An anatomical dental crown is a hard shell consisting of 95% inorganic minerals that covers the top of the tooth. Dental crowns are subject to mechanical, temperature and chemical influences, therefore, in order to preserve the tooth and restore its functions, the question of installing a crown made of artificial materials often arises.

Tooth crown - what is it?

A tooth crown is a non-removable structure, which can be continuous or consist of interlocking elements (dentures). Installing a crown on a tooth is the most affordable, simple and popular type of dental prosthetics, but this method of dentition restoration is not suitable for everyone, so the final decision on the possibility and feasibility of installing a dental crown should be made by the dentist.

What is a crown needed for?

A dental crown is necessary not only for a beautiful appearance, a dazzling smile and psychological comfort - it performs a number of functions, among which the most important is protecting a damaged or destroyed tooth from external influences.

In addition, installing a crown allows you to solve several other problems, for example:

• preservation of speech function and proper functioning of the speech apparatus;
• restoration of full chewing ability, necessary for healthy digestion and prevention of diseases of the stomach, intestines and esophagus;
• reconstruction of an anatomically correct tooth shape (necessary to prevent bite pathologies).

The decision on the possibility of prosthetics is made by the doctor after a visual examination and examination of radiographic data, which allows one to assess the degree of damage to the tooth root and identify the presence of hidden purulent or inflammatory processes. Indications for prescribing prosthetics may include the diseases and pathologies listed below.

Premature wear of tooth enamel

Tooth enamel is the hardest tissue of the human body, consisting of minerals of inorganic origin (more than 97%). It protects the tooth from damage and pathogenic microorganisms. Premature wear of the enamel coating can be caused by:

• alcohol abuse and smoking;
• frequent consumption of rough food, seeds;
• long-term use of toothpastes with a high content of abrasives, etc.

Prosthetics can protect the tooth from further destruction and solve the problem of increased sensitivity.

Tooth decay of 70% or more

If most of the hard tissues are completely destroyed and the tooth cannot be restored with fillings or extensions, the doctor may recommend prosthetics and the installation of an artificial dental crown. This type of treatment may be required after tooth depulpation (removal of the dental nerve), since the “dead tooth” is deprived of nutrition and becomes susceptible to external factors and pathogens.

Dental crowns - before and after photos

Pathologies of the maxillofacial apparatus

Most of these disorders are congenital defects that occur during fetal development. If the bones of the skull form and grow incorrectly, this can lead to serious problems in the future, for example:

• speech impairment;
• curvature of the dentition (in the absence of effect from the use of braces);
• wrong bite.

All these pathologies often require the extraction of one or more teeth, so prosthetics for such a clinical picture are necessary to restore the integrity of the dentition and preserve the basic functions of the upper or lower jaw.

The need for prosthetics of adjacent teeth

If the patient requires other types of orthodontic or orthopedic care, for example, the installation of a clasp or bridge prosthesis, it is necessary to perform prosthetics on the adjacent teeth, even if they are completely healthy. Installing a crown is also a mandatory procedure after implantation of a dental implant - this will protect the structure from possible damage and extend its service life.

What types of crowns are there?

All crowns are divided according to three characteristics. Products that are used as a basis for bridges are called abutment crowns. Restorative crowns are used to restore the appearance of a tooth, its anatomical shape, and the functions that a particular tooth performs. They allow you to restore the integrity of the dentition and provide psychological comfort.

Table. Classification by design and structure of products.

Pay attention! The choice of crown depends not only on the cost of the product and the work required to install it, but also on the available indications and contraindications. The final decision must be made by the orthopedic dentist.

What materials are crowns made from?

Dental crowns can be made from different materials, which is why the cost of some products can differ tens of times (the average cost of dental crowns varies from 3 to 40 thousand rubles). Listed below are the main materials used to produce such structures and their brief characteristics.

Porcelain

Quite an expensive material, but its cost is justified by the properties of the material. Porcelain crowns are as close in appearance as possible to real teeth: they have a natural milky tint, the required degree of smoothness and a translucent coating. It is almost impossible to visually distinguish an artificial prosthesis from a real tooth, but only if a person takes good care of his teeth and tartar or dense bacterial deposits do not accumulate on their surface.

Please note! Porcelain crowns are not suitable for all patients. For example, when installing a metal-ceramic bridge, the use of such crowns is impractical.

