Dental stump inlay for a crown: what is it, types of stump inlays

If a tooth is destroyed by caries or as a result of injury, it must be restored, otherwise the tooth can be lost, and the absence of even one dental unit in a row is fraught with the most unpleasant consequences for health. For example, due to the absence of a tooth, an incorrect bite may develop, which leads to disruption of the correct process of chewing food and the development of various diseases of the digestive system.

If the tooth is slightly damaged, then most likely the doctor will use a regular, light-curing filling to restore it. But if the damage is significant, it would be more correct to use a stump tab.

Many people do not even know what kind of structure this is - a stump tab and for what purpose it is used by dentists. Meanwhile, the use of stump inlays makes it possible to successfully restore teeth that at first glance seem completely hopeless and must be removed.

In the article we will tell you in detail about what stump inlays are, what types of them exist, and why severely damaged teeth are best restored with inlays, and not with fillings and pins.

What is a stump tab

A stump inlay in dentistry is a pin structure used for prosthetic purposes when it is impossible to restore the natural tissues of the coronal part of the tooth. The inlay is attached to the root part, protruding onto the visible surface of the tooth, forming a support for the artificial crown. The main condition for its use is the ideal health of the tissues and roots surrounding the unit. The stump tab, in contrast to the anchor pin, intended only to strengthen the tooth, consists of two parts of elements: the lower one, installed in the canal, and the upper one, which gives the tooth its shape. The system rests on the surface of the tooth being restored and is able to evenly distribute the load on the root.

Benefits of installing the product

The “stump” is always made according to the patient’s individual casts. It is an exact copy of the internal space of the dental canals. This ensures the closest possible fit of the artificial part to the walls of the damaged unit, completely eliminating the formation of air voids in which pathogenic microorganisms can multiply in the future.

In addition to the base, which is immersed in the channels, the system also contains a protrusion machined for the crown. This structure of the prosthesis promotes uniform distribution of the chewing load, and therefore prevents atrophy of the jaw bone.

In the case of multi-rooted molars, “stumps” with several pins are made. Thus, such devices can be safely called universal. They are suitable for the restoration of any tooth, regardless of its location.

Manufacturing technology

1. The method of layering ceramics. After receiving the impressions, a refractory model is made, a ceramic pin is tightly installed in the channel, ceramic is applied to it, and firing is performed. In the process of applying ceramic layers, it is possible to choose different colors and shades of the material, dyes and modifiers.
2. Production of ceramics from tablet molds by pressing. An inlay is modeled from wax, and sprues are installed in the direction of the ceramic flow. Using a silicone ring, investment material is introduced and a limiter is placed. Pressing is carried out in an oven equipped with a microprocessor control system. The resulting product after pressing and casting is a solid single crystal, the abrasion of which is comparable to the natural abrasion of hard dental tissues.
3. Manufacturing using CAD/CAM method. Allows you to form prostheses and parts that match the implant, abutment, and the shape of the tooth stump. The unit is scanned in the mouth or on a model, 3D modeling is carried out using a special program, the information received is transferred to a milling machine, which mills the product under computer control. The method is precise and complex, requiring high costs for professional training of personnel to operate the equipment.
4. Injection molding manufacturing method. Casting a working model from plaster/polyurethane, selecting an ashless pin similar to the root canal, applying silicone varnish to the root. The pin is inserted into the canal and modeling is carried out with ashless plastic/wax. After a control check, the cast stump insert is removed and transferred to a metal casting. The method is technologically easy, low-cost, requires a minimum of material costs, but is very sensitive to the quality of casting. With strict adherence to all norms and rules, reliable and high-quality microprostheses are obtained.

Features of the material

The alloy of cobalt and chromium is widely used in prosthetics and implantation due to its unique features:

• does not oxidize with saliva or under the influence of food;
• biocompatible with oral tissues;
• does not lose its original properties and color over time;
• durable;
• withstands heavy chewing loads;
• hard, but at the same time elastic;
• has a low thermal conductivity;
• hygienic;
• does not shrink;
• provides high-quality adhesion of the product to dental tissues.

The cost of restoring a tooth with such an inlay is significantly less than other methods of microprosthetics.

Manufacturing methods

1. Straight. It is characterized by its low cost, ease of implementation, and does not require the presence of fire-resistant models or impression materials. With the direct protocol, the future core inlay is modeled in the oral cavity, and then dental laboratory specialists replace the wax with the working restoration material. Disadvantages: insufficient visibility of the surgical field, risks of thermal injuries to the mucous membrane, large time expenditure for the dentist.
2. Indirect (indirect). It is used for all types of defects; production takes place in two stages: obtaining an impression plus obtaining a model.

