How are teeth ground for crowns? Does it hurt? Why is this done? How is the procedure performed?

What is preparation or grinding of enamel: a complete list of indications for this procedure

Article navigation

1. What is preparation
2. What preparation is needed before turning?
3. Types of turning
4. Peculiarities of turning for different types of prostheses
5. Types of ledges when fixing crowns
6. Features of the procedure in children
7. Will it hurt when turning?
8. What to do if there is pain after turning
9. Is preparation always necessary?
10. How much will the turning cost?

Question to a specialist
To restore “problematic” or missing teeth, we go to an orthopedic dentist who offers various prosthetic options. However, the installation of a veneer, crown, removable dentures or bridge is almost always preceded by dental grinding - and the very mention of it immediately frightens patients. What kind of procedure is this, in what situations is it used, will it hurt, what are the features of the preparation and how the process works in patients of different ages - all this is discussed in today’s material.

Is it painful to install a metal-ceramic crown?

Installing a metal-ceramic crown is a completely painless process.
The only unpleasant moment may be taking impressions with impression material, especially if you have an increased gag reflex. In this case, it is better to resort to 3D prosthetics CEREC.

What is preparation

At its core, the preparation process involves removing part of the hard tissue. This layer, represented by enamel (the outer shell) and dentin (these are the internal tissues), must be equal to the thickness of the prosthesis. Armed with a bur, the doctor cuts off the excess and gives the crown the shape on which the prosthesis will easily and reliably fit. It is important to ensure maximum density and absolute accuracy of its fit. As a rule, the shape of a natural tooth is a cone or cylinder.

Relatively speaking, you will have to “cut off” the amount that is equal to the thickness of the prosthesis. For example, zirconium dioxide will require minimal grinding, but metal-ceramics (after all, there are both ceramics and metal) will require the removal of a thicker layer of living tissue.

Preparation is also carried out during filling, but in this case only inflamed tissues are removed, while healthy ones are preserved. If you need to install a prosthesis, even living tissue will have to be removed.

What are metal-ceramic dental crowns and bridges made of?

The crown consists of 2 parts – the frame and the covering.
If the crown is metal-ceramic, then the frame is made of metal . In the Health Clinic Istok is a special alloy made in Germany - GIALLOY . The frame is covered with ceramic mass , which is baked in an oven at 400C. The color of the ceramic mass is selected by the doctor in accordance with the color of your teeth or at the request of the patient. The Istok Health Clinic uses ceramics from well-known manufacturers Noritake, Ivoclar, Duceram Plus, e-max Ceram

What preparation is needed before turning?

In order to secure the future prosthesis well, the prepared crown must be strong, free of plaque and stone, and free of carious lesions (if any, the doctor will, of course, remove them first). Also, before treating the enamel under any prosthesis, it is important to remove soft and hard plaque.

South Korean implant Osstem - from 35,000 rubles.

Hurry up to sign up for a free consultation and lock in promotional prices.
Call now or request a call

Opening hours: 24 hours a day - seven days a week

Types of turning

The choice of technique depends mainly on the individual clinical picture, as well as on the volume of tissue that needs to be trimmed. There are types that are more extended in time, and there are very fast, safe and pass without the slightest pain. Let's look at all of them that currently exist. But keep in mind that the choice always remains with the attending physician, who will assess the situation and select the most optimal option.

Ultrasonic

This method involves the use of a special apparatus that produces high-frequency vibrations - ultrasonic. And the device itself is called a “scaler” or “scaler”. By the way, it is used to clean enamel from plaque. Also, instead of a scaler, a piezo device can be used - its action is again based on the use of ultrasonic waves, but they are more powerful, which allows it to be used on harder tissues.

During the procedure, the doctor does not touch the enamel with the instrument. Almost no heating occurs. So the risk of damage disappears. As for pain, it may well occur if there is increased sensitivity, so anesthesia will be appropriate. The method makes it possible to dissect only a small volume.

Laser

This is another effective non-contact turning method. The laser acts on the enamel pulsed, but again removing only a very small layer of enamel and inner dentin. By the way, unlike ultrasound, this method is safer, since laser beams have a wound-healing effect. The method is absolutely silent and allows you to quickly achieve the desired result.

Preparation with a drill

This technology involves the use of a good old drill and a diamond (or metal) tip . In fact, this is the most common and optimal turning option. The doctor can choose different speeds of rotation of the bur, but to prevent overheating, water must be supplied. In fact, the process is no different from drilling in the treatment of caries - everything is done in a similar way.