Metal ceramics

These crowns are made of a metal base, which can be gold, platinum, nickel, palladium and other metals, and a ceramic veneer. The thickness of the metal plate does not exceed half a millimeter, and in some cases ultra-thin alloys of 0.2 mm are used.

Metal-ceramic crowns are the most popular type of such structures, as they have a large list of positive characteristics, including:

• long service life and wear resistance;
• good survival rate;
• hypoallergenic;
• attractive appearance.

The cost of metal-ceramic crowns belongs to the middle price segment and starts from 6,000 rubles.

Zirconium

In the production of dental prostheses, zirconium dioxide is mainly used - a refractory oxide in the form of a white crystalline powder, practically insoluble in water, acids, alkaline solutions and other liquids. Zirconium crowns have high sealing properties, have a long service life (the longest among all types of crowns) and are absolutely no different in appearance from other teeth.

The only drawback of zirconium-based crowns is their cost - the price for such prosthetics ranges from 11,000-27,000 rubles.

Ceramics

Crowns made without the use of a metal frame cost almost 2 times more than metal-ceramic products, but have almost the same characteristics and properties. They do not stand out from the background of other teeth, have high wear resistance and can withstand maximum chewing loads, which is especially important if prosthetics are carried out on small or large molars.

The cheapest are products made of metal or a mixture of metal with the addition of composite materials. Their price is about 3000-4500 thousand rubles, but externally such products do not look very attractive. In terms of their main characteristics (strength, wear resistance, tightness and durability) they can be compared with metal-ceramic products.

Among the huge variety of artificial crowns, choosing what suits a particular person is possible only with the help of specialists. Before prosthetics, the doctor will prescribe an x-ray to the patient, and will also conduct therapeutic treatment, if necessary, since any prostheses are installed only in the absence of any dental pathologies. After installing a crown, it is important to follow the doctor’s recommendations so that the product lasts a long time and does not require replacement after a few years.

Video - Dental crowns in dentistry

These prostheses need to be installed in the following cases:

• when most of the tooth is affected by caries;
• severe destruction of the dental organ (more than 70%);
• the tooth is destroyed after injury, the root must be intact;
• external defects of teeth (hereditary or acquired), changes in their color when aesthetics suffer;
• enamel predisposition to pathological abrasion;
• loosening of teeth, which is the cause of periodontal disease (temporary dentures will make them more stable);
• when a bridge is installed, thanks to the crowns it is fixed to the supporting teeth;
• the presence of uneven edges on the tooth, which injure the mucous membrane.

Which material to choose?

Thanks to new developments, in modern dentistry there are several types of materials from which crowns are made. Let's consider the main ones:

1. Metal ones are classic dentures that have been used for many years. Most often they are made of gold. The advantages of such products are strength, reliability and durability. They do not oxidize, have an abrasion coefficient almost like that of natural enamel, and do not damage opposing teeth. The main disadvantage is minimal aesthetics, which is why they are placed on invisible areas of the jaw.
2. Metal-ceramic, combining the advantages of metal and ceramics. They have durability, strength and high aesthetic values. They cost less than all-ceramic ones. The disadvantage of these prostheses is the mandatory preparation of a large amount of living tissue before their installation, as well as the possibility of abrasion of the enamel on the opposite dental organs. A strip of black metal near the gum may also be visible if its edge is lowered or the product was not made accurately.
3. Crowns that have the most aesthetic appearance are made from ceramic or porcelain. They are as similar as possible to natural teeth and retain their properties for a long time. However, ceramics are significantly fragile and cannot always withstand the load of chewing. For this reason, ceramic products are often placed on the front teeth. The main disadvantage of these crowns is the high price.

Manufacturing

Crowns are made using prepared plaster models. Metal, metal-ceramics and ceramics can be used as the manufactured material.

Manufacturing is quite labor-intensive and time-consuming, so while the dental technician is working on their creation, the patient is put on temporary plastic products. This way, the aesthetic appearance of the ground teeth is restored, and they are protected from external influences and infection. These dentures, in addition to protecting teeth, also allow them to be fully used when chewing.

Grinding of teeth for installation on their crowns

Grinding of teeth is called preparation. This procedure is performed using a drill into which a diamond bur is inserted. This way the tooth can be given the desired shape.

When grinding living teeth, the procedure is painful, so the patient is given anesthesia before it is performed. If you need to grind a pulpless tooth, anesthesia is not always used, but if you need to move the gums, it is better to do it.

