Not all people can boast of perfect teeth, despite the fact that the standard of living is now much higher than in previous years and even centuries. Hereditary diseases, drug abuse, and injuries can sometimes cause problems and make smiles look unhealthy and unattractive.
But now such troubles can be dealt with with the help of veneers - thin plates that cover minor defects on the front of the teeth and correct their aesthetics. Installation of such overlays often requires preparation of the enamel, which does not seem like a wasteful action.
Benefits of veneers
All those shortcomings that dentists previously proposed to correct by installing crowns are now quite successfully masked with veneers. This:
- Cracks and chips in enamel;
- Darkening, spots;
- Areas with erosion of tooth enamel;
- Tetracycline teeth;
- Uneven cutting edges;
- A slight rotation of the tooth around the central axis, etc.
Emax veneers are considered the best aesthetic solution in microdental prosthetics. The surface of plates made of artificial material of natural origin reliably imitates the transparency, shine and color of human enamel, so those around them perceive the teeth as “native”.
Why is preparation necessary?
Orthopedic treatment often requires the dentist to resort to grinding of the enamel. Such pre-treatment ensures the most durable attachment of the prosthesis to the surface of the tooth and its hermetically sealed coating. A few years ago, the procedure was painful and traumatic, which scared patients away and left bad memories. Nowadays, enamel preparation is performed using minimally invasive methods, using high-tech equipment, quickly and without experiencing painful sensations.
Nevertheless, patients continue to express concerns and ask whether this step can be avoided when installing veneers. However, in the vast majority of cases it is unlikely to be possible to completely avoid preparation. The reason is the high requirements for the quality of contact between the plate and the tooth. The surface of the enamel is never perfectly smooth; there are always microscopic tubercles, grooves, and depressions. If the veneer does not fit tightly, these cavities become the focus of bacterial masses.
In addition, the enamel is removed before the veneer is placed to reduce the final thickness of the tooth. When a plate is applied without preliminary preparation, the tooth will become larger and more massive, which will not beautify the smile and cause functional discomfort to the person.
The third reason for preparation will be a large amount of carious tissue. To eliminate the possibility of further damage to the tooth under the veneer shield, they will need to be removed.
But under some circumstances, when installing veneers, the dentist leaves the patient’s teeth intact.
Does it hurt to put a crown and how to put a crown on a tooth in dentistry
From this article you will learn:
- does it hurt to put a crown,
- stages of prosthetics,
- how much does it cost to put crowns on teeth – prices 2021.
Making and installing a crown on a tooth is a complex procedure consisting of many stages. In this article we will talk about many subtle points that affect the aesthetics and service life of your crowns. These points relate to both mistakes when choosing the type of crowns by the patient himself, and mistakes made en masse by dentists at the stages of their manufacture.
For example, most of the complaints from patients about the quality of prosthetics relate mainly to 2 things. Firstly, poor aesthetics, and the fact that the crowns stand out against the background of neighboring teeth. Secondly, the quality of therapeutic preparation of teeth for crowns. The latter leads to complications - pain, suppuration, the need for re-treatment and even tooth extraction.
Does it hurt to insert teeth?
Typically, patients are interested not only in how a crown is placed on a tooth, but also how painful it is. The most unpleasant stages here, of course, are preparing teeth for prosthetics (i.e.
their treatment, root canal filling), and sometimes also the process of taking impressions. If already dead teeth are used for crowns, then turning them is completely painless and does not even require anesthesia.
If living teeth are ground down, a local anesthetic is first injected.
The only painful moment that I myself (being a dentist) have personally experienced is when, when taking an impression, the doctor performs gum retraction.
Retraction refers to the widening and deepening of the gingival sulcus, which is accompanied by a small degree of separation of the soft gum tissue from the tooth.
This is done in order to make a more accurate impression of the neck of the tooth, and it is better to do this immediately under anesthesia.
How is a crown installed on a tooth?
If you decide to put a crown on a tooth, then it will be useful for you to know what stages of this process you will have to deal with. In the process of placing a crown on a tooth in dental clinics, the following stages can be distinguished...
