Options for prosthetics of anterior teeth after extraction

A beautiful smile undoubtedly matters to a person. After all, this is what many people fix their attention on when they meet. A smile leaves an unforgettable impression on the interlocutor. It plays an important role in your confidence when communicating. A beautiful smile will improve contact with your interlocutor, improve behavior and leave behind all sorrows and self-doubt, and will also melt the heart of any stranger. But if the smile is not perfect and there is a defect in the front teeth (cracked dental plate, extracted tooth, crooked bite or tooth fragment, caries), how can we talk about self-confidence? Such a person will become isolated from others, become withdrawn, stop smiling, and will feel awkward when communicating. All this can leave a mark on a person’s profession and on his personal life.

No one wants to show problems with their front teeth to others, so dentures are the best solution for such patients.

When performing prosthetics after removal, it is important to restore and preserve the functions of the organ:

• Correct bite;
• Shape;
• Natural color;
• Gum health.

Prosthetics of the front teeth is also an aesthetic issue, therefore, to create a beautiful smile, it is necessary to use high-quality, durable materials that will visually look good. In dentistry, several methods of installing dentures are used and leading materials are used to give each patient a dazzling smile.

The main indications for the use of anterior dental prostheses are:

• Cracks in the dental plate, chips, broken teeth;
• Lost teeth or congenital adentia;
• Carious teeth;
• Crooked bite;
• Yellowing or darkening of the enamel;
• Crooked teeth, irregular shape and uneven “facial” surface of the tooth;
• Early unsuccessful prosthetics.

To solve your problem and select the correct method for installing dentures after removing your front teeth, you can consult the Dr. Levin dental clinic by calling the clinic.

What prostheses can be placed in the smile zone - the most complete list of solutions and their features

Article navigation

1. Indications for prosthetics
2. Important Features
3. Prosthetic options
4. Removable prosthetics
5. Fixed dentures
6. Implantation of incisors and canines
7. Which dentures are better?
8. Which material to choose
9. In what situations is enamel grinding not necessary?
10. Periodontitis and periodontal disease
11. Contraindications
12. Dentists' recommendations
13. Price

Question for a specialist
People practically do not use incisors for chewing food, which is why when restoring them, high demands are placed mainly only on aesthetics and restoration of the correct bite. It is very important that your smile looks natural and natural. However, the material must still be strong enough to withstand the average load of biting food. Because of all these features, prosthetics of the front teeth contains many nuances, which will be discussed further.

Prosthetics to improve appearance. Veneers, Lumineers, Ultraneers

It often happens that the teeth are healthy, but for some reason the owner is not satisfied with their appearance, or there is minor damage to the teeth, for example, small chips, damage to the enamel, severe fluorosis, in this case, onlays may be an option for prosthetics of the front teeth for teeth - veneers, ultraneers or lumineers (in the above series the cost increases).
These are types of cosmetic prosthetics that involve applying thin porcelain plates to the surface of the teeth. Sometimes they are called artificial enamel. Lumineers are thinner than ultraneers or veneers and require less tooth preparation, but veneers are more wear-resistant and allow you to “close” a wider range of dental defects. The thickness of veneers is from 0.7 to 1.3 mm, ultra-veneers - 0.3-0.7 mm, lumineers - 0.3 mm or less. Veneers can hide the following defects: cracks, chips, deviations in tooth shape, defects in the coloring of the tooth surface.

When installing lumineers, there is little or no grinding of teeth; they are manufactured only in a laboratory in the USA. Ultraneers are the Russian analogue of lumineers.

Veneers, lumineers or ultraneers are often installed in pairs or four - on all front teeth, since a tooth with this type of prosthetics can stand out from the rest due to its aesthetics - be overly beautiful).

The choice of the type of onlay is made based on the amount of damage to the tooth tissue and the patient’s requirements.

Indications for prosthetics in the smile area

When thinking about prosthetics for the upper or lower front teeth, you need to know in what cases it is necessary. It is clear that the complete absence of an incisor or canine tooth along with the root is a direct indication for prosthetics. But there are other cases when it is a prosthesis in the classical sense that is needed, and not a filling. Let's look at the main indications for prosthetics in the smile area:

• chipped crown: the defect is more than half of its original size,
• cracks in the enamel or its abrasion,
• malocclusion: only in case of minor pathologies it is corrected with dentures, otherwise braces/aligners (orthodontic aligners) are needed,
• frequent caries under fillings,
• enamel defects: darkening, smoker’s plaque, “tetracycline” staining, fluorosis, thin enamel layer,
• complete absence of a tooth along with the root.

That is, prosthetics are necessary to recreate the aesthetics and functionality of a smile, as well as to create a more attractive appearance. The latter is especially true for public people and women.