The orthodontist needs to grind the tissue of the dental organ, a layer of which will be equal to the thickness of the prosthesis. Depending on the crown used, 1.5-2.5 millimeters of dental tissue can be removed from all sides of the dental organ. When attaching cast structures, less grinding will be required, and if ceramic or metal-ceramic products are installed, more grinding will be required.

The ground tooth forms a stump where the crown will later be attached.

How is the crown of a tooth restored?

The crown part of a tooth can be destroyed in different ways in different cases, which is why it is restored in different ways. To do this, either a stump inlay is installed in the tooth, or a pin is placed, and this does not in any way affect the appearance of the tooth.

A pin is a highly durable rod that is screwed into the root canal after it is filled. It plays the role of a basis for attaching the filling material. Then the tooth is built up and ground down for a prosthesis.

Using a stump inlay, you can make a very reliable restoration of a dental organ that will last a long time. It is made in a laboratory from a special metal that is non-toxic. The inlay consists of a coronal and root part. The root one is attached in the root canal of the tooth, and the coronal one has a look that is ready for attaching a crown to it.

The first stage of installation is preparatory

Before installing a crown, the dentist must carefully examine the patient's oral cavity; if necessary, an x-ray can be taken. Based on the examination results, a treatment plan is drawn up and the necessary procedures are recommended. It is also important to examine the patient for contraindications and allergies to any material.

The doctor and the patient select the most suitable type of crown. The timing of when the prostheses will be manufactured and installed, as well as the cost of treatment, is clarified.

If there are diseases of the gums and teeth in the oral cavity, they are cured.

1. Removes the nerve from the tooth and grinds it down. It is important to grind a layer of the tooth that will correspond to the thickness of the prosthesis. When attaching a crown to anterior units with one root, removal of the nerve is necessary, because during grinding a pulp burn may occur. Depulping a multi-rooted tooth is not necessary, because the risk of burns in such a situation is minimal.
2. Treats teeth affected by caries. Performs filling of canals. Cleans teeth from tartar and plaque.
3. If the dental organ is severely damaged, it is depulped, the canals are filled and the coronal part is recreated with a filling compound.
4. When attaching a crown to a living tooth, anesthesia must be used.
5. If there is a filling on the supporting tooth, it is replaced with a new one.

After preparing the teeth for attaching the prosthesis, impressions are taken from them, from which crowns will be made in the laboratory.

Laboratory (second) stage of installation

Using impressions taken from prepared dental units, plaster models of dental organs are made in the laboratory. This way, the dental technician gets an exact plaster copy of the patient’s teeth, maximally reflecting all their features. With the help of these models, further production is carried out.

Fitting and fastening - the third stage of installation

Before the crown is installed and even before the completion of manufacturing work, the first fitting of the prosthesis is performed. They check that it sits on the stump accurately and firmly.

Next, adjustments are made to the product if necessary and it continues to be formed in the laboratory. If metal-ceramics is used as the material being manufactured, it is necessary to coat the metal frame with an aesthetically attractive ceramic composition.

After completion, the prosthesis is fixed with a temporary composition, which allows you to evaluate the comfort of wearing the prosthesis, the possibility of allergic reactions, and eliminate the possibility that it will interfere with connection with opposing teeth. The reaction of the dental units and neighboring tissues to the presence of a new element in the oral cavity is checked.

At this time, defects in filling the dental canals, inflammation or severe pain may appear.

The most common defect is the following: overbite, which causes the prosthesis to fit loosely on the neck of the tooth, injuring the gums and causing bleeding.

If there are such complications, measures should be taken to eliminate them.

Temporary dentures are worn from two weeks to a month. If the patient has no complaints, they are removed, the dental unit is cleaned and the permanent product is secured with permanent cement. Then the crown is irradiated with a special lamp, which promotes hardening of the cement. All excess cement is carefully removed.

Note: You can chew on the tooth where the crown was placed after a couple of hours, and the maximum load can be placed on it after one day.

Cases in which crown removal is necessary

The need to remove the crown may be due to the following reasons:

1. The tooth was poorly prepared for installation of the prosthesis. Statistics show that 60% of cases of dental canal filling are carried out with errors. This serves as a prerequisite for the development of inflammation, and tooth treatment leads to the need to remove the structure.
2. Error during construction. If the product distorts the bite, does not fit tightly around the neck, or causes physical or aesthetic problems, it is removed.
3. Planned replacement. At the end of its service life (usually 10-15 years), the prosthesis is replaced.
4. Damage to the structure, the appearance of cracks or holes on it from washed cement, requires urgent replacement of the product.
5. The occurrence of complications.