Initial consultation with an orthopedist (prosthetist) −
During the initial consultation, the doctor, assessing the condition of the teeth externally and using x-rays, must offer possible prosthetic options, and the patient, accordingly, must approve one of the options. Based on this, a treatment plan is drawn up, which may take into account -
- removal of non-viable teeth,
- preparing teeth for crowns (filling, depulping),
- choice of the type of crowns, for bridges - the number of supporting teeth, etc.
- The cost of making crowns and treatment in general is calculated, the deadline for prosthetics is determined, after which the patient must sign a treatment plan and a contract for the provision of services.
Important: at this stage the patient must choose one of the types of artificial crowns offered to him. Choosing the type of crown is not easy for the average patient, and there are a lot of pitfalls that the dentist will never tell you about. Articles to help you choose -
→ Pros and cons of metal-ceramic crowns → How to choose crowns for front teeth
Preparing teeth for prosthetics −
In some cases, crowns can be placed on living teeth. This is preferable because dead teeth are more fragile, and therefore, if the teeth are left alive, this has a positive effect on the service life of the crowns.
In what cases can teeth be left alive? As a rule, we are talking about large chewing teeth.
This is due to the fact that large teeth have a greater distance from the surface of the enamel to the pulp of the tooth (than single-rooted teeth) and, therefore, the risk of thermal burn of the pulp when grinding the tooth for a crown will be much lower.
Moreover, under crowns made of metal-free ceramics, even the majority of single-rooted teeth can be left alive. This is due to the fact that under ceramics the tooth is ground down by 1.0 from the side surfaces, and under metal-ceramics – on the same surfaces by 2.0 mm. Therefore, metal-free ceramics also allows you to increase the service life of the tooth itself under the crown.
When using metal-ceramic prosthetics for single-rooted teeth, the nerve is almost always removed. If this is not done, then turning such a tooth can lead to a thermal burn of the dental pulp, i.e. neurovascular bundle.
In this case, after some time, its inflammation will develop, and the crown will then have to be removed and the tooth re-treated.
If the tooth under the crown is destroyed by a carious process (there is pulpitis or periodontitis), then planned depulpation of the tooth and treatment of inflammation at the apex of the root are required.
When depulping a tooth, it is carried out -
- removal of a nerve from a tooth,
- instrumental treatment and expansion of root canals (Fig. 2),
- the canals are filled with gutta-percha (Fig. 3),
- after which a filling is placed on the crown part of the tooth (Fig. 4).
Important: if the crown part of the tooth is destroyed by 1/2 or more, the tooth must be strengthened with a pin fixed in the root canal (otherwise the crown can easily fall out along with the filling). There are 2 main methods for restoring severely damaged teeth.
What is the best way to restore a badly damaged tooth? –
- The first option (Fig. 5) – patients also call it a crown with a pin or a crown on a pin. This is when a pin is screwed into an already filled root canal, and then, based on it, the crown part of the tooth is restored using filling material. Only after such restoration is the tooth ground down for a crown.
- The second option (Fig. 6-8) – the crown part of the tooth is restored using a stump inlay. Such an inlay is cast from metal in a dental laboratory and consists of a root part (which is fixed in the canal) and a crown part, which has the shape of a tooth that has already been ground for a crown. This method provides greater reliability, strength and longer service life of the crown. Manufacturing of a core inlay for a crown -
Preparation of teeth for crowns −
In common parlance - grinding teeth. The preparation process is carried out by an orthopedic surgeon, who (using a drill and a set of diamond burs) gives the tooth a certain shape.
Preparation is a painful process if living teeth are ground down. In this case, local anesthesia is required.
When dead teeth are ground down, anesthesia is given only if the doctor needs to strongly press the gum away from the tooth during preparation.