Restoring anterior teeth using dental crowns

Crowns for the front teeth in dentistry are used when the teeth are destroyed by more than 60%. Such a tooth is first treated with core inlays. From an aesthetic point of view, it is optimal to use zirconium dioxide inlays. Such inlays do not change the shade in the area of ​​the thin mucous membrane of the gums to blue or gray in the area of ​​​​the base of the front tooth. Crowns differ in the material from which they are made. Crowns for the front teeth can be ceramic, metal-ceramic or zirconium. One of the most budget options, and therefore popular, is a metal-ceramic crown. But gradually, metal-ceramics on the front teeth is losing its popularity due to the likelihood of darkening at the base. In cases where there are difficulties with grinding teeth while sleeping, zirconium anterior crowns are used. The best aesthetics can be achieved by using metal-free ceramics and zirconium on the anterior teeth.

Important features of restoration of incisors and canines

Features of prosthetics of the anterior teeth of the lower and upper jaw are as follows:

• it is important to recreate the aesthetics of the smile and face: choose the right shape and color of dentures that are identical to the enamel of neighboring units of the dentition,
• it is important to pay attention to the position of the gums: the contour of the mucous membrane should be natural and natural,
• it is important to ensure good fixation of the prosthesis: so that a person can not only smile, but also bite and chew food normally (although biting off very hard foods will no longer be possible in any case),
• It is important that the restoration does not cause discomfort and does not provoke pathologies: allergies or inflammation.

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Cost of prosthetics.

The final cost of anterior dental prosthetics is influenced by a number of factors. The type of prosthesis, the material from which it is made, and the time period for manufacturing the prosthesis. In addition to these factors, the cost is influenced by the qualifications of the dentist, the use of special modern techniques, as well as the pricing policy of the clinic where the treatment is performed. One of the most budget-friendly are temporary plastic crowns, costing from 200 rubles per crown. In the last couple of years, zirconium crowns have been considered the most expensive; the price for such crowns starts at 25 thousand rubles.

The frontal dentition or smile zone is of great importance in a person’s life; the optimal way to restore the integrity of the dentition is considered to be prosthetics of the upper and lower front teeth on implants with a ceramic and metal-ceramic crown. In terms of external indicators, this is an ideal solution specifically for restoring the front teeth (incisor, canine) or the so-called smile zone. Due to the absence of a metal frame, metal-free dentures and crowns do not refract light, which makes artificial teeth even more natural.

Competent specialists from the Zuub.rf clinic network will solve the problem of tooth restoration as efficiently, quickly and painlessly as possible. The Zuub.rf clinic network is a guarantee of quality and low price.

If you have the symptoms described in this article, be sure to make an appointment at our clinic.

Don't self-medicate! Even the smallest problem, if not treated correctly, can significantly complicate your life.

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Removable prosthetics and its features

• When to use: if one or more front teeth are missing along with the roots, that is, they are completely removed.

The peculiarity of removable dentures is that they are fixed to the supporting teeth with hooks (clasps). These clasps are noticeable when you smile (if the hooks are made of metal) or often become loose and break (if the clasps are made of plastic). The attachments can damage the enamel of the supports or the surrounding gums, causing inflammation. By the way, this can also include a rapid decline in aesthetics, because plastic teeth quickly darken from plaque, and it will not be possible to whiten them to an ideal state.

Most often, a removable butterfly prosthesis is placed on the front teeth (if the chewing ones are preserved) - and only as a temporary solution. In other cases, in order to also partially restore the chewing teeth, you will have to make a massive prosthesis with a voluminous plastic palate or gum - this way it will hold better, but with less comfort.

In orthopedic dentistry, there are the following types of removable dentures:

1. acrylic: made of long-known and inexpensive acrylic plastic,
2. Acry-free (“Acry-free”): a modern variation of the previous type. Made from plastic that contains virtually no acrylic monomer (somewhat a toxic substance found in conventional acrylics),
3. polyurethane: Russian alternative to nylon structures. The material is soft and flexible,
4. clasp: unlike all the others, clasps have a metal arch, which adds rigidity and more correctly distributes the chewing load. The upper palate is not made solid, but in the form of a small bridge, which increases wearing comfort. Clasp ones will be placed only if at least part of the lateral teeth is missing, otherwise they simply cannot be fixed,
5. Quattro Ti (“Quadrotti”): similar to clasp ones in structure and scope, but “Quadrotti” do not have a metal arc. They are made only from Dental D material (a combination of nylon and plastic), patented by Quattro Ti.

To read about each individual type of prosthesis, click on the name to go to the corresponding page with a description.

Prosthetics with zirconium crowns –

The next option for aesthetic prosthetics of the front teeth is ceramic crowns made of zirconium dioxide (such crowns are called zirconium). This material has the strength of metal, and therefore crowns made from it do not require an internal metal frame. The absence of the latter should certainly provide more aesthetic options when using prosthetics with zirconium crowns, but in reality, not everything is so simple, and you can find a huge number of patients who are dissatisfied with such prosthetics.

Let's start with the fact that there are 2 types of zirconium crowns.

• The first option assumes that only the internal frame reinforcing the structure is milled from zirconium dioxide, which will then be covered with layers of ceramic mass (porcelain). The disadvantage of this option is that the porcelain often chips. According to statistics, after 3 years, chips occur in at least 6% of patients with zirconium crowns, and after 5 years – in at least 10% of patients.
  In addition, if for this version of crowns a cheap version of zirconium dioxide blocks is used (milky white, not transparent, i.e. translucent), then even after applying layers of porcelain, the crowns end up looking unnatural, because have a milky tint.