Removal methods

Removing the product is quite difficult, especially if you need to keep it intact in order to reinstall it.

If removal is due to a broken structure, it is better to cut it with special tools.

If it is necessary to preserve the prosthesis, the following is used to remove it:

1. Crown removers (the most common are Kopp hooks) are special tools in the form of flat hooks that can be automatic or manual. With their help, the prosthesis is removed at the part where it connects to the tooth.
2. The forceps securely grasp the prosthesis with its jaws and remove it from the base.
3. Ultrasonic installations. Ultrasound waves can destroy the adhesive cement, after which the prosthesis can be easily removed.
4. Pneumatic tools, the use of which also contributes to the destruction of cement and facilitates the removal of the crown.

What are the complications?

Let's consider complications that can appear after the installation of crowns:

1. Strong pressure from the product on soft tissue disrupts blood circulation and contributes to the formation of bedsores. In this case, the soft mucous membrane can die off at the point of contact between the gums and the crown. This is how prosthetic stomatitis can develop.
2. Damage to supporting dental units by caries. Poor cleaning of the oral cavity or poor preparation of the dental organs for the installation of a prosthesis leads to the accumulation of food particles under the crown, where bacteria that cause disease develop.
3. An allergy to the metals that make up the prosthesis may not appear immediately after installation of the structure, but after some time. There is a burning sensation in the mouth, dryness, and inflammation occurs.
4. Galvanic syndrome can be caused by the presence of various metals in the mouth. The result is the formation of an electric current, which enhances oxidative reactions. At the same time, the patient feels a metallic taste in the mouth, there may be a general malaise, a headache, the structure and neighboring dental organs may change color.

Each of these complications requires a quick reaction and a visit to the attending physician, otherwise you may lose the supporting tooth. The doctor will most likely remove the crown, perform treatment and install a new one.

The most interesting questions for patients

Question

Is it painful to have a crown installed?

Answer

Denture placement can cause discomfort, just like any other dental procedure. The greatest number of unpleasant sensations occurs during the preparation stage, which includes drilling, grinding of dental organs, cleaning and filling of canals. But the fact that the crown is generally attached to pulpless teeth minimizes the likelihood of pain. If live teeth are ground, anesthesia is used. And the actual attachment of the crown to the stump is completely painless.

Question

How long does the procedure take?

Answer

The installation has several stages. To prepare your teeth, you need to visit the dentist one to two times, and sometimes more. The duration of each visit depends on which teeth are planned to receive a crown and their condition. It may take several weeks to make a crown. The prosthesis is placed on temporary cement for a period of 2 to 4 weeks. Then it is finally attached. In this case, the total time spent on installing a crown can be from 1 to 2 months, and sometimes more.

Question

Are crowns placed on living teeth?

Answer

For living multi-rooted teeth, the condition of which does not require depulpation, a crown is allowed. They can also be placed when installing a bridge, when crowns are attached to ground healthy teeth.

Installing crowns on teeth is one of the most common options in modern dentistry to restore their shape and functionality. The procedure requires time and some manipulations, but in many cases this is the only correct way to take care of your health and aesthetic component. Let's figure out how to put crowns on teeth.

Teeth, under the influence of various factors, are destroyed, subject to caries, injured, or even need to be removed. When fillings and other methods of eliminating defects are not possible, crowns are placed.

This is one of the types of prosthetics. With the help of a non-removable structure made of special materials, pronounced anomalies are eliminated.

Main indications:

• Severe destruction of one or more teeth due to extensive caries or trauma with preservation of the root – 70% of all cases. It is necessary to prevent splitting of the base and correctly distribute the chewing load;
• The presence of pathological abrasion of enamel. All teeth are preserved, but protection from surrounding negative factors is required;
• , resulting in noticeable loosening. Stability is achieved using temporary crowns;
• Installation of a bridge structure: crowns for support can be fixed to healthy teeth;
• Unsightly appearance caused by defects or significant discoloration of the enamel.

The decision in which cases to place a crown on a tooth is made based on the results of an individual consultation with a dentist. As a rule, in addition to examination, an x-ray examination is required.

Dmitry Sidorov

Orthopedic dentist

A crown is a type of prosthesis. Therefore, further in the text the word “prosthesis” can be safely considered its synonym.