The tooth tissue is ground down by the doctor to the thickness of the future crown (Fig. 9-11). Crowns made of metal-free ceramics (for example, zirconium dioxide or glass ceramics E.
max) require less grinding of tooth tissue - approximately from 1.0 to 1.5 mm on different tooth surfaces. But under metal-ceramics, the teeth are ground down on all sides by 1.5-2.5 mm - as a result of which almost nothing remains of the tooth.
As a result of preparation, the tooth crown takes on the appearance of a “stump”.
Tooth preparation for metal ceramics –
Important: high-quality tooth preparation for a crown is a very complex and time-consuming process. The most difficult thing here is to create a ledge in the gingival part of the tooth crown.
The reliability and service life of your crown largely depends on the correct formation of the ledge. It must be admitted that most doctors make a lot of mistakes at this stage.
How the ledge is formed is clearly shown in the video below.
Grinding front teeth for crowns: video
Taking impressions, making plaster models of teeth –
Impressions are taken from the ground teeth using special impression compounds (Fig. 12). Subsequently, based on these casts, plaster copies of your teeth are created in a dental laboratory (Fig. 13). Such plaster models depict the patient’s teeth with very high accuracy, including those ground for crowns, and it is from such models that they are manufactured.
When preparation for veneers is not necessary
Preparation of enamel is practically not required if a person has direct veneers made from composite mass. This is a special type of correction of the external surface, when the doctor layers a special material on the enamel. The procedure is performed in one clinic visit. However, composite veneers delivered without any treatment are still a rather rare case.
Ceramic veneers are made in a dental laboratory using a synthetic impression. Here it is important to tightly and firmly attach the plate to the tooth tissue, so grinding down the enamel is a necessity.
Exceptions to the rules when tooth preparation will only harm quality veneering:
- Visual correction of tooth rotation is assumed;
- Severe initial wear of the enamel;
- There are irregularities in the cutting edge of the tooth;
- The vestibular surface of the tooth requires thickening.
When installing any types of veneers - ceramics, porcelain, composite - you will have to remove the enamel if it is destroyed by caries. It is impossible to preserve the pathology under the veneer.
In exceptional cases, for example, when restoring a missing tooth wall, preparation as such is not performed. The doctor simply adds some roughness to the enamel so that the plate clings better to the surface being corrected.
Reviews
Preparing teeth for veneers is the most difficult and unpleasant procedure for the patient. If it is performed with a rotary abrasive instrument, local anesthesia is used to reduce discomfort.
If you have ever had a tooth ground down for a veneer, tell us about the sensation. What method was used to prepare it, how long did the procedure last, was it painful? The comment form is located at the bottom of this page.
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What happens if you install an Emax veneer without grinding?
A doctor who cares about his own reputation will never agree to glue a veneer without preparation if he is absolutely sure that treatment is necessary. The patient should trust a qualified specialist to be satisfied with the result. Let's try to imagine what will happen if you put a veneer on a solid tooth in violation of the technology requirements:
- Significant darkening will remain visible even through the surface of the Emax veneer. Thin lumineers are especially translucent, so even when choosing these expensive porcelain onlays, turning is sometimes required.
- Despite the relatively small thickness of the ceramic plate, it still looks bulky on unprepared teeth: it adds volume, looks unnatural, and sometimes even interferes with articulation and chewing of food.
- A ledge often forms above the Emax veneer, near the gums, where plaque and bacteria accumulate. Pathogenic flora is also able to penetrate between the surface of the tooth and the plate itself. In such gaps it develops unhindered, causing caries and its complications.
Many patients are misled by advertising articles that say that it is possible to remove Emax veneers from unground enamel and thereby return the teeth to their natural appearance. This statement is erroneous, since veneers made from this material are relatively thick, and therefore always require paring, unlike ultra-thin veneers without grinding Luxneers and American lumineers (Lumineers).
Preparation methods
The latest methods of grinding down enamel to install artificial overlays involve gentle processing technology and high-precision equipment.
Laser method
A beam of polarized light acts on the hard tissues of the tooth. The moisture contained in them evaporates, and many hydraulic shocks occur, as a result of which the enamel is destroyed.
