Tab to the tooth for a crown: a crown with the tab
Tab is on the tooth under the crown is a mikroprotez tooth that restores its anatomical form. Sometimes this method of treatment is the only option to save the destroyed tooth.
Indications for the production of
In prosthetic dentistry dentures microdenture shown in such cases:
- Carious destruction of more than 50% of the tooth surface.
- Traumatic fracture of the tooth crown.
- Multiple fall of a composite filling.
Preparation of the root to the setting tab
During examination of the patient, the dentist pays particular attention to the following points:
- The ratio of the height of the preserved hard tissues of the tooth to the surrounding gingival edge. To achieve a positive future result of the restoration tooth root should be 1-2 mm above the gingiva.
- For your teeth chewing miconia area must maintain its integrity.
After visual and instrumental inspection of the oral cavity specialist sends the patient for x-rays. On sighting the x-ray image the doctor evaluates the condition of the periodontium (the ligaments of the teeth), the bone structure and the presence of filling material in root canals. Note that the tooth to be reconstructed, must be perfectly sealed. The quality of endodontic treatment directly affects the durability of the tab.
If during the examination the dentist has determined neoprobirovannye channel, then the patient undergoing pereplanirovana problem tooth.
Contraindications to orthopedic treatment using tabs
Dentistry is considered an invalid setting kultovyh root tabs under the following conditions:
- The presence at the top of the root granuloma or cyst.
- Poorly sealed root canals.
- Perforation (through hole) in the field of physiological separation of the roots of the chewing teeth.
- The accompanying gingivitis, periodontitis, or periodontitis.
- Resorption (melting) of nearby bone plate by more than a third of their height or mobility of the damaged tooth.
- Traumatic fracture or dislocation of the tooth root.
Classification of dental inlays
Depending on the goal denture tabs are divided into two large groups:
- Restorative tooth tab which is used to reconstruct the anatomical shape of the tooth surface. It is usually completely match the color of the restored tooth.
- Root post-and-core tab. This so-called tab for a crown. This microdenture intended for forming a support for fixed prosthetic construction. Cultivee design, usually made from metal alloys.
Depending on the material, the experts identify the following types of structures:
- A composite restoration. They are, in fact, differ little from traditional fillings. The only difference of this method of prosthesis is considered high accuracy since it is produced in the laboratory.
- Ceramic inlays. This aesthetic restorations, which are distinguished by reliability and durability of its design.
- Cultivee metal tabs. This group of tabs relates to kultovym reconstructions. They can be manufactured from cobaltchromium alloy (CHIEF-alloy), silver or precious metals.
CHIEF-tabs do not cause allergic reactions and does not corrode.
Silver as the main material, has antibacterial properties. But lately, such designs are practically not used in prosthetic dentistry because of the high probability pigmentirovannyj the nearby gums, which negatively displayed on an aesthetic restoration.
Tabs made of precious metals are considered to be completely inert for the patient (no side effects) and accurate.
Structural features of tabs
The tab in the tooth for a crown consists of two parts:
- The pin is a metal rod that is rooted and fixed in dental cement.
- Stump. Surface part corresponding to the physiological shape of the tooth.
According to the theory the length of the pin part needs to be three times greater than the height of the stump part.
In orthopaedic practice doctors sometimes recommend to set the collapsible option kultovyh tabs. In such cases, the tab consists of two parts, which in turn is installed in the root of a tooth. The indication for this prosthesis is a significant divergence of the longitudinal axes of the roots.
Prosthodontics patients root stump inserts is carried out in two main ways:
- Video technique. On the first visit, the dentist prepares the tooth is destroyed and calibrates a root canal special milling cutters, for further removal of the cast. After that, the doctor takes a cast root copings with the plastic pin and C-Silicone. The resulting mold is sent to the laboratory, where a cast plaster model and simulated the design in wax, then the wax is replaced with metal. Otprepariroval tooth covered with a temporary filling. On the second visit, the podiatrist fixes the prosthetic structure at the root of the tooth.
- Indirect method. In the primary visit, the technician conducts mechanical processing of the defect bone tissue. The doctor carves all pigmented and non-viable dental tissue. Dentist also expands the mouth and the actual root canal. After preparation in a patient taking the upper impression and the lower jaw and record the nature of occlusal contact. Dental laboratory technician models and molds metal tab, which takes into account individual features of the structure of the oral cavity of the patient. On re-admission orthopedic surgeon fixes the restoration with glass ionomer cement.