  Clinical case No. 4 –

  Read also:  Can you drink alcohol after getting dental implants?

  Note the unnatural color (no color gradient from the neck of the tooth towards the incisal edge of the incisors) that is present on adjacent teeth. In addition, there is no transparency of the cutting edges, i.e. crowns essentially look like plastic. Keep in mind that in most clinics in our country, zirconium crowns are made at approximately this low professional level.

• The second option is monolithic zirconium crowns “Multi-layer”. Monolithic - means that the crowns will be made entirely of zirconium dioxide, i.e. without applying layers of porcelain (accordingly, in this case there is no problem of ceramic chipping). But the most important thing is that in this case more expensive “Multi-layer” zirconium dioxide blocks will be used.
  Such blocks have a gradient of color and transparency, which makes it possible to mill crowns from them, which will also have a gradient of color and transparency, varying from the neck of the tooth and towards the incisal edge. Accordingly, the presence of a gradient of color and translucency will make the crowns on the front teeth more similar to real ones.

  Clinical case No. 5 (multi-layer) –

  In the photo above you can see newly made “Multi-layer” zirconium crowns, which still need to be fixed in the oral cavity. The crowns are made for the entire dentition - they are single crowns, with the exception of a 3-unit zirconia bridge in the side of the jaw (where you can see the artificial pink gum). Pay attention to the natural color and transparency that change - in the direction from the necks of the crowns to the cutting edge.

Is it worth it or not to make zirconium crowns?

Everything will depend on the specific situation in the oral cavity. In general, zirconium dioxide crowns are a good choice if you need to replace an entire group of front teeth at once (for example, 6-8 or more). This is because the dental technician only has a limited range of color options when working with zirconia. Those. If you have a complex tooth color, then one or more crowns will almost always differ from your neighboring natural teeth.

But this problem is solved if you do all the front teeth at once, in which case they will all look the same. And in this case, of course, you should pay attention to the fact that the crowns are made monolithic - from “Multi-layer” zirconium dioxide blocks, and not from cheap milky-white blocks that are not translucent. BUT, again, sometimes you have to deviate from this rule if the patient only needs 1-2 single crowns on the front teeth.

In this case, only the frame is milled from “Multi-layer” zirconium dioxide blocks, and then layers of porcelain are applied to it. Despite the higher risk of chipping, this technology will allow the dental technician to make crowns more similar to neighboring teeth, because When working with porcelain, the dental technician has a much wider range of color options. The main thing here is that cheap milky-white zirconium dioxide, which does not have translucency, is not used for the frame of the crowns.

The cost of zirconium crowns - the cost of 1 zirconium crown averages from 30,000 to 40,000 rubles. In the regions you can find prices starting from 25,000 rubles, but for this price the crowns will be made of cheap zirconium dioxide of a milky white color, which is not translucent. At the same time, we will next tell you about Emax ceramic crowns, the price of which averages from 25,000 to 30,000 rubles, and this despite the fact that they also benefit in aesthetics.

Zirconium dioxide with increased aesthetics:

Clinical case No. 6 –

Clinical case No. 7 –

When choosing ceramic zirconium crowns for your front teeth, you must ask your doctor for information about the manufacturer of the zirconium dioxide blocks from which your crowns will be milled. These should be translucent/pre-colored zirconium dioxide blocks (“multi-layer”) - preferably such as Katana® UTML (Japan) or Prettau® Anterior (Germany).

For more information about the various options for manufacturing zirconium crowns, read the article: → Options for manufacturing zirconium crowns, prices"

Fixed dentures to restore the smile area

• When to use: if teeth have lost their aesthetics, are partially destroyed, there are chips - these are indications for installing veneers or crowns. If the teeth are missing along with the roots, then bridges are placed.

Fixed ones correspond to almost all features of prosthetics, since they are highly aesthetic, are well fixed, and the absence of plastic gums and palate makes wearing them quite comfortable. But all this provided that an experienced orthopedist was involved in the prosthetics, high-quality materials and technological equipment were used.

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The advantage of non-removable ones is that they last much longer than removable ones. Fixed ones do not move, they do not need to be taken out of the mouth to clean (and the person will not forget to put them back), they do not need to be glued to the cream, and there is no need to get used to a foreign object in the mouth. The disadvantages include the cost, which is significantly higher than that of removable ones.

Aesthetic prosthetics – veneers, lumineers, ultraneers

Veneers, lumineers and ultraneers are durable and aesthetic microprostheses for the smile area; they are installed only on the front part of the dentition and mask minor defects, creating a “Hollywood smile”. They can cover cracks in the enamel, small chips, interdental spaces (diastemas and trema), and slightly level the inclination of the teeth.