Tooth preparation

The first visit to the dentist before the immediate installation of the core tab consists of preliminary diagnosis and preparation of the oral cavity.

The specialist assesses the condition of the damaged element and the mouth as a whole , and also treats existing diseases.

On a problematic tooth, it is important to stop the development of a carious cavity and remove tissue damaged by the disease.

A temporary crown is placed on the treated element to adapt the patient and to avoid the growth of soft tissues. The temporary crown remains until the inlay is made.

Indications for installation

• destruction of the coronal part;
• periodontal diseases (splinting);
• defects in the shape, position of the unit, supragingival area;
• There is no way to put a pin with a filling. For example, if the chewing units are destroyed.

Contraindications for installing a post-core restoration on a pin

: caries, cysts, damage or absence of roots, gum disease, periodontal disease, pathological mobility of the dentition, allergies to the alloys from which the structure is made.

We offer

:

• single crowns;
• veneers, lumineers;
• bridge-like devices;
• implant-supported restoration;
• systems with stump pin system.

Indications and contraindications

Restoring a tooth with a stump insert is indicated in cases where more than 50% of the tooth is destroyed , and it is not possible to perform a regular filling:

• when the crown is completely or almost completely destroyed, however, the tooth has a strong root, not affected by carious changes;
• products are used as an auxiliary method when it is necessary to create supports for a bridge structure;
• when the nerve of the tooth was removed due to carious changes, and the roots were deeply filled.

It is not advisable to perform restoration using this method if the patient:

• periodontal disease develops (the contraindication is valid until the disease is completely cured);
• the roots of the unit being restored are not suitable for installing pins (too thin, fragile, or have a deformed shape);
• the roots have not been completely sealed;
• the roots were destroyed.

In all of these cases, the choice of treatment method is made in favor of tooth extraction.

Let's consider together the advantages of a ceramic tooth inlay and indications for installation.

In this post you will find detailed information about Inlay tabs.

Here is all the most important information about the rules for taking impressions of teeth for prosthetics.

Advantages of stump inlays

Compared to other post systems, the stump post is much stronger. It distributes the load more evenly and fits tightly to dental remains, which prevents the formation of cracks and the development of caries.

Other advantages include the possibility

:

• regenerate destroyed/lost units;
• support natural teeth with bulk fillings;
• remove increased enamel abrasion;
• restore anatomical form/functionality;
• align curvature, maintain aesthetics;
• make prosthetics on implants.

What are they made from?

The stump base can be made from:

• Metal (cobalt or chromium alloy, silver, gold). Metal devices are very reliable and practical. They are almost impossible to break. But they don't have great aesthetics. Over time, the pre-gum zone sags a little, and then the metal base begins to peek out. It is not surprising that today doctors rarely install metal.
• Metal ceramics. Strong, but not as durable as metal. It is prone to falling out, which is extremely undesirable, since treatment has to be carried out from the very beginning.
• Ceramics. The best solution in terms of aesthetics. Does not show through gum tissue. Ideal for smile area prosthetics.
• Zirconia. Devices made of zirconium oxide match the color of the enamel. They are incredibly durable - like metal. Not prone to destruction. They do an excellent job of restoring the aesthetics of a smile.
• Composite. Such a “stump” is not reliable enough. Compared to others, it adheres better to the surrounding tissues, but if the goal is to get a long-lasting result, it is still better to give preference to zirconium oxide.

Comparison with classic pins

Standard pins - pros:

• gentle tissue preparation;
• the ability to conduct therapy in one session;
• low price.

Minuses:

• the coronal and intraradicular segments of the restoration may become separated because there is no chemical bond between them;
• in the case of active rods, there is a risk of a wedging effect during the screwing process;
• the absence of a base in the structure leads to a sharp increase in the propping load on the root during operation;

Pros:

• the stump and the pin are cast from identical material and connected, which 100% eliminates the possibility of their separation;
• slight wedging effect during cementation of the stump inlay;
• minimizing disjoining pressure, since the chewing load is transferred to the walls of the root, along its axis, to the rod.

Stump pin inlays can be used when the destruction index of the occlusal surface of a unit is more than 60-100% (standard pins - 50-60%). They are durable and guarantee the reliability of the structure.

