special temporary cement, from which the tooth can then be easily cleaned.

Installation process

When the metal frame for the ceramic crown is ready, the doctor calls the client for a preliminary fitting. The unfinished design is put on the prepared tooth and see how it fits. If it is perfectly installed and the client does not experience severe discomfort, it is returned to the laboratory and completed.

A fully created metal-ceramic prosthesis is installed in several stages:

Temporary crowns are removed, the area of prosthetics is cleared of cement.
A metal frame is being installed.
A ceramic crown is attached to the frame and carefully fixed.
The client checks the bite and the comfort of wearing the prosthesis.

If everything is in order, then the client is allowed to go home, having previously been instructed on how to take care of the prosthesis. Just in case, a re-admission after some time can be prescribed.

Photo of metal-ceramic crowns on the front teeth

Dead pulp and exposed metal are a common problem with these crowns.

Photo of the finished product

An example of a bridge