Types of crowns

Several materials are used to make prostheses, each of which has its own advantages:

• Ceramic or porcelain. The metal-free design conveys the natural look as accurately as possible and does not lose its properties for a long time. A significant drawback is that this expensive material is not able to withstand heavy chewing load. Most often used for incisors.
• Metal (cast). A classic option that has been used for many years. The metal may be different. It is characterized by high strength and abrasion coefficient as close as possible to natural enamel. The most famous example is gold teeth. A significant drawback is the extremely unaesthetic appearance.
• Metal-ceramic. It is characterized by durability, good aesthetics and strength. Metal-ceramics optimally combines the properties of porcelain and metal in both price and quality. The disadvantage is the preparation of a large volume of dental tissue and an increased abrasion rate of natural tissue.
• Temporary plastic. It is installed on ground teeth during the production of the main crown and in order to protect them from aggressive environmental influences.

Installation steps and features

Installing a crown on a tooth is a multi-step procedure that involves multiple visits to the dentist. What is important is high-quality execution and a responsible approach to each stage, both on the part of the dentist and the patient.

The initial stage includes treatment planning, selection of a specific method and site preparation. Conclusions and recommendations are given based on the results of the examination, x-rays and based on the analysis of the clinical case.

The treatment plan may include the following items:

• filling, removal of stone and non-viable teeth, treatment of inflammatory processes;
• agreement on the issue to be raised in a specific case;
• preparing the tooth for the procedure;
• determining the number of supports for;
• calculation of the total cost of the procedure;
• determination of production and fixation dates, coordination of the schedule.

Before installing a crown, the tooth is processed as carefully as possible. If necessary, tartar is removed, the canals are filled, and depulpation (that is, removal of the nerve) and turning are performed.

Depulpation is used in the preparation of single-rooted teeth to eliminate the possibility of pulp burns during the grinding procedure. In addition, root canals are expanded and instrumented. For chewing teeth that have several roots, this risk is much less. Most often they are left “alive”, that is, the nerve is not removed.

After this, the stage of restoration of the prosthesis begins, which is carried out in one of two ways: using a pin or a stump tab.

Font usage. A special mechanism - a font - is screwed into the sealed canal, and the prosthesis is restored based on it. Turning is done after this.

Turning (preparation) is the process of giving a special shape by grinding using diamond burs, as a result of which a stump remains, and a crown is already placed on it.

Stump tab. This is a device specially manufactured in a dental laboratory, consisting of two parts: the root part, which is fixed in the dental root canal, and the coronal part, prepared for fixing the prosthesis.

Based on the criteria of reliability and practicality, this method is considered the best when installing dental crowns.

Living teeth must be prepared under local anesthesia. The procedure involves pushing back the gums, which causes discomfort. Therefore, anesthesia is also recommended when working with dead teeth.

The tissues are ground to the thickness of the future prosthesis: this is 1.5–2.5 mm. Installation requires removal of a larger layer than with cast dentures.

After preparing the base for the crown, an impression is taken using a special impression mass and transferred to the dental laboratory. Based on it, a plaster model of teeth is made. This is a model for casting a crown.

This process is quite lengthy. Fitting is required, including when installing crowns on implants. This is necessary to determine the quality of the product, the color ratio, and to check how accurately the contour and density are reproduced. At this stage it is possible to eliminate shortcomings and make adjustments.

To ensure that the patient does not feel discomfort while the crown is being made, he is given a temporary one made of plastic. It is very fragile and simply protects the ground tooth from external influences.

When the crown is ready, the final stage of installation begins. Its algorithm is as follows:

1. The crown is fixed with temporary cement. The doctor and patient observe the reaction. Considering that a prosthesis installed with permanent cement can only be removed by cutting, temporary fixation is necessary to prevent possible problems in the future;
2. After removal of the temporary cement, thorough cleaning is carried out;
3. Before placing a crown on a tooth, a final fitting is required. The doctor makes sure that the prosthesis is in the correct position and that the teeth fit comfortably;
4. Final fastening is carried out by applying a special permanent cementitious composition to the inner surface. The wearing prosthesis is exposed to irradiation to accelerate hardening;
5. Removing excess composition to avoid irritation and inflammation of the gums.

After just an hour, chewing loads are acceptable, and after a day you can use maximum pressure.

Types of fastening

You can place a crown on a tooth using special locks. The abutment teeth are ground down minimally. The process of installation and removal is greatly facilitated due to the fact that the clasps act as supports. This method is called fastening with locks and is considered a very promising area of ​​prosthetics.