Watch the video at the end of the article - you can get an idea of ​​how the process of preparing a tooth cavity using a drill occurs.

Air abrasive method

This technique is based on the use of a jet of water and a composition with abrasive particles. Using an air-abrasive method, the doctor is able to smoothly grind off the required amount of tissue. The patient does not feel pain. There is almost no heating and vibration. But the technique makes it possible to remove, again, only a minimal amount of tissue.

Chemical turning method

This method involves using exclusively active acids. Penetrating into tissues, special compounds destroy them. The doctor will only have to remove the softened areas and give the crown the necessary shape so that it fits well under the future prosthesis or structure. The procedure is not quick. The method is considered outdated and is not often used.

On a note! Thus, in 99% of cases it is drilling with a drill that is used for prosthetics (and not for the treatment of superficial caries). It is this technology that allows you to remove any amount of tissue in an extremely short time. True, anesthesia will definitely be required (except for those cases when the tooth is already “dead”, that is, without a nerve).

Peculiarities of turning for different types of prostheses

The type of prosthesis that the patient and the doctor chose to install also determines the preparation technology. Let's consider the features of preparation for each type.

For veneers and lumineers

High-quality turning for veneers allows you to achieve good contact with the artificial plate. The patient will not then feel the pad in his mouth as something foreign. But here it is important to understand why exactly this procedure is necessary:

• for a good fit of the veneer (we will explain later how exactly the turning is done),
• so that the linings do not “stand out”, that is, so that the teeth are not excessively thick,
• so that the row can be leveled using veneers. For example, you will have to grind off the front part of the enamel if one of the elements is crooked and stands out in front. Of course, one overlay will be slightly thinner than the others. But it also has a limit on the minimum thickness - often in such situations the tooth is simply given a new shape.

When installing veneers, the enamel is ground down by the dentist in a special way. First, the doctor treats only the outer, “front” part, followed by the side and cutting surfaces. Very often, vertical and horizontal recesses are made in the front, which are filled with dental glue. All this significantly improves the fixation strength of the pads.

Don't know what type of prosthetics to choose?

We will help in the selection, advise where to read more information and compare types of prosthetics.
Consultation with an orthopedic doctor in Moscow clinics is free! Call now or request a call

Working hours: from 9:00 to 21:00 - seven days a week

It is interesting that to install, for example, thin veneers made of pressed ceramics or lumineers, such strong grinding is often not necessary (especially if your own teeth are straight). It is enough to simply grind the surface using an air abrasive method or a laser to make it a little rougher. This again will allow the lining to be fixed much better and for a longer period.

Under the tabs

Inlays are prosthetics that replace fillings. They are needed in situations where there are still too few indications for a crown, that is, it is too early to place it. Grinding under an inlay is slightly different from preparing for a filling. In order to install the product well, the doctor will only remove all inflamed (carious) tissue, after which he will carefully process the cavity and take impressions, because the inlay is created in the laboratory.

For crowns

A crown helps restore the integrity and beauty of any tooth, and also protects the fragile pulpless unit from destruction and the risk of caries. When preparing a tooth for a crown, it is important to create a special ledge (their types are listed below) - in fact, the future prosthesis will rest on it. Such ledges are most often located under the gum so that the entire tooth can be completely covered, as well as the transition between the crown and living tissues can be hidden.

Let's consider the features of preparation depending on the material of a single prosthesis:

• for cast metal: grinding starts from the sides, remove up to 0.7 mm,
• like plastic: they are more aesthetically pleasing than metal ones; They can be used to cover both front and side teeth. But here the rules are as follows: a plastic prosthesis is made thicker, especially if a metal base is added. So you will have to grind off quite a lot - more than 1.5 mm,
• for metal ceramics: remove up to 2 mm on each side. Such a prosthesis again consists of a combination of materials, so it turns out to be quite thick,
• under porcelain: the dentist gives the unit being processed a cone-shaped or cylindrical shape. Requirements for the ledge: it is made rounded and goes under the gum by 1 mm. Turning – up to 2 mm on each side. When using pressed ceramics - much less, up to 1 mm,
• for zirconium: it is important to obtain an accurate edge of a rounded or shoulder-shaped ledge. As a rule, it grinds down about 0.5-0.7 mm.

It is important to understand that these indicators are completely average. Everything depends not only on the material as a whole, but also on the specific doctor and laboratory equipment.

Complex on 4 OSSTEM implants with delayed loading - from RUB 170,000.