Benefits of orthopedic treatment tabs
Today inlays for a crown are considered the most effective way to restore a significantly damaged tooth. Post-and-core tab unlike parabulbarly and anchor pins is the most physiologically
distributes chewing pressure. This eliminates the possibility of a split tooth root during mastication. In addition, post-and-core tab is a reliable support for artificial crowns and bridges.
Cosmetic retail of composite and ceramic materials provide high aesthetics of the restoration. Restored in this way teeth can serve for many years.
Features of tooth preparation for prosthetics tabs
The reliability of the prosthesis depends on the following factors:
- Complete sealing of root canals.
- The root part should take not less than two-thirds of the length of the root.
- During a dissection of the hard tissues, the dentist should avoid excessive thinning of the walls of the channels or split roots.
- The lack of perforations and inflammation in the periodontal tissues.
The procedure for establishing
Fabrication and fixing of microdenture is carried out in two visits to the dentist. Anesthesia usually is not required. This is because in the root of the missing nerve endings and all dental procedures are absolutely painless.
Clinical stages of prosthetics include:
- Examination and consultation with a podiatrist.
- Machining of the damaged tooth using a drill.
- Imprint of the jaws. The mold must be two-component. First, the dentist places the patient in the oral cavity of the base attikou mass, which is in pasty form. The second part of the mold is a silicone fluid, penetrating into all the recesses of the tooth. This technology allows you to obtain detailed and qualitative mirroring prosthetic bed.
- Fixing the finished prosthetic. This restored the root isolated from the saliva and oral fluid. In such cases, the patient sets the dental dam. Fixation microdenture is carried out by means of special cement. The best remedy is considered a fixation of glass ionomer material with high durability and low shrinkage.
Care kultovym orthopedic microdenture
After the establishment of the tab doctors recommend that patients adhere to the following rules:
- Hygienic care such restoration shall be carried out in two-a-day brushing teeth with a toothbrush and toothpaste. Thorough cleansing of the surfaces prevents the development of secondary caries and racemethionine of prosthetic. Crown on the teeth on the tab requires regular maintenance.
- After each meal the patient should rinse the mouth with warm water.
- Cleaning interdental spaces is done using dental floss.
- Cultivee tabs should be prosthetic artificial crown within 2-3 months.
- At least once a year to undergo a preventative dental check.
Complications of prosthetic dentistry
Crowns tab of metal are in the form of:
- Racemethionine restoration, which occurs when the failure of the algorithm prosthesis or penetration of the fluid in the root canals during fixing of the structure.
- Root fracture of the tooth or perforation of the root canal. This complication occurs after excessive machining of the damaged tooth.
- Allergic reactions of the mucous membrane of the oral cavity. The clinical picture of the disease manifests swelling and redness of the gums. Eliminate allergies can only replace tab.
- Pigmentation of the soft tissue in the periodontal region. Darkening of the gingival surface was observed at the contact of periodontium with a silver tab.
What artificial crown is better to install on cultive tabs?
In modern dental clinics crowns on the teeth on kultovyh tabs recommend ceramic or metal-ceramic crowns. This is the most aesthetic and durable restoration. Ceramic material for the prosthesis does not change its color, and has high strength.
After fixation of microdenture experts recommend to make a temporary plastic crown, whose function is to protect the tooth root from bacterial contamination. In addition, a temporary prosthesis prevents the growth of gingival tissue in the area of restoration and as a consequence the occurrence of bleeding gums.
The procedure for establishing permanent crowns to copings
After fixation of root copings and removal of excess cement, the doctor conducts the following activities:
- Local infiltration anesthesia. You first need to clarify the allergic status of the patient.
- The formation of a subgingival ledge. This so-called step at the root to establish the crown. This technique of prosthesis fully recovers periodontal area of the oral cavity.
- Placing a retraction thread for temporary peeling of the gums.
- The removal of the cast upper and lower jaws.
- Fixing temporary plastic crown, which is made directly in the mouth or in the dental laboratory.
- Fitting the metal frame of the future restoration and recruitment of the future shade of the tooth.
- Re-fitting the metal-ceramic crowns and correction of the malocclusion.
- Cementation of artificial crowns.
Upon completion of all procedures the doctor recommends the patient for two hours to abstain from food and liquids. Tab post-and-core and crown in the first hours is very susceptible to mechanical damage.