Installing a crown on an implant involves the use of a special prosthetic technology. No treatment of adjacent teeth is required. If implantation was previously used, the structure can be installed in two fixation methods:

1. Screw. Used for single crowns. The adapter-abutment and the crown are connected outside the oral cavity, after which they are attached to the implant through a special hole with a screw. A filling material is used to close the canal.
2. Cement. When replacing several teeth, the abutment is fixed to the implant, and then the crown is attached with cement.

Reasons for removing dental crowns

The most common cases when its removal becomes necessary include:

• Poor quality of the preparatory stage. According to statistics, 60% - unsatisfactory filling;
• Planned replacement;
• Design errors, poor quality workmanship or materials causing pain or discomfort;
• Violation of the integrity of the structure;
• Occurrence of complications: allergic reaction to materials, galvanic syndrome, prosthetic stomatitis.

The main question that interests most patients is whether the procedure is painful? Like any dental procedure, installing a metal-ceramic crown or any other causes some discomfort.

The most painful is the preparation stage, namely tooth extraction, grinding, filling. But modern means, including anesthesia, allow dentists to perform absolutely painless procedures.

A high-quality and timely prosthesis allows you to get rid of serious diseases and prevent their occurrence, while providing an impeccable aesthetic appearance.

Clinics offer many options for crowns, the key difference between which is the material used. It is this parameter that largely determines the quality, cost and indications for the use of a particular crown. Another very important nuance, which also affects the quality parameters, is the manufacturing technology of the product.

Types of crowns

1. Metal crowns. They are considered hopelessly outdated, but are still used in many clinics. They can be made from various alloys (cobalt-chromium, titanium, and so on). Options with spraying (for example, “gold-like”) or with plastic lining are possible. They are made using solid casting technology: the structure is cast entirely from a tooth impression. The stamping technique can also be used.


2. Crowns made of precious metals. As a rule, these are alloys based on gold or platinum. Crowns made from pure material are not used due to high cost and functionality problems. The alloy allows you to achieve the necessary strength and maintain biocompatibility. Manufactured using solid casting technology.


3. Metal-ceramic crowns. The most common products that consist of a metal frame and ceramic coating. First, the frame is cast, then a layer of ceramic is applied, which can be manufactured using computer modeling.


4. All-ceramic crowns. Metal-free ceramic crowns. Due to its biological inertness, this material is considered one of the safest for soft tissues. Manufactured using firing technology (on a refractory model or platinum foil); ceramic pressing method (surface painting technique or layering technique); on a milling machine using CAD/CAM computer modeling.


5. Some classify such crowns as metal-free products, but this is not so. Zirconium is a metal, but it is much more aesthetically pleasing and safe compared to others. They are manufactured using computer modeling using special milling equipment. There are two types of zirconium dioxide crowns: monolithic (entirely made of zirconium dioxide without veneering) and combined (porcelain mass is applied to a zirconium dioxide frame).

There are also temporary crowns that are placed while the permanent structure is being manufactured, but we cannot talk about them as a full-fledged orthopedic structure.

Each of these types of crowns has variations within its category (type of alloy, material features, production method). The overall quality indicator consists of many nuances that must be taken into account when choosing a product. Below is a table with the main parameters that determine the quality of the crown. Two plus signs or two minus signs indicate a characteristic feature of the crown in a particular indicator.

Quality table

All types of crowns are capable of restoring the functionality of a tooth, but the appropriateness of choosing one or another product largely depends on the specific clinical case.

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. If you are not shy about a “metallic” smile, then we recommend installing solid crowns of this type. Stamped products are not even the last century, but the century before last. Loose fit, thin walls and the risk of bacteria accumulation under the crown - the list of disadvantages can be listed for a long time.


• Gold and platinum crowns. 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 particular crowns have the optimal price-quality ratio. However, this product has its downsides. 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 glass-ceramic crowns (Emax, Empress and similar) allow prosthetics to be performed in any part of the jaw. Their only drawback is the very high price (20,000 rubles or more for one product).


• Zirconium dioxide crowns. Very strong, very durable and very expensive. Monolithic zirconium crowns are more often used for prosthetics of chewing teeth, since porcelain veneer increases the possibility of chipping. The cost of one crown can reach up to 25,000 - 30,000 rubles, which makes it practically unaffordable for many patients.

Which crown is better for a front tooth?