Complex implantation Osstem (South Korea) with delayed loading after 4-6 months.
Guarantee for the doctor’s work - unlimited Call now or order a call

Opening hours: 24 hours a day - seven days a week

This is interesting! Today, it is very common for metal-ceramic crowns to be created with “shoulder mass.” In terms of thickness, they are no different from ordinary ones, but they have a very big advantage: the outer ceramic coating covers the metal underneath, that is, the metal base does not come into contact with living tissues in any way. This eliminates allergic reactions and does not cause blue gums.

Accordingly, if you plan to install a bridge, then grinding down the supporting teeth will be carried out in the same way as when fixing single crowns. Because the bridge consists of them.

For removable dentures

Often, teeth need to be ground down in order to install removable dentures. But only if a reinforced fixation system is used. For example, clasps that are placed inside the crown part, or telescopic crowns that are fixed on top of living teeth.

When splinting

To prevent the patient's teeth from becoming loose (this also happens with advanced periodontal disease or periodontitis), splinting is used. To secure the splint, the enamel is prepared minimally - for this, a small depression is made on the inside of the entire dentition, inside which a special splinting thread is placed. However, in a number of situations it can be simply secured from above, so turning is not required.

Preparing to install dental crowns

Traditionally, crowns are placed on dead (pulpless) teeth, but sometimes there is a need to install a structure on living teeth. This has a positive effect on the final result of prosthetics, since living dental units are stronger and less susceptible to destruction processes, which ensures a long useful life of the crown. Usually, chewing teeth are not depulped during prosthetics. They have a significant area of ​​the natural crown and the distance from the enamel layer to the pulp is greater, which eliminates burns to the natural tissues of the oral cavity during prosthetics.

Types of ledges when fixing crowns

If you look at the photo below, it will immediately be clear what ledges are - they are needed to fix the crowns. Such ledges are located under the gum so that the border between the tooth and the prosthesis is hidden.

Accordingly, they also come in different shapes:

• knife-shaped: in fact, in such a situation there is no ledge - the top of the tooth will simply have the shape of a cone. Solid metal crowns are fixed in this way (but today this method is rarely used),
• rounded: used for attaching metal-ceramic crowns, but also not used often,
• shoulder: this is the most popular option, and it is also universal. Such a ledge, although large in thickness, is considered the most aesthetic. It has an angle of approximately 90 degrees.

Will it hurt when turning?

The word “grinding” used to sound scary coming from a dentist. Today, the preparation process does not last long and takes place without any discomfort or pain. Before starting the procedure, the doctor will “freeze” the mucous membrane with a special gel, and the patient will not feel the injection with a good local anesthetic at all. Anesthesia is used both in the case of working with living units (in order to “turn off” for a while the nerve that is sensitive to any manipulation) and with “dead” units in which the nerve is absent. After all, turning involves a very painful retraction of the gums.

Removing dental crowns: indications and features of the process

Removing dental crowns is a procedure that becomes necessary if certain complications arise after installing the prosthesis. Removal of the structure may be required in situations:

1. Poor quality preparation for dental crown prosthetics. If the tooth canals are poorly cleaned and poorly sealed, then an inflammatory process may begin to actively develop in them. If such a process occurs, the crown will need to be removed and the tooth treated or removed.

2. Inaccuracies in the manufacture of a crown on a tooth, in which the installed structure will overestimate the bite and not fit tightly to the tooth.

Crowns are also removed for planned replacement. High-quality structures can last up to 10 years or more, but after that the crown will be replaced with a new orthopedic product. Crown removal may be uncomfortable for the patient, so it is usually performed using local anesthesia. To remove the structure, it is sawed with a bur, removed, and those medical manipulations that are necessary for a particular case are performed.

We hope the material helped you learn all the important nuances of installing crowns on your teeth, and you can always get more detailed advice on prosthetics from the dentist at our Vanstom clinic in Moscow! To make an appointment, just call us!

What to do if there is pain after turning

It happens that after the anesthetic wears off, the patient experiences unpleasant sensations. They can be either a type of norm or a pathology. Teeth hurt after grinding for the following reasons:

• overheating occurred: the bur rotates at a very high speed, so if the doctor performed the procedure quickly, without stopping, tissue overheating could occur. In this case, the pain will be monotonous, but will go away on its own after a few days or weeks, less often - after a couple of months,
• During preparation, too much was removed: the dentin layer has become thin, the nerve is close, so it is completely normal that the tooth will react with pain. But this is no longer the norm - to prevent such situations from occurring, most doctors still suggest depulping before installing a prosthesis,
• the gums are injured: quite often doctors use special threads and metal plates to push back the mucous membrane. Therefore, slight inflammation and swelling of the gums after the procedure is normal, which disappears on its own within a few days.
• errors when grinding: what to do after the procedure for processing units if the painful symptoms do not disappear even after several days? This is a reason to visit the dentist. It is possible that the nerve was injured or the root split, which led to the development of an inflammatory process. In such a situation, the pain will be acute, tissue swelling is possible (and not only the gums, but even the face). This situation requires a prompt solution.

