Inlays, onlays, bridges and crowns
Reliability and high aesthetics
Installation time — from 2 weeks Types of dentures
Today, the difference between the terms crowns, inlays, onlays and veneers has been very much erased. All of these types of restorations are fabricated according to the same protocols using the same techniques and are fixed in the same way, so doctors often refer to them by a common term - adhesive restorations.
The use of certain prosthetic or restorative methods depends on the specific clinical situation and indications. The orthopaedic surgeon takes into account the patient's characteristics, muscle structure and tension, and chewing type. There is a lot to consider when making a decision. Therefore, it is impossible to say unequivocally: «If we have destroyed such a part of the tooth – it is an inlay, a large part of the tooth – it is a crown».
There are always half measures. For example, in one case we understand that functionally we can do with an overlay, but from an aesthetic point of view we would like to increase the area, change the shape, color – in this case we get almost a half-crown.
The most important thing in prosthetic teeth – is to discuss the options in detail with the patient, to plan the treatment carefully and to model the designs accurately. The main advantage of prosthetic restoration of teeth is that it is possible, so the result of treatment is characterized by precision and durability.
Dental crowns
If we are talking about crowns, it is a rather voluminous restoration. Dental crowns are used to restore the anatomical shape of the tooth, chewing and speech functions, forming a beautiful aesthetic effect. A crown can be a forced measure if the tooth has a nerve removed and a large amount of tissue is missing. It can also be placed on a living tooth to restore the original shape of the tooth and, as a consequence, the correct bite: the height of the tooth, the shape of the cusps, the area of the chewing surface directly affect the bite and the health of the teeth in the future.
What kind of crowns are there?
Metal-ceramic crown
The metal-ceramic crown is one of the options for prosthetic teeth, but is currently inferior to modern materials.Metal-ceramic crowns consist of a dense, one-piece framework made of metal (alloys of cobalt and chromium, chromium and nickel or noble metals: platinum, gold, palladium) with a ceramic coating.
Metalloceramic crowns involve significant processing of the tooth, as the metal framework is up to 0.5 mm thick and the ceramic coating is up to 1.5 mm thick. Despite the thickness of the ceramic coating, the color of the metal bleeds through, making such a restoration noticeable in the neighborhood of a healthy tooth. Metal can also cause allergies.
Zirconium Dioxide Crown
Zirconium dioxide crowns come in zirconium dioxide framework with ceramic application, as well as zirconium dioxide full shape restorations without ceramic application. There are no differences in terms of durability.
Advantages of a zirconia crown
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Zirconium dioxide is a material that can withstand very high temperatures, quite strong shocks. It has high density and strength. Therefore, zirconium dioxide is considered to be the strongest material today.
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Crucially, this type of prosthodontics creates the possibility of preserving more tissue during tooth treatment, as it is not necessary to create such thick frameworks in order to get the appropriate strength of the restoration.
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Another positive property is the hypoallergenic nature of this type of construction and lightness compared to metal frames.
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Metal-free restorations have aesthetics that are very close to natural aesthetics due to the properties of light conduction, light refraction, so zirconia crowns are close to natural enamel and dentin.
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High cost of restorations.
All-ceramic crown
All-ceramic restorations are mainly used to cover the anterior teeth or to restore a small area with an inlay. Zirconia crowns are mainly used to restore the function of the lateral teeth, as they are currently the most durable and meet high aesthetic requirements.
Restoration with an all-ceramic crown (also called a double-sided veneer or a 360’ veneer) is relevant when the aesthetic appearance of the tooth is changed with a small treatment area.
Preparing a tooth for a crown
In order to secure a crown or any other restoration, the tooth must first be treated for carious and non-carious lesions. This is to prevent the development of complications after the prosthetic restoration.
The depth of treatment depends on the degree of damage to the tooth tissue and the prosthetic option chosen. For example, if we use an all-ceramic crown, this will allow us to preserve more of the living tooth tissue, whereas a metal or zirconia framework crown will require more treatment.
Tooth restoration with inlay, onlay
Tabs are classified as microprostheses and are used to restore the form, function, relief and aesthetics of the crown part of the tooth as an alternative to composite restorations.
Tabs are used when the tooth is alive, i.e. it is not depulpated, it has a preserved chamber where the nerve is located.
Depending on the degree of tooth destruction, different types of tabs are used. The body of the tab can have both a very small area and overlap four of the five walls of the tooth.
In case of abrasion in the lateral sections, we use pads in order to restore the lost height, function, relief.
In case of severe tooth destruction (including the absolute absence of the crown part and removal of nerves), a stump tab is used as a connecting link between the root of the tooth and the crown part in order to avoid fracture and as a support for the installation of the crown.
Advantages of inlays, onlays over composite fillings
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Accuracy
The inlay or onlay is made using computer modeling, which means it reconstructs the tooth as accurately as possible. -
Durability
The inlay is more resistant to abrasion and lasts much longer. -
Aesthetics
In the area of the inlay or onlay, the fit is not compromised because the bond between the restoration and the tooth is much stronger. This means that the boundary between the restoration and the tooth is completely invisible. -
Dental health in the future
When inlays are created in the laboratory, their function is tested in an articulator (a special device that simulates the movement of the patient's jaws). In this way, the technician in the laboratory is able to restore all the lost cusps, to fully restore the contacts that should be with the teeth of the opposite jaw. This ensures proper alignment and prevents premature tooth erosion. -
Correct bite
Due to the strength of the material, which does not shrink, there is no cavity between the tooth and the restoration in which recurrent decay can develop.
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The cost is higher than composite restorations
Tooth restoration with a composite filling
- The therapist models the seal directly in the oral cavity. His task is complicated by the presence of soft tissues, the presence of fluid in the mouth, the patient's ability to lie with his mouth open, and time constraints.
- The general practitioner does not have the conditions for accurate restoration of the anatomy of the tooth, which are available in the technical laboratory. With therapeutic tooth restoration, it is not possible to completely restore the relief and all the tubercles.
- The therapist is forced to do his job by eye, this does not give an entirely accurate result.
- In the future, the filling material, even if we hypothetically assume that everything is very accurately restored, will wear out over time.
- Perhaps most importantly – when there is little tooth tissue left and we are restoring it with a filling material, there is the possibility of the walls chipping off because in the area between your tooth and the filling, sooner or later there will be a break in the fit. Over time, the wall can break away.
Prosthetics with bridges
Bridges are most often used by orthopaedic doctors as a temporary stage of prosthetics or when an implant cannot be placed.There are clinical cases that result in soft tissue damage, and the repair work does not allow implants to be placed in that location. In such cases, we can turn to bridges.
In cases where we are restoring the frontal area of the teeth we can resort to a metal-free bridge.
When restoring the absence of individual teeth, an implant is preferred in order to preserve the neighboring teeth. Each of the supporting teeth under the bridge can give complications in time, which may lead to its extraction.
The techniques for fabricating bridges do not differ from those for creating crowns and other adhesive restorations.
- CBCT, scanning, photo protocol
- A detailed treatment plan in 1.5 hours
- Personal curator's help
Cost of restorations