In the case of the front teeth, aesthetics come to the fore, since the incisors and canines are most visible when smiling. The main task of a crown is to look natural, not stand out from the rest of the dentition and have the necessary margin of safety. The question of which crowns are best placed on the lower teeth (or on the upper teeth) does not make sense, since the same solutions are used on both the upper and lower jaws.

Which crowns are best for front teeth?

• Metal crowns. Today, installing a metal crown on a front tooth is signing a death sentence for your smile. On the other hand, when there is absolutely no money to restore teeth, even this option can be considered. There is an alternative - a combined crown, the outer part of which is covered with plastic and the inner part with metal. However, you should not count on the durability of such a design: the plastic is painted, erased and, in general, is not very resistant to the influence of the external environment.


• Crowns made of gold or platinum. A great option if you are a famous rapper, a gypsy baron, or just want to put together a Soviet fashion set “Prosperous”: a sheepskin coat, a fur hat, a mohair scarf, a mustache and a gold fixie. In all other cases, this option does not make sense.


• Metal ceramics. Inexpensive, but very controversial from an aesthetic point of view, an option. The metal frame is transparent, not to mention the tell-tale blue rim at the point of contact between the gum and crown. On the other hand, such a decision is the answer to the question of which crown is best to put on the front tooth if you are limited in funds. To avoid the appearance of “cyanosis,” you can order metal-ceramic crowns with the so-called shoulder mass, when the entire area is covered with ceramics, but this option will cost about twice as much. For the same purpose, a frame made of gold or platinum is used, which also significantly increases the price.


• Ceramic crowns. Perhaps the best dental crowns for prosthetics of front teeth. Since the issue of strength is not so acute here, classic all-ceramic crowns, which are cheaper than more advanced glass-ceramic products, are quite suitable.


• Zirconium dioxide crowns. The most expensive of the possible options. If price is not an issue for you, then crowns with a zirconia frame and porcelain veneer are an excellent option.

Photos before and after crown installation

Tooth crowns: which ones are better in price?

The cost of crowns consists of materials, technologies and equipment used, as well as the qualifications of the doctor and the level of the clinic where the treatment is performed. Below in the table you can see which crowns are best to put on your teeth, based on their cost.

Types of crowns for teeth and which ones are better in terms of cost

You can see all prices for dental crowns.

A dental crown is a prosthesis that is an exact anatomical copy of a lost or damaged tooth. A crown is a non-removable structure that is placed on a tooth prepared using a special technology and replaces a canine, incisor, premolar or molar. What types of dentures are there, is it painful to put a crown on a tooth and how long does it last?

Indications for installation of dental crowns

The high popularity of this type of prosthetics is explained by excellent results at an affordable cost of services. Installing crowns allows many people to regain self-confidence and get rid of inhibitions. Prosthetics is not just the restoration of damaged teeth. With the help of a high-quality prosthesis, you can strengthen and protect a damaged tooth, restore chewing and speech functions, and be able to smile freely.

Before making a dental prosthesis, you need to choose a material and weigh the pros and cons (we recommend reading: how exactly are teeth prosthetic in dentistry?). This type of prosthetics has virtually no contraindications. Allergic reactions may occur if there is an individual intolerance to certain types of materials for the manufacture of structures, as well as to the cement with which the crown is attached to the tooth. Questions may arise about which crown is better and whether it is worth installing them at all.

The decision on the need for prosthetics is made by a specialist after a detailed study of the initial data. Based on a visual examination and the results of an x-ray examination, the doctor selects the most suitable type of prosthesis and makes recommendations on the material.

Absolute indications for installing dental crowns:

How to choose the type of crown for your teeth?

Types of dentures vary in design complexity and materials. The choice of crown type depends on the objectives of prosthetics and the degree of tooth decay. Types of dentures:

• full – replaces the entire tooth;
• equatorial – made of metal and used for splinting teeth;
• stump - used in case of severe destruction of hard tissues;
• half-crown - placed on the tooth, covering it on all sides except the vestibular (visible) part;
• pin - inserted under the crown, it strengthens or replaces the root;
• telescopic prosthesis.

Materials from which the structure is made

What is the best material to make crowns from? Various materials are used to make dentures: metal, ceramics, porcelain. To determine which crowns are best to install, you need to familiarize yourself with the features of each material and find out its pros and cons.