Veneers (in fact, lumineers and ultraneers are also veneers) are presented in the form of thin ceramic overlays. Their thickness varies between 0.3-0.6 mm. And if ultraneers are just thin veneers (0.3 mm), then lumineers are already a patented brand with its own manufacturing technology (the thickness of lumineers is about 0.2 mm). You can evaluate the aesthetics of lumineers restoration using photos before and after prosthetics of the front teeth.

Among the positive aspects of veneers are the highest aesthetics and durability (10-20 years of trouble-free wear). The disadvantages include very careful operation of the restoration, high cost, and the need to install 6-8 veneers or lumineers per row at once. But in the case of classic veneers, it is possible to replace one or two front teeth.

Traditional prosthetics with crowns

If the top is destroyed by more than half, but the roots are intact, it is recommended to use dental crowns.

A crown is a cap-shaped prosthesis that restores a single defect and is placed on some kind of support. It perfectly follows the shape of the natural tooth apex and is fixed very firmly with special cement. But it is rarely possible to remove a crown without damaging it, for example, to treat root canals or periodontitis. In this case, you have to make a new one. And after several removals/fixations, a situation often arises that the root has to be removed (if it is severely damaged due to caries or frequent treatment). Then it is no longer possible to install a crown; you have to look for other prosthetic options.

To fix the crowns, a certain support is required:

• the preserved part of the natural tooth apex: it is previously ground down to give the shape of a stump or a truncated cone,
• post: a metal screw that is secured into the tooth root. The advantages of the method are low price, the disadvantages are uneven load on the root, insufficient fastening reliability,
• stump tab: a more successful (but also expensive) analogue to a pin. The inlay can be made of durable metal-free materials, the shape exactly follows the cavity inside the root and rises above the gum so that the crown can be fixed to it. Metal-free materials transmit light in a similar way to natural tooth enamel. This option looks more aesthetically pleasing and will last many times longer than pins.

Bridges

They are used when 1-4 teeth are missing in a row. A necessary condition is the presence of supports (or their healthy roots) along the edges of the defect.

Bridges (or bridges) are several crowns connected in a row. Bridges differ from single crowns in that they do not have holes at the bottom and rest on the gums, and the outer ones are created for fixation on supports. Also, “wings” – located along the edges of the bridge – can be attached to these supports.

Adhesive bridges1 have just such “wings”. These bridges are temporary, but are fixed quite reliably (they can come off due to chewing gum or very hard food). The installation can be performed on children and adults - on a temporary basis while awaiting implantation, for example.

The advantages of bridges include high aesthetics, long-term fixation and comfortable operation. But they have a very big drawback - the need to grind down the supports and remove their “dental nerves”. These factors, plus additional chewing load, lead to rapid failure of the supports. You have to re-treat them, and eventually remove them - and each time you need to redo the bridges or make new ones. As a result, when the defect becomes very extensive, you will have to completely abandon bridges in favor of other types of prosthetics.

Another significant disadvantage is that when wearing bridges (as well as removable structures), the bone will constantly atrophy under the plastic base or “empty” crowns. Along with the bone, the gums also recede, making the smile unattractive and allowing food to accumulate in the space between the denture and the gums. After every few months of wearing it, you have to go to an orthopedist and adjust the displaced prosthesis.

Prosthetic replacement of anterior tooth after extraction

After tooth extraction, it is better to do its prosthetics using the express implantation technique, in the absence of contraindications. To do this, immediately after tooth extraction, an implant and a special abutment are installed in its alveolar socket to form the correct gum shape. A crown is temporarily placed on it. After the implant has healed for approximately several months, a permanent crown is installed.

The advantages of express implantation include:

• This procedure does not require any additional incisions, which is less traumatic to the gums;
• The implant is installed in an open manner, which also does not require additional surgical intervention;
• This method is perfect for patients who do not want to wait until the hole heals and a bridge or crown can be installed.
• Short healing period;
• There are few side complications that are unpleasant for the patient.

Implantation of incisors and canines – installation of 1 crown and bridge on implants

• When to use: in the absence of any number of teeth on any of the jaws. These may be single or isolated defects; an entire segment or all teeth may be missing at once. You can even place an implant in the hole of a recently removed tooth root.

An implant is an artificial metal root that is fixed in the bone tissue if there is no tooth root in it. When restoring anterior teeth, it is recommended to install a white aesthetic abutment made of zirconium dioxide. It also corrects the position of the gums, which allows you to achieve ideal aesthetics.

Today, the most ideal method of prosthetics in dentistry is dental implantation. It is suitable for any area of ​​the dentition, with any number of defects - from single and scattered to complete edentia. The most significant advantages of implantation look like this:

• no need to grind down adjacent teeth,
• the highest possible aesthetics – crowns on implants are completely indistinguishable from natural teeth,
• very strong fixation of the implant in the bone and the crown on the implant itself,
• ability to withstand good loads: but the frontal zone should not be overloaded,
• materials for implantation are biocompatible with the body,
• implant-supported dentures have the highest wearing comfort,
• the service life of the implant is eternal, and the prosthesis on it will last at least 15-25 years,
• implants help rebuild the bone around them, maintaining gum level.

Crowns or bridges are placed on top of the implants, as well as bridges with small inclusions of artificial gum (to mask the uneven contour of the natural gum).

