Which crowns are best for chewing teeth?

Not everyone manages to keep their teeth intact throughout their lives. When teeth are lost, the patient loses the ability to smile beautifully, and he experiences disturbances in speech and chewing functions. Orthopedic dentistry is designed to solve these problems. Restoration of the structure and functions of the masticatory apparatus occurs through the installation of orthopedic structures. Modern designs for prosthetics completely replace lost teeth. They are adaptive, hypoallergenic, and have a long service life.

Indications for installation of a prosthesis

The general indication for prosthetics is damage or absence of a certain number of dental units. Dental defects lead to ineffective chewing of food. The bite is disturbed, the aesthetics of the smile suffers. The most common indications for prosthetics are the following disorders:

• Adentia (complete or partial loss of teeth). Restoration of the dentition is carried out by removable prosthetics or implantation of dental units.
• Complete or partial destruction of the coronal part of the tooth, in which filling is impractical. When preserving the root, a pin structure or stump tab is used.
• Pathological abrasion of enamel, which is a systematic violation of the enamel layer of dental units. The loss of hard dental tissues leads to malocclusion.
• Traumatic damage to teeth. The patient may be offered various options for restoring the dentition, depending on the severity of the situation.
• Pathology of the alveolar process leading to serious malocclusion. A frequent consequence of partial edentia, leading to the restructuring of the alveoli and a decrease in the functionality of the dentition.
• Single and multiple dental defects. The patient can be offered various design options depending on the existing problems.

Alternatives to crowns –

However, we must not forget that there are alternatives to artificial crowns. In addition to crowns, traditional tooth filling (with preliminary fixation of a pin in the root canal) can be used to restore a severely damaged tooth, and an implant can be used to restore a single missing tooth.

Which is better: a filling or a crown, a pin or a crown?

When the crown part of a tooth is significantly damaged, it can be restored not only with a crown, but also with the help of filling materials. However, there is a clear rule: if the crown of a tooth is destroyed by more than 1/2, the tooth must be restored with an artificial crown. This is especially true for pulpless teeth (from which the nerve was removed), because Such teeth become very fragile and often cannot withstand chewing pressure.

But, if the crown of the tooth is destroyed by less than 1/2, then you can use the method of restoring the tooth with filling material. If such a tooth is pulpless, then a metal or fiberglass pin is fixed in one of the root canals, which will ensure a more reliable fixation of the filling. However, keep in mind that under no circumstances should a filling with a pin be used to restore teeth whose crowns have been destroyed by more than 1/2. This is almost a guarantee that over time a fracture of the crown or root of the tooth will occur.

Restoring a completely destroyed tooth - if the crown of the tooth is completely destroyed, but if the root is strong, this is not yet a reason to remove the tooth. In such cases, restoration of the coronal part of the tooth is carried out using a stump inlay, onto which an artificial crown is subsequently fixed.

Which is better: a crown or an implant?

When it comes to replacing missing teeth with crowns, an alternative to a traditional bridge can be installing an implant. The latter has a lot of advantages over the bridge, because in this case, you will not have to grind down adjacent teeth for crowns, thereby reducing their service life.

Moreover, the cost of installing 1 economy-class implant is almost equal to the cost of a metal-ceramic bridge (especially taking into account the cost of preparing teeth for prosthetics and making temporary plastic crowns). A bridge will be better than an implant only in one situation - when the teeth adjacent to the missing one have large fillings or are pulpless (i.e., in any case, they require strengthening with artificial crowns).

Types of prostheses

Modern orthodontics offers many types of dental restoration. Each method has its own advantages and disadvantages and is used to solve a particular problem. The type of prosthesis and method of prosthetics are selected by the attending physician together with the patient, based on the clinical situation, budgetary capabilities and patient preferences. Orthopedic structures are distinguished by the method of fixation, the material of manufacture, the defect being replaced, and the type of fastenings in the oral cavity.

Classification by method of fixation

Based on the method of fixation, a distinction is made between removable and non-removable structures. A very special type is fixed dentures on implants.

• Removable structures. They can be removed from the mouth independently. They solve the problem of the absence of one or more units in the dentition. Inexpensive and easy to care for.
• Fixed structures are permanently fixed in the oral cavity. They are durable, strong and efficient. They have a higher cost.
• Implantation is the most complex and expensive type of prosthetics. Implants are a multi-component structure that is inserted into the bone tissue of the jaw and replaces the root part of the teeth. On their basis, the restoration of the dentition is carried out.