What types of crowns are there:

Preparing for installation

Before putting a crown on a tooth, you need to carry out a number of preparatory measures (we recommend reading: is it possible to put a crown on a tooth if only the root remains?). Preparation stages:

1. selection of the most suitable type of crown based on a comprehensive examination;
2. preparing the oral cavity for the procedure;
3. production of a prosthesis.

During the consultation, issues such as selection of material, choice of method of attaching the model, as well as the cost of the procedure are resolved. The service life of crowns primarily depends on the quality of preparation. In many cases, removal of nerves from prosthetic teeth is indicated. This is necessary to avoid inflammatory processes during the operation of the crown. The entire dentition is treated for inflammation, caries, and hard and soft dental deposits are removed.

In some cases, tissue trimming is required to ensure a tighter fit of the crown. This operation is performed in the following cases:

• with pathological growth of soft gum tissue;
• in the presence of uneven edges, which after fixing the crown will look unaesthetic;
• in the presence of deep gum pockets;
• when diagnosing chronic inflammation of soft tissues.

If gingivitis, periodontitis, or periodontal disease are detected, therapeutic treatment with medications is first carried out. Surgical intervention is resorted to in extreme cases. Trimming of soft tissues is performed with a scalpel, laser or diathermocoagulator. During surgical correction of the gums, impressions are taken only after the mucous membrane has healed. You can watch the video to see how tissue is trimmed for a crown.

If most of the hard tissues are lost, the volume necessary for prosthetics is restored using:

• implantation of a pin, which replaces the tooth root in its absence;
• mounting a stump inlay, which partially replaces hard tissue.

The next step is to grind the teeth using a drill. The top layer of tissue is removed under local anesthesia due to the pain of the procedure. After this, the doctor takes an impression and sends it to the laboratory. Based on the impressions, the dental technician makes the prosthesis. It will take some more time to try on and correct the design.

If you have to wait a long time for dentures to be made, the patient is offered temporary dentures made of plastic, since worn-down teeth look unaesthetic and sometimes their sensitivity increases. This applies to complex ceramic structures - they take a little more time to create.

Installation steps

After the crowns are made, the second part of the procedure begins. Stages of installing a crown on teeth:

1. fitting of the design;
2. trial fixation;
3. final fixation.

During the fitting, the doctor determines whether the crown fits comfortably and whether it hurts the patient. If defects are identified, corrections are made. If the crown does not cause any discomfort to the patient, temporary fixation is performed. For this, special cement is used. If no allergic reactions are detected within 30 days, final installation is performed. The surface of the teeth and dentures is cleaned of temporary cement residues, then the crown is fixed using a stronger mixture. When it hardens, you can remove the prosthesis only by sawing it into pieces.

Do they put a crown if there is a crooked tooth nearby?

Installing a crown near a crooked tooth or in the presence of an incorrect bite is somewhat different from conventional prosthetics. In this case, the dentist may offer the following options for performing the procedure:

• install the prosthesis exactly the same as the natural tooth;
• correct the crooked adjacent tooth and install the denture correctly.

The choice of treatment tactics is selected individually in each case, taking into account the shape of the bite and the degree of curvature of the teeth. In this case, the doctor must take into account the opinion and desire of the patient.

In what cases does the crown not hold well?

The main reason for poor fixation of the structure is poor preparation of the tooth for prosthetics. A properly prepared unit is of sufficient height and is shaped like a rectangle or cylinder. When a tooth is half ground down or has a cone shape, the likelihood of unintentional crown removal increases. Also, the reason for its unreliable fastening can be a large gap between the stump and the inner surface of the prosthesis.

In addition, the cause of poor fixation can be:

• inflammation and swelling of soft tissues at the site of contact with the tooth crown;
• formation of a tooth root cyst;
• a fragment of an instrument remaining in the root canal;
• poor fit of the crown to the tooth, when it does not fit tightly enough around the neck of the tooth, leaving the root exposed;
• mechanical damage to the crown, formation of cracks and chips;
• untimely replacement of the structure.

Service life of the structure

The service life of the structure depends on many factors: the material from which the structure is made, the quality of its manufacture, care and compliance with operating rules, and the condition of the gums. Metal crowns can last up to 25 years, the service life of metal-ceramic structures is 10–12 years, and plastic ones - no more than 5 years (we recommend reading: the pros and cons of plastic crowns installed on chewing teeth). At the end of the warranty period for using the crown, an inflammatory process may occur in the gum area, the tissues swell, and an unpleasant odor appears from under the crown. Timely replacement of the structure will help avoid complications, discomfort and pain.