The advantages of the technique are the speed of impact, the absence of pain and the silent operation of the laser system. It is no secret that the buzzing of a drill is considered one of the most unpleasant auditory stimuli. There is no need for preliminary sanitation of the oral cavity, because the laser perfectly burns out all microflora in the treated areas.
It should be noted that working with a laser requires a steady hand and high qualifications from the dentist, and the professionalism of a specialist is usually well paid. In addition, laser treatment is superficial. If, for example, caries penetrates deep into the enamel, additional exposure will be required.
Ultrasonic treatment of enamel
Ultrasonic treatment of enamel also does not involve preliminary anesthesia - except in extreme cases, with tooth hypersensitivity. Under such exposure, tissues do not overheat and are not destroyed excessively - only within the required limits. Many doctors consider ultrasound as most appropriate in preparation for veneering.
Install veneers without grinding Luxneers teeth at Dr. Lopaeva’s clinic
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Or call +7(985)532-21-01
Chemical treatment of teeth
Preparation of enamel using this technology includes treating teeth with softening pastes. As a result, the outer tissue is easily removed. The disadvantage of this method is the duration of the procedure: the chemical composition requires time to act, approximately 30 minutes.
The advantages are significant:
- Painless;
- No overheating or thermal injury to tissues;
- The risk of excess enamel chipping and cracks is eliminated.
Tunnel preparation method
Grinding using this method will require the use of a special turbine unit. The doctor uses a multi-speed bur with a diamond tip. This treatment is used more often than others and allows for extremely precise control of the degree and depth of impact on the enamel.
The disadvantages of the procedure include pain (anesthesia is required) and increased requirements for equipment. The turbine greatly overheats the tooth tissue. If the device does not have a special cooling device, the patient will be injured. If you work carelessly with a bur, damage to soft tissues is possible - the dentist should not be distracted by anything while working.
Air abrasive method
This method is used only for treating the outer layers of tooth enamel and is used in combination with other methods. The principle of operation of a special installation is to influence the tooth with abrasive powder ejected under pressure. The enamel is removed painlessly and quickly. In this case, it is possible to avoid excessive heating of the organ tissues.
The choice of tooth preparation technology can be planned in advance during a consultation with a doctor. Not every clinic has the full range of equipment; the condition of the patient’s oral cavity and his individual reaction to the technique are also taken into account.
Does it hurt to put crowns on your teeth?
Almost all patients faced with the need to install a crown are interested in the question of whether the process of prosthetics involves pain and other discomfort. Unfortunately, almost all dental procedures are quite painful, so most of them are performed under local anesthesia.
Whether it hurts to put a crown on a tooth depends on the professionalism of the dentist himself and the characteristics of the body (sensitivity threshold) of the patient himself. As a rule, unpleasant sensations can arise exclusively during the preparatory stage of prosthetics, which includes:
- removal of the dental nerve;
- depulpation, cleaning of canals;
- grinding of hard tissues (the “working” tooth is ground down using a bur machine so that the crown “fits” well).
Nevertheless, the use of good anesthesia and precise, calibrated work by the dentist can reduce the risk of discomfort at the preparatory stage of prosthetics to nothing.
Therefore, those patients who are interested in whether it is painful to grind teeth for crowns can safely go to the dental office without fear of discomfort.
As for the process of installing a prosthesis on a dead tooth, it is absolutely painless - the product is adjusted and fixed with a special glue.
Advances in modern dentistry allow the use of local anesthetics, which eliminate the risk of discomfort during work.
The “working” unit is depulped (the nerve is removed), which means that pain sensations as such are completely eliminated.
Even the gums into which an anesthetic injection is given before starting work will not hurt - the dentist first applies an anesthetic gel to it. So, prosthetics, i.e.
Installation of metal-ceramic and ceramic crowns on the front or chewing teeth is a painless procedure.
The most potentially dangerous, from the point of view of the possibility of pain, is the preparatory stage - removing the nerve, cleaning the canals, depulping, turning the tooth. But the professional work of the dentist in combination with local anesthesia makes it possible to make it as comfortable as possible for the patient.