Classification by material of manufacture

In modern dentistry, many materials have been developed for the manufacture of prosthetic structures. Here are the four main types:

• Plastic structures are made from polymerized acrylic. This lightweight and durable material is inexpensive and available. The lightweight porous structure ensures a tight fit, which significantly reduces the adaptation time. Under heavy loads, plastic prostheses are prone to loosening and are therefore short-lived. Used for temporary use.
• Nylon prostheses are made from soft, hypoallergenic synthetic material. They are secured in the mouth using special clasps. The disadvantage is its short service life. The chewing load is distributed unevenly, which can lead to bite problems.
• Zirconium dioxide structures. Zirconium dioxide is a durable natural mineral, naturally enriched without the presence of synthetic impurities. Used for the preparation of fixed dentures. It has many advantages: it holds the chewing load well, its shade is close to natural enamel, and it has low thermal conductivity. Zirconium dentures are not used to treat severe malocclusions, since a strong crown begins to destroy neighboring teeth.
• Ceramic dentures are made from specially treated ceramics with the addition of lithium disilicate. The crown material is very durable and reliable, its structure is closest to tooth enamel. Ceramic dentures have the highest aesthetics, therefore they are used for prosthetics in the smile area.

Classification of dentures according to the volume of the replacement defect

Depending on the clinical situation, the patient may be indicated for a complete or partial denture:

• Complete dentures are removable or conditionally removable structures used in the absence of all units in the dentition. A complete denture simulates the entire dentition. The base of the prosthesis rests on the gums and helps fix the structure in the oral cavity.
• Partial dentures help restore dentition when several teeth are missing. They imitate a fragment of the dentition, replacing several nearby missing dental units or teeth lost in different parts of the jaw.

Classification of prostheses by type of fastenings

Depending on the method of fastening the prosthesis in the oral cavity, the functional load on the supporting tissues is distributed differently. The following types of orthopedic structures are distinguished:

• Lamellar dentures are a type of removable structures. Effective for partial or complete edentia. They differ in the material of manufacture and the method of attachment in the oral cavity. Attached directly to the mucous membrane.
• Bridges are non-removable structures used in cases where several dental units are missing in a row. They are attached to dental units spaced apart from each other and ground for crowns.
• Supported or clasp dentures are distinguished by a special way of transferring the load: through the supporting teeth, periodontium and mucous membrane. This method is called semi-physiological.

How to insert teeth: methods used today

Everyone is interested in which teeth are best to insert, what materials are used for this, and how long will you have to wait until the dentures or crowns are ready? More inquisitive patients ask: are wisdom teeth prosthetic? It all depends on the specific case. If, for example, you need to insert three teeth – the 5th, 6th and 7th, then the 8th tooth may well become the supporting one. But if only the wisdom tooth itself is lost, then it does not need to be replaced. If a removable prosthesis of chewing teeth is made, then, as a rule, there are no “eights” in it: this is justified, since the amount of work of the dental technician is reduced and, accordingly, the patient’s costs are reduced. The remaining teeth - canines, incisors, molars - are definitely subject to prosthetics.

There are several ways to insert teeth:

1. Make a removable denture based on natural or implanted teeth.
2. Replace a missing tooth with an implant.
3. Place a bridge supported by an implant or natural teeth.
4. Install a clasp prosthesis.
5. Create a removable denture supported by soft tissue and mucous membrane with complete edentia.

There are also several materials from which crowns and artificial teeth are made. They vary significantly in cost, which allows you to choose prosthetic options for different budgets.

How to choose the right dentures

The selection of a denture is made by the attending dentist together with the patient. After the initial examination, the doctor assesses the clinical situation and advises the patient, explaining what type of prosthetics is indicated for him. The patient makes a decision taking into account the doctor’s recommendations and his preferences.

Doctors at the Consilium Dent dental clinic will provide a free initial consultation on the selection and installation of orthopedic structures. After the initial examination, the dentist will select the optimal prosthetic option and advise the patient on how to prepare for prosthetics. He will talk in detail about how to care for the oral cavity during and after prosthetics. When choosing, the number of missing teeth, the condition of the tooth bed and gums, financial capabilities and the desire of the patient are taken into account.