On a note! The important point is that after turning, a temporary prosthesis is almost always installed - be it a veneer or a plastic crown. After all, after preparing the support, impressions are taken, based on which the dental technician in the laboratory will work on the design of the prosthesis. To save the tooth and restore its aesthetics, the doctor will suggest a temporary replacement.

Installing a crown on a tooth

A dental crown is installed on one tooth in several stages.

1. Diagnostics.

   To find out whether it is possible to put a crown on a tooth, the doctor examines the oral cavity visually and necessarily sends it for an x-ray.

2. Treatment.

   Then the necessary treatment is carried out. Most likely, you will have to remove the nerve under the crown and fill the canals.

3. Grinding of teeth for crowns.

   If the dental tissue is slightly damaged, then the remaining walls are ground down. In the case where the “top” of the tooth is completely missing, a dental inlay is additionally installed under the crown, which will ensure its reliable fixation. Previously, instead of an inlay, a pin was installed; today, a dental crown on a pin is considered an outdated technique, which has a number of complications leading to tooth loss.

4. Making dental crowns.

   After all the preparatory procedures have been completed, impressions are taken from the patient and sent to a dental laboratory.

5. Installation of dental crowns.

   This is followed by fitting of the finished product in the oral cavity and installation. Many people are concerned with the question “What are dental crowns glued to?” Orthopedic structures are placed on special cement, which allows the prosthesis to stay in place for a long time and reliably.

All manipulations are carried out over several visits. Making dental crowns is possible in a few hours, provided the necessary equipment is available in dentistry.

Crown on a living tooth without pulp removal

If we are talking about grinding healthy teeth to fix a dental bridge, then an important question arises about the need to depulp the tooth. Everything here is very individual. But, as a rule, doctors prefer not to take risks and in most cases remove the nerve.

Color of dental crowns

Modern technologies make it possible to produce orthopedic structures indistinguishable from natural teeth. Naturally, we are talking about ceramic, metal-ceramic and plastic crowns, and not metal ones. Ceramics used in modern dentistry are able to completely imitate the color and transparency of the enamel of the teeth adjacent to the prosthetic. The same applies to the plastic used to make temporary crowns. But if we are talking about metal-ceramics, then crowns with a zirconium frame can “get into color,” and in the case of other metals, the frame can be visible through artificial enamel. In modern dental laboratories, the color and shade of enamel for crowns is selected according to the Vita scale, which represents the majority of natural tooth shades.

How are dental crowns removed?

There are 3 main ways.

1. Kopp apparatus.
   Using a special drill, the doctor breaks the cement at the base of the prosthesis, then removes the structure with forceps.
2. Sawing
   . The structure is cut in the center and removed.
3. Coronaflex.
   The crown is removed carefully and without damage using compressed air. The method is expensive, but after the procedure it is possible to re-install an artificial tooth.

Dental crowns are removed if the following problems occur:

Toothache under a crown

Modern materials make it possible to make dental crowns that fit as closely as possible to the tissues of the prepared tooth, however, sadly, the patient sometimes has the feeling that his dental crown hurts. Of course, it’s not the crown that hurts, but the tooth underneath it. Toothache under a crown can mean several different problems, but the most common is the formation of secondary caries in the area where the crown adheres to the tooth tissue. If this happens, be prepared to remove dental crowns, re-prepare the teeth and install new orthopedic structures. If this is not done, the tooth under the crown may completely collapse, leading to its loss.

Caries under the crown

Sometimes this is due to an error by a doctor or dental technician, when the procedures for making or installing a crown were violated: if it does not fit tightly to the tooth, if saliva got under it during installation, if caries was not completely treated, the formation of secondary caries under the crown is more than likely .

Unpleasant odor from under the crown

The smell from under the dental crown occurs when food debris or saliva gets under the denture. Bacteria multiply faster in this environment, causing an unpleasant odor. Inflammatory processes in the dental tissues under the denture also lead to an unpleasant odor.

Important!