Our dentistry offers installation of several types of core microprostheses

:

• serve within 5-25 years;
• reliability of fixation;
• excellent strength;
• simplification of subsequent fastening of bridges;
• the ability to work with any degree of destruction, restoration of bite;
• lack of access for pathogens. No inflammatory processes;
• simple replacement of the prosthesis if necessary.

What are the quality parameters of dental prosthetics with inlays?

If the technology was violated during the process of fixing the inlay, or the patient has not undergone preventive examinations for years, then secondary caries may occur at the border of the contact of the microprosthesis with the dental tissues. Then it will be necessary to carry out treatment and remove the dental inlay. At the same time, the design itself does not in any way stimulate the occurrence of caries. To avoid it, the main thing is to prevent technological inaccuracies during the installation process, so that the tightness of the dental inlay with filling the cavity with composite cement is equal to 0.004 microns. It is also important to ensure that there are no overhanging edges for a complete aesthetic and functional restoration of the tooth.

If the tab is installed correctly, then it does not provoke an increase in tooth sensitivity, and if not, then the antagonist tooth may begin to react to irritants due to malocclusion.

If pain occurs as a result of complications such as caries, pulpitis or periodontitis, the dental inlay must be opened and appropriate treatment carried out. After which this microprosthesis will need to be replaced with a new one.

Classification of stump inlays

View	Description
By installation method
Cast	Manufactured under high pressure and temperature. The non-separable model consists of a main part and pins for fixation. Can be replaced over time
Collapsible	Designed for two to four channels. Similar in design to cast ones, only some pins are made removable. This is due to the fact that channels do not always have a symmetrical structure. Comes with a lifetime warranty
Based on base material
Metal	These can be cobalt-chrome, precious metals and their alloys. They are characterized by increased reliability. Disadvantages include an unaesthetic appearance, which is why they are most often placed behind the smile line
All-ceramic	Made from zirconium dioxide or pressed ceramics. Zirconium is as durable as its metal counterparts. Ceramic inlays are aesthetically pleasing and natural-looking, which is why they are used for front teeth. All-ceramic ones are produced automatically. This ensures maximum compliance with the bite
Metal-ceramic	Products made from metal ceramics are of average quality and affordable price. Due to the difference in thermal expansion of metal and ceramics, there is a high risk of falling out
Composites	Composite inlays are rarely used due to their low durability

Important

: It is desirable that the materials of the pin and crown parts of the core structure coincide. For example, if the microprosthesis is metal and the crown is ceramic, then the metal will be translucent.

Types of restoration dental inlays: description, characteristics

In this section of the article, we will tell you about what restoration dental inlays can be, used in tooth restoration as an alternative to conventional fillings. Prostheses will be classified mainly according to the material of manufacture and according to this criterion, the inlays can be ceramic, composite, or metal. The material of the tooth inlay will affect both the performance characteristics of microprostheses and their cost.

Ceramic tooth inlay and its features

Most often, ceramic dental inlays are used to restore chips on living teeth and act as a high-quality and more reliable alternative to conventional fillings.
Ceramic inlays can only be placed on teeth that are alive, not loose, and have been treated for caries. Ceramic dental inlays have many advantages: they are aesthetically pleasing, durable, do not change their beautiful color even with prolonged use, and do not wear off. The high density of the marginal contact of the ceramic inlay with the natural tissues of the tooth eliminates the risk of developing secondary caries.

But ceramic dental inlays have some disadvantages. Some consider the disadvantages of ceramic inlays for teeth to be the high price of this type of microprosthesis in Moscow (from 8 thousand rubles), however, it should be noted that the high cost is fully justified by the long service life of ceramic inlays and their impeccable aesthetics. Please note that with ceramic inlays installed on your teeth, you will need to give up the habit of chewing nuts, crackers, and other types of too hard foods with your teeth. The ceramic inlay may not withstand such heavy loads!

Metal tooth tab: characteristics, pros, cons

Metal restoration inlays are used quite rarely these days, and all because microprostheses made from this material have a number of disadvantages:

• When installing metal inlays in the mouth, a very unpleasant galvanic side effect for the patient may occur, expressed in constant and profuse salivation, a pronounced metallic taste in the mouth;
• Installing metal inlays does not allow for high-quality and tight contact between the microprosthesis and the natural tissues of the tooth, and this increases the risk of developing secondary caries. Gold inlays on teeth can provide a good fit, but their price will be high, because gold is a noble and expensive metal;

• Metal inserts can cause allergic reactions;
• The aesthetics of metal inlays also leaves much to be desired.