Installation of dentures for anterior teeth without turning

This is the restoration of damaged teeth, when the neighboring teeth intended for support are not ground down or depulped. In this case, it is worth performing implantation. This is one of the most gentle and atraumatic methods of installing upper and lower teeth. The essence of the method is that in the place of the lost tooth, an implant is installed in the jaw bone tissue, which performs the function of a root. Subsequently, a crown is put on it.

There are also methods that do not require grinding of a layer of healthy teeth, but they are rather temporary.

To summarize: which prostheses are better?

Which prosthesis is better to choose for prosthetics of front teeth? Let's summarize all the information already available and determine the optimal solution.

Problem	The best decision
If 1 tooth is missing with a root	The crown on the implant will last from 15 years, and the service life of the implant is decades
If several teeth are missing	A segment or several crowns, again installed on implants
If the top is chipped	If the chip is small - less than 30% of your own enamel, then a veneer is placed. If most of it is missing, a crown on a pin or stump tab
If the top is destroyed	If the roots are healthy and intact, then a crown is placed on the stump tab. If the roots are destroyed, they are removed and an implant is placed.

Implantation is the best alternative to prosthetics

If the incisor is removed or the remaining roots are in poor condition and cannot be used for prosthetics, implantation is the best solution. This option is more complex and expensive, but this is the only way to avoid bone tissue atrophy, which is very important.

During implantation, a titanium root is implanted into the jaw bone. The top is covered with a flap of gum. As soon as the regenerative processes are completed and the pin has taken root, a crown is installed.

Implants are the best replacement for lost teeth. They do not allow the gums to sag. They fully participate in chewing food and ensure impeccable aesthetics in the gingival region. You should not be afraid of their installation - all manipulations are carried out under anesthesia, so the patient does not experience pain.

What material to choose for dentures in the smile area

• plastic and metal-plastic: the most affordable option, but has poor aesthetics and a short service life, therefore it is used only as a temporary solution,
• metal ceramics: a durable and inexpensive option, but not aesthetically pleasing enough for the smile area. In addition, if the metal comes into contact with the gum, it will turn blue over time - this will be noticeable,
• solid ceramics: looks as natural as possible and is quite durable, especially provided that in the frontal area the load on the teeth is minimal,
• Zirconium dioxide or aluminum oxide: the most preferred option, natural, strong and durable. But also the most expensive.

When is metal ceramics used?

Metal-ceramic crowns are one of the most popular options in orthopedic dentistry. It is used quite often because it has an affordable price, high strength and aesthetics. However, they are best used to restore the masticatory sections, but not the anterior ones.

The disadvantages of metal ceramics are as follows:

• may cause allergies: in this case, the cobalt-chromium alloy can be replaced with gold, but the cost of treatment will increase significantly,
• when metal and gums come into contact, “cyanosis” of the mucous membrane may occur,
• your own tooth enamel must be sharpened,
• Mandatory nerve removal is required, even if the root canals are healthy.

When to use ceramics

A more preferable option for the frontal zone. Moreover, modern ceramics have become stronger and more durable. Such dentures are distinguished by natural translucency, the ability to select the shade of ceramics in full accordance with the color of natural enamel. They do not cause blue gums and require minimal grinding of the own enamel, while the dental nerve (if indicated) can be preserved. The only drawback is that they are higher in price than metal-ceramic ones. In addition, it is not advisable to fix them on implants or pins - a metal base can lead to splitting of the structure. Solid ceramics are attached only to your own tooth or core inlay.

When is zirconium dioxide used?

Zirconium dioxide or aluminum oxide are durable materials that are processed using modern computerized equipment. CAD/CAM technology is used to create a customized prosthesis, as well as scanning the entire oral cavity and modeling structures in a computer program. This allows you to achieve incredible precision at all stages of prosthetics. Among the main advantages are the longest service life (from 15-20 years), incredible aesthetics of both the restoration itself and the gum area, the absence of allergic reactions and minimal grinding of the enamel.

Not only crowns and bridges, but also veneers can be made from ceramics and zirconium dioxide.

Don't know what type of prosthetics to choose?

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Crowns made from “IPS E.max” –

IPS E.max materials are metal-free lithium disilicate ceramics intended for the manufacture of crowns and veneers. The E.max material is glass-ceramic, the light transmittance/transparency of which is almost identical to natural tooth enamel. Because of this, lithium disilicate crowns and veneers are sometimes completely indistinguishable from real teeth.

There are 2 main E.max materials for making crowns. Firstly, this is “E.max PRESS”, which is designed for the manufacture of crowns and veneers using injection molding at high temperature and pressure. Let's say right away that this material is the best if you want to make single crowns or veneers, or you need a 3-unit bridge on your front teeth.

Secondly, this is “E.max CAD”, intended for the manufacture of crowns and veneers using the milling method (CAD/CAM technology), so the same method is used here as in the manufacture of zirconium crowns. Compared to E.max PRESS, this material already has slightly less strength and is no longer suitable for the manufacture of bridges and thin veneers. Another disadvantage is that E.max CAD has a much smaller range of material shades, which limits the dental technician’s ability to ensure that the crown actually blends in color with the adjacent teeth.