Removable dentures. What to prefer?

If all or a significant part of the teeth are lost, the patient will be offered the installation of a removable denture. The removable design is a plastic plate that fits tightly to the mucous membrane and follows its shape. This ensures its strong attachment in the oral cavity. Artificial teeth are attached to the plate, imitating the patient’s own lost dental units. There are two types of removable structures: partially removable and completely removable.

The best partially removable designs

Partially removable dentures are used for partial restoration of the dentition. This type of denture is indicated if only part of the teeth are missing. Plastic and nylon are used for manufacturing. Special hooks or special clasps are used as fastening means. The fasteners are quite strong and provide reliable fixation of the dentition.

Main advantages and disadvantages

Partially removable structures are universal and have many advantages:

• The chewing load is evenly distributed, which ensures the safety of the dentition.
• The oral care procedure is simple and easy.
• Durable clasps provide reliable fixation in the oral cavity.
• The prosthesis ensures complete restoration of chewing function.
• Due to the uniform load, deformation of some dental units is excluded.

Among the disadvantages are the following:

• Dentures are quite expensive.
• Not all designs are sufficiently aesthetic, so they are not suitable for restoration of a row in the smile zone.
• Dentures require periodic adjustments.

Removable structures for complete dentures

This type of structure is used for complete restoration of the dentition in cases of total edentia. These are light and durable dentures that are in good contact with the oral mucosa. Typical denture materials used for complete dentures are nylon or acrylic. The fastenings are made in the form of so-called suction cups.

Advantages and disadvantages

Among the advantages, the following should be noted:

• The designs are easy to manufacture, which determines the low price.
• In case of breakdowns or damage, they can be easily restored.
• Cover a significant part of the sky, which makes contact very reliable
• Easy to care and use.

There are also a number of disadvantages:

• The structures wear out quite quickly, since the work of the masticatory muscles is not always coordinated.
• Due to constant pressure, the volume of tissue in the jaw joint gradually decreases. This impairs the retention of the prosthesis, and it may fall out when speaking.
• If the prosthesis is not positioned correctly, pain may occur in the mouth.

Let us compare the removable structure made of acrylic and nylon.

• Acrylic processes are more affordable.
• Acrylic dentures can break over time, while nylon dentures are made of flexible and durable material, so the likelihood of breakage is minimal.
• An acrylic prosthesis does not deform; a nylon prosthesis can change shape.
• Nylon has a smooth structure, does not absorb odors, does not stain, and is non-toxic. Acrylic is a more porous material and is susceptible to staining and staining over time.
• The color of nylon is closer to the shade of natural enamel and looks aesthetically pleasing. Acrylic has a wide range of shades; it is possible to choose an option that is as close as possible to the individual shade of the teeth.
• Nylon constructions are more hypoallergenic than acrylic ones

Removable dentures without palate

Sandwich dentures are designed for partial prosthetics and are an arch made of dense polymer that imitates the jaw arch. They are fixed to the molars that are preserved on both sides of the jaw. The fasteners are telescopic crowns that fit tightly and fix the product.

The advantage of these designs is that they leave the palate and sublingual space free, which ensures the preservation of diction and the natural sensitivity of taste buds. In some patients, such prostheses cause a gag reflex, which can make wearing difficult. Such patients are recommended to opt for the clasp system.

Expert advice

There is no clear answer to the question of which prosthesis to choose in a given case. The structural features of the patient’s jaw apparatus, his age, and the severity of the problem are of great importance. Approximate recommendations are given in the table:

Which crown is better for a chewing tooth?

On the one hand, the answer to the question of which crowns are best to place on chewing teeth is obvious. Molars are tireless workers who bear almost the entire chewing load, so they need to be restored with very strong and reliable crowns. The issue of functionality really comes first, but you shouldn’t focus only on it. Despite the fact that molars are not so noticeable when smiling, it is simply criminal not to worry about aesthetics in this day and age. In addition, the choice of crown is also important from the point of view of the compatibility of its material with soft tissues.

Which crown is best for chewing teeth?