The only significant advantage of metal inlays for teeth is the fairly low price for this type of microprosthesis in Moscow. The cost of a metal tab in the capital’s clinics starts at 4,000 rubles for one orthopedic product.

Composite inlays for teeth

Composite inlays are used to restore single-rooted teeth, which include incisors and canines, that is, the front teeth included in the smile area.
Installation of a composite inlay can only be carried out if the tissue in the tooth being restored is preserved in a volume of at least 50%. Composite inlays are also called pin inlays because when they are placed in the tooth canal, a pin is first placed on which the dentist will apply the composite material in layers. If the tooth is severely damaged, installing an inlay on a pin is not recommended, since over time the pin may begin to wobble in the tooth canal and its mobility can lead to a fracture of the tooth root. If your tooth is more than half destroyed, you do not need a restoration, but a stump inlay followed by installation of a crown!

How much will a composite tooth inlay cost? The answer to this question will depend on what type of post and composite material the dentist uses during the restoration process.

The price of a restoration insert will also depend on the method of its manufacture. All inlays, except composite ones, are created in the laboratory using dental impressions. The tooth for the inlay must be ground down, although the volume of tissue removed will be less than the amount of dental tissue that is removed for the crown. The most complex manufacturing technology is for ceramic crowns, which are made from pressed ceramics: they are created using CAD/CAM computer technology. The complexity of the technology increases the price of ceramic inlays, but such microprostheses will have high anatomical accuracy, which means they will last longer.

Multi-channel and single-channel tabs

When treating a multi-rooted tooth, the doctor must make a decision: to make a collapsible or solid-cast core microprosthesis. If the root canals run parallel, solid blanks are used. Before choosing one of the various options for inlays, the patient is diagnosed - they take pictures and CT scans. Computed tomography helps to visualize the condition of the root segment, the configuration of the canals, and the presence of bone and periodontal diseases that require treatment. A multi-root microprosthesis is a good option because it creates uniform pressure on the entire tooth while being held in several canals at the same time. A crown with such a base can be used to mount a bridge restoration without the risk of destruction or damage.

Requirements of orthopedic dentistry for the use of core inlays:

• the root canal must have good patency over a length identical to the length of the pin;
• absence of purulent-inflammatory processes in the root zone;
• the walls must be of sufficient thickness (2 mm or more) to resist the chewing load transmitted through the stump structure, the protruding area must not be affected by caries;
• the stump should not be covered by the gum, otherwise gingivectomy is indicated;
• apical tissues should not have manifestations of chronic/acute inflammation.

Crown inlays: contraindications

We have already said that the indications for using inlays for crowns are the complete destruction of the tooth crown, or if only thin walls remain of the crown. However, there are also contraindications to their use -

• the root of the tooth should not be destroyed below the gum level,
• root canals must be properly sealed,
• there must be no inflammatory processes at the roots of the teeth,
• allergy to the materials of the tab (allergy to metal is rare),
• cannot be installed on mobile teeth.

Important: if your root is destroyed just below the level of the gum (by 1-2 mm), then in some cases it will still be possible to make a stump inlay on it. To do this, the gums around the root of the tooth are peeled off and the bone tissue is cut down with a bur (an osteotomy is performed). Such a height of bone tissue is removed so that the gum mucosa is just below the level of root destruction. Osteotomy is performed by a dental surgeon and is quite inexpensive.

Stages of production and installation of prostheses

We work in several stages

:

1. Preparation. We remove the carious area, perform a filling, take an x-ray for verification, and form a cavity.
2. We unseal the roots by half or one third, giving them a taper and width. It is also important to choose the optimal tab option.
3. We take an impression of both jaws and cast it from plaster in a dental laboratory. It is important that the microprosthesis corresponds to the antagonist organ.
4. We scan the cavity and carry out modeling on a computer.
5. We send the task to an automated milling machine, which produces the product.
6. We burn the workpiece in a special oven.
7. We treat the area with an antiseptic and fix the fat-free microprosthesis with cement.
8. Trying on and selecting a crown, installing a finished core inlay.

Complications and errors

Errors in the manufacture of core inlays are divided into two groups: those associated with the work of the orthopedic dentist and the actions of the dental technician.

Clinical:

• unsealing of the canal to an unsatisfactory amount;
• root perforation during turning;
• giving an inadequate shape to the channel, which can lead to de-cementing of the structure;
• errors when taking impressions.