Clinical case No. 8 (before and after photos) –

Take a look at the before and after photos posted above. In this case, the patient used E.max CAD ceramics, although E.max PRESS ceramics has a significantly larger range of material shades (which provides more opportunities to make the crown invisible against the background of neighboring teeth). But in this case, the patient had crowns made for 10 front teeth at once, and therefore the dental technician was not faced with the task of accurately imitating the color and transparency of the neighboring teeth.

From this we can conclude that if you need to make one or more crowns, it is better to choose E.max PRESS ceramics. If you are going to make crowns for all the front teeth (at least one jaw), then “E.max CAD” ceramics are also suitable.

For more information about the various options for manufacturing zirconium crowns and the rating of manufacturers of zirconium dioxide blocks, read the article: → Options for manufacturing E.max crowns, prices

In what situations is enamel grinding not necessary?

How is prosthetics performed in the frontal area? First, the oral cavity is prepared - caries is treated, tartar and plaque are removed, and if necessary, diseased roots are removed. Then, if you need to place a crown, bridge or veneers, you first need to grind down the supports. After this, impressions are taken (you can also perform a 3D scan of the oral cavity), which are sent to the laboratory. But turning can be avoided if the following restoration options are chosen - lumineers, clasp on hooks, immediate or removable dentures.

Prosthetic options for anterior teeth

• Temporary and permanent;
• Removable and non-removable.

Temporary prostheses are needed for emergency filling of the defect. This option is performed for a broken tooth, extraction, and when removing or replacing other dentures. To do this, temporary plastic prostheses or removable dentures are used to close the existing defect. The wearing period of such implants is 30-60 days. This time will be enough to make a permanent prosthesis and sanitize the oral cavity.

Permanent prosthetics are performed after the root implant has healed, with healthy neighboring teeth, and in the absence of inflammatory changes in the oral cavity.

Removable prosthetics can be used in people who, due to contraindications, cannot currently perform such a procedure and it is postponed for some time. Or when it is not possible to install a prosthetic bridge due to the lack of more than four teeth in a row or the supporting teeth are damaged. Such patients are recommended to wear removable dentures.

Fixed prosthetics are carried out according to indications and include the following techniques:

• Implantation;
• Bridge prosthetics;
• Installation of crowns;
• Installation of veneers or lumineers.

There are several options for prosthetics of the upper and lower front teeth

Periodontitis and periodontal disease - is it possible to get dentures with such a diagnosis?

If you have periodontitis and periodontal disease, there are not many options for restoring your smile. For example, it could be a splinting “clasp” that will fix loose teeth, but will not cure periodontitis or periodontal disease. Therefore, these pathologies will have to be treated regularly, although they never go away 100%, especially in the later stages.

The ideal option again is implantation, because... implants are not natural roots on which plaque would accumulate, leading to the progression of periodontitis. Implants even promote the regeneration of your own bone and, accordingly, increase the level of gums. But here it is important to understand that it is often impossible to do without removing the remaining diseased teeth or their roots, because they are the source of infection.

What types of dental prosthetics exist if only one tooth is missing?

If the destruction is so great that there is nothing left to save, you will still have to resort to removal. So, one tooth had to be removed, and now there is an unsightly empty space in its place. You should not wait for the “neighbors” in the dentition to move into the vacant space, disrupting the bite and interfering with normal chewing of food. It is better to immediately contact an orthopedic dentist, who will select the appropriate way to return the “prodigal” tooth to its place. There are several different ways to do this:

• Implantation.
  A method that today is unrivaled in terms of reliability, durability and scope of function restoration. In modern dentistry it is considered simply ideal. If it is possible to carry out implantation, it is better to opt for this method of prosthetics. A titanium “artificial root” is screwed into the jawbone, onto which a crown made of metal-free ceramics or metal-ceramics is then installed. A very reliable and durable method that not only returns aesthetics to the dentition, but also almost completely restores its functions.
• Bridge prosthesis.
  A dental “bridge” is made of three interconnected crowns: one replaces a missing tooth, and the remaining two are attached to the supporting teeth and play the role of “bearing beams” of the bridge. The advantages of this method are affordable price and reliability, the disadvantages are the need to grind the supporting teeth, as well as the need to remove the entire prosthesis if it breaks.
• Adhesive prosthetics .
  The method is similar to installing a conventional bridge with support on the teeth adjacent to the defect. But at the same time, turning these “supports” is not required: the doctor will simply make micro-incisions on the tooth enamel, into which he will place a strong fiberglass thread and secure it with the help of composites. A more gentle and faster method of prosthetics than installing a “classical” bridge, but not as durable and reliable (recommended only for front teeth that do not bear the same load as chewing teeth).
• CBW prosthetic system with micro-locks
  . Here, too, neighboring teeth are used as a support for the prosthetic crown, but they do not have to be ground down. It will be enough to make small holes to fix the micro-locks that will hold the crown. A fairly reliable and quick way to restore a defect, however, dentists consider it not very durable and often recommend using it as a temporary option.
• Immediate prosthesis, or “butterfly”.
  What could be easier than installing a neat, removable structure with nylon or metal wire fastenings? Such a prosthesis does not scratch the enamel, is quickly installed and removed just as quickly, and does not require grinding of dental tissues. It would seem like a patient’s dream. But in fact, an immediate denture is quite uncomfortable when worn constantly, it is short-lived and is not intended to permanently replace a lost tooth. This is a temporary structure, which is usually installed for the period while a permanent prosthesis is being made.