Removing dental crowns and installing new ones must be done approximately every 10 years, otherwise you risk becoming one of those users who frantically write in the search bar in their browser: “I swallowed a dental crown, what should I do?!” By the way, modern materials for making crowns are absolutely non-toxic; sharp edges and chips pose a danger if swallowed. Therefore, if it was not a small piece of a fallen-off crown that was swallowed, but the entire structure or a substantial part of it, you should consult a doctor - a surgeon, a gastroenterologist, or the nearest emergency room.

Is preparation always necessary?

The good news is that no, not always. If a minor correction of the defect is expected - for example, with the help of artistic restoration, then the dentist will simply limit himself to grinding. This will enhance the adhesion of the glue and material.

Dentists do not always treat enamel before fixing veneers[ii] - this has already been discussed earlier. No preparation is required when installing classic removable dentures, which are fixed to the supporting teeth using plastic or metal hooks. Teeth are also not injured when defects are replaced with implants - these are artificial analogues of roots, the installation of which in no way affects the position and condition of neighboring teeth. Even when you subsequently need to place a crown on top of the implant.

Important! It is necessary to understand that preparation will be required only if there is “something left” of the tooth. That is, if the top is destroyed at the root, there will be nothing to grind. In such situations, you need to build up the root - for example, using a pin or stump tab. And then fix the single prosthesis from above.

However, you still cannot do without the turning stage when installing a classic crown. Science has not yet come up with other ways to reliably fix such prostheses.

Free consultation on the cost of treatment in our dentistry

Leave a request and the clinic administrator will contact you within 15 minutes!

For single-rooted dental units, the depulpation process is mandatory, since the risks of thermal burns during grinding are quite high and this is fraught with the future development of an inflammatory process under the crown. Single-rooted teeth are drilled out, the nerve is removed, and the canals are cleaned and filled.

If there are dental diseases - caries, pulpitis, periodontitis - manipulations are performed to treat them. The nerves of the unit are removed, the canals are expanded with a special instrument, filled with gutta-percha, after which a filling is installed on the tooth itself. In case of serious damage to a tooth due to caries, it is important to install a strong filling and provide additional fixation. If this is not done, the dental crown may simply fall out along with a poor-quality filling. The process of restoration of a natural dental crown can be implemented in practice using two methods:

1. Installing a crown on a pin. The pin element is screwed into a pre-filled root canal and the natural coronal part of the tooth is restored at its base. After the filling is made, it is ground down to install the crown.

2. Using a stump insert. This element is manufactured in laboratory conditions and, when installed, is fixed in two areas at once: the dental canal and the area of ​​the natural tooth crown.

These labor-intensive manipulations are carried out exclusively in the presence of serious destruction in the area of ​​the natural dental crown, and if we compare the methods in terms of reliability, then the most high-quality result can be obtained by placing a stump inlay.

How much will the turning cost?

The cost of dental preparation differs depending on the economic policy of the clinic.
But in most situations, no one highlights it as a separate service - it is simply included in the overall price of prosthetics. That is, for example, if installing a ceramic crown costs 20 thousand rubles, this implies that the price also includes preparation. But sometimes you will have to pay an additional 500 to 2000 rubles for a temporary crown, which is placed on a ground tooth to protect it. Not all clinics operate on an all-inclusive basis, so you definitely need to clarify what exactly is included in the price of prosthetics. Belenchikov A. A., Biragova A. K., Epkhiev A. A. Assessment of changes in the microstructure of hard dental tissues after preparation with various types of burs. Journal of health and education in the 21st century, 2022. [ii] Vedernikova L. V., Zholudev S. E. Planning the aesthetics of ceramic veneers without preliminary tooth preparation, 2013.

Indications for prosthetics by installing dental crowns

There are certain indications for installing a crown on a tooth, as for any other dental procedure. In what cases is prosthetics with dental crowns performed? It would be advisable to carry out the procedure in the following circumstances:

• Significant destruction of dental units by deep caries.
• Traumatic tooth destruction, in which the unit still has healthy roots.
• Aesthetic defects: noticeable discoloration of the enamel coating, chips.

Also, the installation of temporary crowns will be justified in case of periodontitis: the design will prevent further loosening of the teeth and, accordingly, will protect them from falling out. Indications for crown installation are determined during a diagnostic examination. Do you need to get a crown on your tooth? The orthopedists of our dentistry in Moscow - VENSTOM - will help you find the answer to this question! Come see a specialist at any time convenient for you. We are located next to the Baumanskaya metro station, you can walk to the clinic from the metro in just five minutes!