Laboratory:

• poor-quality casting when using the casting method;
• non-compliance with processing standards during the pressing method;
• violation of the firing regime when applying ceramic layers.

Quality criteria for core restoration: high aesthetic level, reliable fixation, long service life, uniform distribution of pressure when pressed.

Recommendations for care and use

Caring for teeth and the entire oral cavity after stump reconstruction does not require special rules.

The procedure is no different from everyday hygiene. Just remember to brush your teeth twice a day, use a soft-bristle brush, and also:

• after snacks, rinse your mouth with mouthwash (they can be replaced with cooled boiled water or herbal infusions);
• supplement the cleaning procedure by treating the mouth and teeth with an irrigator, a dental brush and floss;
• visit the dentist at least 2 times a year.

To prevent damage to the restored tooth, it is necessary to avoid excessive loads on it when chewing, and to refuse to eat “inappropriate” (hard, tough, sticky) foods.

Hygienic oral care

After installing the microprosthesis, 10-14 days pass before fixing the bridge or crown. During this period, the prosthesis requires special careful care:

• chewing food with the opposite side of the jaw;
• exclude solid foods;
• teeth are brushed as standard;
• The oral cavity is rinsed with an antiseptic solution after each meal;
• the gums are treated with an anti-inflammatory agent.

Stump inlays do not require specific care. It is enough to regularly brush your teeth, undergo an examination by a doctor, and undergo a professional sanitation procedure. To clean crowns, it is recommended to use soft brushes, dental floss, and special brushes. With proper care and following the recommendations of dentists, the stump insert will serve you for many years.

Reviews

If you are a patient and you have had stump inlays made from CBC installed, or you have something to say about these structures from a specialist’s perspective, share your experience with the readers of our portal in the comments to this article so that they have the opportunity to form a more complete opinion about the subject discussions.

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Why us

• it doesn’t hurt: during installation we use different types of anesthesia, depending on the patient’s individual parameters;
• it’s fast: treatment will require 2-3 visits;
• it’s reliable: we provide a 3-year warranty;
• it’s convenient: we work with any materials – gold, zirconium dioxide, porcelain;
• it's safe: we have our own dental laboratory. We use equipment from European brands, which guarantees high accuracy and safety of products.

Restore a tooth that seemed hopeless - install a core tab at an attractive price at Dr. Razumenko’s dentistry in Moscow!

Price

Stump prosthetics is an expensive dental service. Of all the existing materials used for the manufacture of inlays, the cobalt-chromium design is the most affordable in terms of cost.

The specific price depends on the type of product. Thus, the cost of a cast insert starts from 3 thousand rubles, and a collapsible one – from 5 thousand rubles.

The complexity of the case and the choice of dental clinic play an important role in the final cost.

Prices for installing a stump tab

To find out the cost of a stump tab, sign up for a consultation at Dr. Razumenko’s dental clinic. To do this, fill out an application on the website or call: 8 (495) 380-01-38.

Code no.	NAME OF PROCEDURES	Unit of measurement	Cost, rub.
712	Fixation of restoration with glass ionomer cement	1 500,00
735	Single-root post-core inlay CAD/CAM	7 000,00
736	Multi-root post stump inlay	8 000,00
737	Single-root/multi-root post stump tab, collapsible	9 000,00
738	Zirconium pin insert	11 000,00
739	Cast pin insert with attachment	12 000,00

* The prices indicated on the website are not a public offer. The exact cost of treatment can only be determined at an appointment with a doctor.

Prices for treatment in Moscow full price list

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Article Expert:

Razumenko Evgeniy Gennadievich

Chief physician and founder of the dental clinic. He has been working in aesthetic dentistry for many years, restoring teeth of any complexity with ceramic and composite restorations. Winner of competitions in aesthetic dentistry. Applies CAD/CAM technologies in prosthetics.

Work experience 22 years

Tab lifespan

The service life of restoration inlays will depend on the material and production technology of microprostheses, as well as on how accurately the patient follows the dentist’s recommendations. Composite inlays last about 5-7 years, ceramic inlays - up to 20 years. This is subject to high-quality dental and oral hygiene and regular visits to the clinic for preventive examinations.

Stump inlays can last you a lifetime, and crowns on them last up to 15-20 years.

Do you still have questions about restorative and core dental inlays? Ask them to the orthopedists of our dentistry in Moscow - Vanstom! You can make an appointment with the clinic’s doctors at any time convenient for you - through the chat on our website, the call back form, or simply by dialing the contact phone number!

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