Comparing prices: which method is more affordable?

The cheapest option is an immediate prosthesis, its cost will be about 2000-5000 rubles. But, as already mentioned, this is a temporary solution: you can wear it for no more than 2-3 months, and then you will need to change it to a permanent structure. An adhesive prosthesis will cost about 6,000-10,000 rubles, which is a very reasonable price for good aesthetics and reliable fixation. However, in terms of durability, adhesive structures are inferior to the same bridges (their price is the sum of the cost of individual crowns; if one crown costs 20-40 thousand rubles, then for a bridge this amount should be multiplied by three). Implantation will cost 20-70 thousand rubles, depending on the type of implant chosen. That is, implantation costs about the same as a good bridge structure, but at the same time it is much more reliable, more durable and does not require grinding of supporting dental units.

Contraindications for prosthetics

All existing contraindications relate for the most part to fixed prosthetics. Moreover, there are many relative contraindications – those that can be “bypassed” over time. For example, relative prohibitions on the installation of fixed bridges or crowns, as well as implants, are imposed on the following groups of patients:

• children under 18 years of age, pregnant women: this is due to the characteristics of bone tissue and the ban on certain anesthetics,
• for diseases of the oral cavity: caries, pulpitis, stomatitis - first you need to be cured,
• for periodontitis and periodontal disease: with classic removable and fixed prosthetics, as well as with two-stage implantation. BUT! When implanted using one-stage protocols - for example, with basal implantation or all-on-6, these pathologies are not considered a contraindication.

There is, perhaps, only one absolute contraindication for removable orthopedic structures, which, by the way, also applies to non-removable ones - these are very serious mental disorders. Also, absolute contraindications, but for implantation, include the following:

• decompensated diabetes mellitus,
• serious pathologies of the heart and blood vessels, endocrine system,
• malignant diseases in the acute stage,
• tuberculosis, HIV,
• inability to carry out high-quality oral hygiene.

Why is missing teeth dangerous?

Losing a tooth is not just a cosmetic defect. It is capable of triggering irreversible changes in the human body that only progress over time.

If even one upper tooth is lost, its pair on the lower jaw is almost not involved in the process of chewing food. As a result, the adjacent teeth take on the load. The result is a violation of their ligamentous apparatus, due to which the risk of loss and periodontal development becomes extremely high.

The loss of several dental units increases the likelihood that the height of the bite will change. As a result, the lower third of the face becomes smaller. This not only leads to an aesthetic problem - the appearance of early wrinkles. Due to the unevenly distributed load, the temporomandibular joint suffers - inflammatory processes and degenerative changes begin.

The patient may experience pain while chewing food or talking. Improper chewing of food leads to diseases of the stomach and other gastrointestinal tract organs.

Recommendations from dentists when choosing a prosthesis

When restoring small defects, chips and darkening, it is better to choose thin ceramic veneers or lumineers - they will make your smile beautiful for 15 years or more.

Removable orthopedic solutions in the smile area often lose their fixation, move, provoke allergies and cause difficulty chewing medium-hard food. Therefore, it is recommended to install them only as a temporary option: while the patient waits for the installation of a permanent fixed prosthesis or implant. Here, a defect in a row or a ground stump is masked with a plaster or bridge so that the smile retains its attractive appearance. Biting food with these restorations is not recommended. On an ongoing basis only if there are contraindications to fixed solutions or implantation, as well as financial limitations.

Fixed options for restoring minor dental defects, such as crowns and bridges, are quite popular due to their availability. If the natural crown is destroyed by more than half, then a worthy option is a ceramic or zirconium dioxide crown coated with ceramics. But in the case of a bridge, the patient is not immune from bone atrophy and gum loss under the prosthesis, as well as from overloading the supports.

Therefore, the optimal method for restoring the frontal zone will be implantation, because implants prevent the bone from further atrophying and maintain the aesthetics of your smile for several decades.

By the way, positive reviews from 90% of patients who underwent implantation speak of the highest comfort of life even 10-15 years after prosthetics. While 60% of people who have had classic removable prosthetics or bridges subsequently regret their decision.

Veneers and Lumineers

Prosthetics for minor damage - chips, cracks, darkening after depulpation - can be carried out using special dental onlays. This refers to veneers and lumineers.

The first are porcelain plates about 0.4-0.5 mm thick. They are installed on a previously ground tooth using a special adhesive composition. The top layer is stitched to the width of the decorative overlay - no more. Veneers allow you to cover chips, unsightly fillings, and improve your smile line. With proper care, they last for at least ten years. Then they can be easily replaced.