Reviews
Irina, 46 years old, Moscow: A year ago I had metal ceramics installed on 2 chewing teeth. The procedure, to be honest, is not pleasant - the doctor was unable to “seat” the crowns onto the stumps for a long time, as a result of which the gums became inflamed (even now they swell and hurt from time to time).
In order to “finish” both prostheses, I had to spend a lot of time and money (I went to the dentist 5-6 times while the preparation, fitting, and fixation of the crowns was going on). However, now I have no discomfort, I can bite, chew, and smile.
The dentures have not changed the original color and structure.
Konstantin, 35 years old, dentist, Novosibirsk: Putting any crowns correctly is an art. This is a job that requires professionalism, precision, care and precision. Modern anesthetics make prosthetics painless, so patients who have indications for crowns need not worry about experiencing discomfort.
Elena, 60 years old, St. Petersburg: Before going to the dentist, I thought for a long time, read reviews on the Internet, chose a clinic and the type of dentures.
As it turned out, I was worried in vain - despite the fact that 6 metal-ceramic crowns cost me a lot, the preparation, fitting, and installation itself were painless - there were no unpleasant sensations or complications.
Stages of preparation for Emax veneers
- Making horizontally directed depressions on the vestibular part of the tooth, which determine the extent of penetration into the enamel. The depth is controlled using a diamond bur. The treatment boundary is prepared to the gum, including the lateral surfaces.
- Carefully remove the enamel layer to a depth of no more than 1 mm. Sometimes it is necessary to thoroughly intervene in living tissue if the carious lesion is extensive. The integrity of the cutting edge of the teeth is also affected.
- The prepared area is polished, coated with a degreasing agent, thoroughly washed and dried. Before the final installation of the veneer, the tooth surface is etched with a special chemical composition that increases the adhesion of the surface to the prosthetic material.
Service price
Services for installing veneers with minimal grinding are provided by the best orthopedic dentists in Moscow. The cost of veneers with minimal grinding of teeth directly depends on the level of the clinic, the professionalism of the doctor and the selected material. This also includes the work of dental technicians and medical personnel.
The high cost is justified by the need for careful work to recreate the transparency of the enamel and its microrelief, the complexity of color transfer and restoration of the tooth structure.
Highly artistic veneers, invisible in the oral cavity, which look absolutely natural, cannot cost 30 thousand
rubles.
The price of such products starts from 50-60 thousand rubles. for one unit. Records made from aesthetic materials made in America will cost even more, however, they will last at least 15 years.
Preparation for ceramic veneers
Ceramic veneers today are unrivaled if we analyze the demand for correction of the smile area with artificial overlays. Silicon oxide-based structures are durable, and their ability to reflect light rays is similar to the properties of natural enamel. Therefore, ceramic veneers are indistinguishable from real teeth.
The big advantage of these products is their resistance to staining and oxidation by food compounds, as well as a long service life compared to composite plates.
There is no single preparation algorithm for the installation of artificial onlays. The process is invariably individual and will differ for each patient. The procedure depends on the type of veneer - direct or indirect, on the location of the tooth in the patient’s mouth, on the presence of carious lesions and the volume of fillings.
Failures are not excluded in veneering. One of the factors of poor aesthetics of installed plates is improper preparation of the enamel. This is done in two ways:
- An indirect method used when installing similar veneers. Such plates cover the entire outer surface of the tooth, so it is important to remove the enamel so that the adhesion of the veneer and the prepared surface occurs perfectly. If the layer is removed too finely, the effect of horse teeth is possible, when the veneer makes the tooth visually massive and unnatural.
- The direct method is used when placing direct composite veneers. Here, it is often not necessary to completely remove the enamel; it is enough to expose individual areas.
There is no need to worry about preparing the enamel before installing the veneer. Today, the action is performed carefully in relation to living tissues and is completely painless. A thoughtful choice of clinic and specialist will be the key to high-quality installation of veneers and your healthy and beautiful smile.
