Ювелирното изкуство

Представете си, че се храните в изискан ресторант и съвсем изненадващо някой от зъбите ви "изхрупва" и вие вече държите част или половината от зъба в ръката си. Отслабен от голяма пломба или фрактура, зъбът ви очевидно се нуждае от "ремонт". Отивайки при вашия зъболекар, той вероятно ще ви препоръча корона или както се нарича ‘обличане’ на зъба, за да се възстанови естетичният му вид и правилното му функциониране.Вие може да имате обаче един или повече липсващи зъби, след като не е било невъзможно да бъдат спасени. В този случай едно от решенията е направата на мост. Мостът както и короната, може да бъде изработен от различни материали. Изборът зависи от местоположението на зъба, естетичните изискания и цената.

 

1. CROWNS

How are crowns made and applied: step by step

1. During the first visit we will take a small impression of the tooth needed for a temporary crown. After applying a local anesthetic we will begin shaping the tooth to make room for the crown. It is necessary to remove a layer of tooth tissue (usually 1,5-2 mm). After thinning, the tooth that remains, looks like a small cone. At the first visit we will put the temporary crown made of plastic or composite resin. 
2. If the tooth has a periodontal pocket, surgery may be needed. This happens before taking the impression for the permanent crown. If there is no such pocket or other problems, we go on with taking an impression at the second visit.
3. Next, we test the unfinished crown to see how it matches adjacent teeth in terms of shape and color.
4. The crown is returned to the laboratory for further processing, and after that is cemented. 

 

Consider this 

1. A local anesthetic is used for thinning and taking impressions even if teeth have undergone root canal treatment.
2. For the restoration of certain teeth a wax design might prove necessary prepared in the laboratory, with new, more beautiful shape and a biological bite.
3. Three visits are necessary for a crown. These are longer than usual, because making crowns requires utter precision. With more teeth needing crowns the number of visits increases respectively.
4. If the tooth has a bone pocket and its surgical filling is a must, the dentist will wait from 6 to 8 weeks before taking an impression for a permanent crown or bridge.

 

Frequently asked questions

1. What can happen if despite a missing tooth, a bridge is not applied? Tooth gaps not only spoil your smile but can also lead to changes in the bite, and consequently, to increased pressure on adjacent teeth. Increased pressure in turn may result in excessive abrasion and caries of teeth under increased pressure. Besides, unless a bridge is applied on time, adjacent teeth drift and tilt with the result being an earlier onset of periodontal disease. Last but not least adjacent teeth may drift while opposite ones may sprout. In more serious cases the bite may be deformed, and other teeth may be lost in the end. here 
2. What material can be used for crowns and bridges? An all-metal solution (gold) is possible. Metal is used for teeth and segments with less visibility while smiling and speaking. One advantage is that less thinning is needed. Another option is a metal ceramics crown or bridge. These are made of a metal base (cap) coated in a porcelain layer matching the color of natural teeth. The metal can be non-precious (gray metal alloy) or precious (gold metal ceramics). This provides a more aesthetic solution compared to all-metal crowns. Still it is also important to know that metal under porcelain does not let light through and gives the tooth an unnatural look, even when the color of porcelain is just like the color of adjacent teeth. This effect can be eliminated in part if the metal underneath is gold – its yellowish tinge under the porcelain coincides with the tooth dentine, hence a more satisfactory aesthetic result.

 

Advantages of gold metal ceramics treatment

1. More precise and better matching the thinned tooth. This prolongs the life of the tooth because it is covered better and is better protected from bacteria and saliva, and hence from caries under the crown.
2. More aesthetic, provides a more aesthetic tinge showing under porcelain.
3. Less damaging for the gum
4. Bluish-gray coloring around the roots is avoided.

 

Disadvantages

1. Higher price – almost double the price of ordinary metal ceramics 
2. More sophisticated clinical and laboratory work.

 

Crowns of pure, metal free ceramics: the best aesthetic solution for front teeth, absolutely invisible and indiscernible from natural teeth

Crowns can be made of porcelain without any metal under it. This is the new high-tech method known as pure or metal free ceramics. An alternative of pure ceramics are composite resins (photopolymers) which are as aesthetic as ceramics. However due to their fragility and the change of their color with time, the composite crowns and bridges can be applied only in zones under less pressure, and if the bite allows for such a treatment. Of course, these high-tech constructions should be made in a carefully selected top laboratory.

 

2. BRIDGES

Is it possible to make a bridge compensating for one missing tooth without thinning adjacent teeth?

NEW:
Yes, thanks to bonding, or adhesive bridges. These allow for minimal intervention against adjacent teeth thus eliminating the necessity to coat them with crowns. Instead of thinning them for crowns, furrows are made in the existing fillings of supporting teeth. Advantage: adjacent teeth are not coated with crowns, thinning is minimal, usually within the bounds of the caries or filling of the neighboring tooth.

Patient info:

During the checkup your dentist will decide whether your case is OK for an adhesive bridge. This also depends on the diagnostic designs following the impression. Usually such a construction is not recommended when missing teeth are more than one, or if adjacent teeth are strongly tilted or drifted. Working with a top laboratory is a must.

 

3. FILLINGS - The requisite evil

To treat a tooth damaged by caries your dentist will remove destroyed dental tissue and will replace it with a filling (obturation). How does this happen? First you are given a very light, sophisticated anesthetic and then the layer of the tooth destroyed by caries will be removed with the dental machine. Next, the rest of the tooth will be tested to find out whether the whole caries has been removed. If so, the tooth will be cleaned from redundant particles and bacteria and the dentist will proceed with the filling itself.

What materials are suitable for fillings?

• Amalgam - In the first place this is the amalgam which however has been fully replaced with new materials.
• Light cure composite - In our surgery we use the latest universal composite created to achieve an optimal synthesis of light, substance and color shades typical of natural teeth. This system is the pearl of new cosmetic dentistry. For the patient it means excellent results, while from the dentist it requires special know-how and specific skills 

 

Light cure composite

Advantages:

1. These materials match almost perfectly the natural tooth color. This allows correcting cracked or chipped front teeth
2. The material is glued to the tooth by means of special adhesive systems which have a further curative effect on the tooth and the pulp
3. Less thinning is needed compared to an amalgam. Only one visit is enough unlike the time necessary for laboratory fillings (inlays, overlays, onlays)
4. Five to ten times cheaper than porcelain laboratory fillings

 

Key patient info

1. These fillings last about 5 years – they are less resistant than gold and ceramic laboratory-made fillings (inlays and overlays). They wear out faster, due to smaller resistance to chewing pressure, shrinkage and micro-leakage from the tooth walls during polymerization, as well as due to the penetration of saliva and bacteria resulting from the shrinkage typical of these materials.
2. In cases of large caries or severely destroyed teeth light cure composite fillings cannot resist the pressure, so you may be advised to choose gold или or ceramic fillings.