• Metal crowns.
  These are reliable and cheap crowns with a good margin of safety: the likelihood of breakage and chipping is minimal. On the other hand, aesthetics with them will be at zero level. Another problem is individual intolerance to materials.
• · Crowns made of gold-platinum alloy.
  They are not cheap (see the course on precious metals), but they are quite reliable, non-toxic and safe for soft tissues. The amount you will pay for the precious alloy is quite comparable to the cost of a ceramic crown, which is much more similar to a natural tooth. However, it’s up to you to decide in this case.
• Metal-ceramic crowns.
  The most popular option for dental restoration. The choice in favor of metal-ceramics is really justified, since these are the crowns that have the optimal price-quality ratio. However, this product has its drawbacks. Firstly, metal-ceramics are less durable compared to classic metal crowns and are more susceptible to chipping. Secondly, the contact edge of the crown is not covered with ceramic, so a blue stripe appears at the junction of the crown and gum, which is bad from an aesthetic point of view. This problem is partly solvable (see crowns for front teeth), but the money spent in this case is not always justified.
• Ceramic crowns.
  It all depends on the type of crown. Classic ceramic crowns are not recommended for installation on chewing teeth due to the high risk of breakage and chipping, but today specialists have managed to significantly increase the strength of the material and improve manufacturing technology. Modern Emax glass-ceramic crowns allow for prosthetics in any part of the jaw. Their only drawback is their relatively high price.
• Zirconium dioxide crowns.
  Very strong, very durable, comparable in cost to ceramic ones. Monolithic zirconium crowns are more often used for prosthetics of chewing teeth, since porcelain veneer increases the possibility of chipping.

Fixed dentures. Which ones to choose?

Fixed prosthetic structures are firmly fixed in the patient’s oral cavity with cementing material and are not intended for self-removal. There are three main types of fixed structures: crowns, bridges, microprostheses.

Crowns

A dental crown is a non-removable orthopedic structure of a natural shape that covers the coronal part of a tooth or a separate area of ​​its surface. Crowns are made from high-quality materials: metal, zirconium, porcelain, ceramics, plastic.

Advantages and disadvantages of crowns

The main advantage of dental crowns is that they are able to completely restore the functionality of the dentition. Other benefits include:

• strength;
• aesthetics;
• low price;
• long service life

Among the disadvantages of structures of this type are:

• metal crowns are not aesthetically pleasing enough, so they are not used in the smile area;
• it is not always possible to choose a design color that fully matches the color of natural enamel;
• in some cases it is necessary to sharpen the tooth.

Bridge structures

A bridge is a type of fixed prosthesis used to replace significant defects in the dentition. A bridge rests on two dental units spaced apart from each other and replaces several destroyed, consecutive dental units.

Advantages and disadvantages of bridges

Bridges are structures that are designed for use in cases of significant defects in the dentition. This quality determines the main advantages of the structures:

• When chewing, the load is evenly distributed, determining the long service life of the prosthesis.
• The use of a bridge helps prevent atrophic processes in bone tissue. They begin due to insufficient load on the jaw in the absence of a significant number of dental units.
• A bridge can ensure normal grinding of food during chewing, and therefore maintain the health of the patient’s digestive system.

The disadvantages of bridges include the following:

• A structure that replaces several dental units is quite expensive.
• Teeth that serve as support have to be ground down and depulped even if they are healthy.

Microprostheses

Microprostheses are microstructures made of ceramic or composite material that serve to restore the damaged part of the tooth surface. These include dental inlays, veneers and lumineers.

Microprosthetics is a gentle technology designed to preserve severely damaged teeth. It allows you to protect the front wall of the tooth and restore the aesthetics of the dentition.

Advantages and disadvantages of microprostheses

The advantages of microprosthetics are obvious:

• A microprosthesis effectively hides defects and strengthens the tooth, which prevents its further destruction.
• An ideally selected shade makes the tooth indistinguishable from other units of the dentition.
• Microprosthetics does not require grinding of teeth.

The disadvantages are:

• Microprosthetics cannot be used for carious teeth.
• The cost of the procedure is quite high.

When choosing the appropriate type of prosthetics, the dentist aims to solve the patient’s problem in the most acceptable way.

Which prosthesis to choose: removable or fixed?