Lumineers are even thinner overlays. Their thickness does not exceed 0.2-0.3 mm. Due to this, they can be glued to the crown without first turning them. They look aesthetically pleasing. Due to the precise selection of colors, they do not stand out against the background of other (uncoated) teeth.

The cost of restoring the smile area

How much does front tooth replacement cost? It all depends on the type of prosthesis, its design, complexity of manufacturing and installation, as well as on the materials and rating of the clinic. For example, restoration of a single defect with a composite veneer costs from 7,000 rubles, with a ceramic veneer – from 15 thousand, and one lumineer costs from 50 thousand.

Prices for metal-ceramic crowns start from 6,500 rubles, for ceramic ones – from 18 thousand, and zirconium dioxide – from 25 thousand. The cost of the bridge is calculated according to the number of crowns. A butterfly prosthesis costs from 12 thousand, a plate prosthesis can be ordered for 15-20 thousand, and clasp prostheses, Acri-free and Quadrotti cost from 35-40 thousand rubles. Installation of 1 implant on a turnkey basis, i.e. together with the crown, it will cost at least 35-40 thousand rubles - this is the most budget option, and premium brands cost 2-3 times more.

1. Ervandyan A. G. Clinical and laboratory justification for the use of adhesive bridges made of ormokers and fiber materials: Dis. Ph.D. honey. Sci. Moscow, 2005. - 140 p.

Summary: which crowns are best for the front teeth?

And now the most difficult thing remains - it is easy to answer the question about the best choice of crowns for the front teeth. By the way, if you don’t go into the issue of price, the choice will be quite simple (the cost of all the above types of crowns – see the links above). The most budget option is metal ceramics, the price for 1 Unit of which starts from approximately 10,000 to 12,000 rubles.

At the same time, highly aesthetic metal-ceramics will cost you from 20,000 to 25,000 rubles (for 1 Unit), which, in principle, already corresponds to the lower price limit for ceramic crowns from Emax Press. In general, the economical option for crowns for the front teeth is only metal-ceramics, or the only option left is temporary crowns made of Multi-PMMA plastic, which are made by milling (they last up to 2 years).

Next, we look at the optimal prosthetic options:

• If you need 1 or several single crowns, in this case it is optimal to choose pressed ceramics Emax. Slightly less optimal are zirconium crowns, the frame of which is milled from pre-colored “Multi-layer” zirconium dioxide, on top of which layers of porcelain will be applied.

• Prosthetics for all front teeth at once – i.e. when we are talking about prosthetics for 8-10 front teeth (at least one jaw). In this case, it is optimal to choose monolithic zirconium crowns “Multi-layer”. The second choice is Emax ceramics, and both varieties are suitable here.

• If you need a bridge, the E.max PRESS pressed ceramic bridge is an excellent choice, because... this will give very good aesthetics. But bridges from this material can be made with a length of no more than 3 Units (i.e., only with a single missing tooth). In this case, it is important to take into account the presence and condition of the chewing teeth, because If you don't have a lot of chewing teeth, an Emax bridge may not be a good choice (it may not withstand excessive chewing pressure and break).
  The second choice is a zirconia bridge. But you probably already realized that if you need to make a bridge of 4 or more units, then in any case it is made only from zirconium dioxide (Emax ceramics will not work here), or metal ceramics. At the same time, if we are talking about extended bridges for all front teeth, then it would be optimal to use monolithic zirconium dioxide “Multi-layer”.

  If we are talking about a bridge prosthesis of short length, then from an aesthetic point of view it is better to make the bridge non-monolithic, i.e. in this case, only the frame is milled from “Multi-layer” zirconium dioxide, which is then lined with layers of porcelain mass. But in this case, there is a small risk of porcelain chipping (in 10% of cases within 5 years of operation), but the chips are still repairable.

Additional recommendations –

From an aesthetics point of view, the situation when you are replacing symmetrical teeth with crowns (for example, 4 central incisors at once or a group of 8-10 front teeth at once) is simpler, and in this case you can choose more economical prosthetic options.
The most difficult options are when you need to take only 1 front tooth or 2-3 teeth, asymmetrically located in relation to the center of the dentition (24stoma.ru). The latter is due to the fact that the human eye primarily pays attention to the differences between symmetrical objects. In addition, if you have a gummy type of smile (the gums are exposed when you smile), this will also require choosing more expensive crown options than in patients whose only the incisal edges of the front teeth are slightly visible when smiling.

Choosing crowns on implants –

When prosthetics of anterior teeth supported by implants, the choice of crowns is reduced to metal-ceramics and zirconium dioxide. However, the first option will have all the usual disadvantages of traditional metal ceramics, i.e. It will be difficult to achieve good aesthetics in patients with high transparency of tooth enamel, and secondly, blueness of the gums will be guaranteed.

Therefore, the optimal prosthetic option in this case would be to choose a zirconium crown, which is installed on a zirconium abutment. You can read more about the pitfalls of prosthetics on implants in the article at the link below.

→ Choosing a crown for a dental implant, price