Knowledge of the advantages and disadvantages of removable and fixed structures will help you choose the optimal type of prosthetics

The choice of the type of prosthesis for each patient occurs individually. Dentists recommend paying attention to removable structures for the following problems:

• with complete or partial edentia;
• if there are pathological changes in the periodontium;
• if oral care is not thorough enough;
• if there are terminal defects of the dentition.
• in case of financial difficulties.

Fixed dentures are recommended for choice in the following cases:

• when no more than one or two units are missing in the dentition;
• if there are significant chips in the enamel;
• with pathological abrasion of enamel;
• with yellowed enamel;
• if it is necessary to restore the smile area;
• in the presence of carious teeth.

What are dental crowns

This is an artificial denture that is installed on a pre-treated natural crown. The purpose of prosthetics is to restore the anatomical shape, aesthetic appearance, and chewing function. Crowns can also be part of some other orthopedic structure: support for a partial removable or fixed denture, splinting for loosening of the dentition, etc.

Crowns on teeth

The design must meet certain requirements:

• restore the anatomical shape of the tooth, its aesthetics and color;
• support chewing and speech function;
• fit well to the neck of the destroyed tooth, make correct contact with neighboring units, as well as with teeth on the opposite side, without creating an obstacle to the closure of the dentition;
• do not interfere with the motor activity of the lower jaw;
• do not cause allergic reactions or tissue irritation.

All designs of this type have their pros and cons.

pros

Of all types of dentures, this one has a number of positive qualities, in some cases giving advantages over other types of prosthetics:

• rapid restoration of appearance and chewing function;
• large selection of materials for prosthetics;
• correct distribution of the load, eliminating the risks of abrasion of adjacent teeth and malocclusion;
• prevention of destruction of periodontal tissues and atrophy of jaw bone tissue;
• the ability to install several prostheses at once;
• if the root is partially destroyed, it is possible to install the prosthesis on a pin; if there is a complete absence of a root, it can be installed on an implant (titanium root).

Minuses

Negative qualities:

• the need to grind a tooth, sometimes a healthy one, if it performs a supporting function;
• a short period of discomfort after installation of the prosthesis; with the correct selection of material and compliance with installation technologies - very short;
• allergic reactions to certain dental materials;
• possible complications are reduced to a minimum with proper prosthetics;
• high cost of high-quality materials and insufficiently good appearance of cheap ones.

Popular questions about prosthetics

Here are collected popular questions from patients about prosthetics asked on the site forum. Experienced dentists answer.

Which prosthesis to choose: plastic or silicone?

Silicone has a short period of adaptation, is comfortable to wear, and does not rub the gums. Disadvantage of silicone: caring for them is more difficult.

Which type of prosthesis is better: a bridge structure or a suction cup prosthesis?

If there is a problem of missing several dental units in a row, the optimal choice would be a bridge. It will ensure uniform distribution of the load on the jaw, will serve for a long time, and is comfortable to use.

Which prosthesis to choose: plastic or nylon?

It all depends on which dental units need dentures. For chewing teeth, acrylic plastic is more suitable as the most durable and comfortable material to wear. Nylon dentures are suitable for premolars and incisors.

Which prosthesis design should I choose from plate-type prostheses?

If a temporary prosthesis is needed, then a removable plate structure is chosen. A fixed prosthesis is chosen in the absence of at least three dental units in a row in the dentition.

Which denture should a person prone to allergies choose: acrylic or nylon?

Nylon has more hypoallergenic properties. In addition, a nylon prosthesis is more flexible and less likely to rub the oral mucosa.

Caring for dental crowns after prosthetics

How long the installed structure will last depends not only on the quality of dental services, but also on proper care. After installing a crown, it is important to follow these recommendations:

• You will be able to eat 2 hours after installation of the prosthesis, and drink immediately;
• For the first few days, it is better to chew solid food on the opposite side; over time, the load can be increased, but you should no longer chew nuts at all;
• after installing prostheses made of plastic or metal-ceramics, it is better to avoid taking coloring foods: coffee, beets, red wine, etc.;
• after each meal you need to rinse your mouth, using an irrigator to rinse the interdental spaces; It is better not to use dental floss, as they can damage the denture;
• brush your teeth twice a day with a soft toothbrush and toothpaste without abrasive particles; President pastes with an RDA abrasiveness rating of less than 50 units are suitable. (Preggy for pregnant and nursing mothers and Junior).

Crown care products