How are teeth ground for crowns? Does it hurt? Why is this done? How is the procedure performed?

What is preparation or grinding of enamel: a complete list of indications for this procedure

Article navigation

1. What is preparation
2. What preparation is needed before turning?
3. Types of turning
4. Peculiarities of turning for different types of prostheses
5. Types of ledges when fixing crowns
6. Features of the procedure in children
7. Will it hurt when turning?
8. What to do if there is pain after turning
9. Is preparation always necessary?
10. How much will the turning cost?

Question to a specialist
To restore “problematic” or missing teeth, we go to an orthopedic dentist who offers various prosthetic options. However, the installation of a veneer, crown, removable dentures or bridge is almost always preceded by dental grinding - and the very mention of it immediately frightens patients. What kind of procedure is this, in what situations is it used, will it hurt, what are the features of the preparation and how the process works in patients of different ages - all this is discussed in today’s material.

Trying and installing a crown

At the stage of manufacturing crowns, a preliminary fitting is required, which will allow us to evaluate the accuracy of manufacturing structures for the patient’s teeth and the tightness of the product. If all is well, the crown manufacturing process ends, the finished prosthesis is handed over to the orthopedist and the patient is invited to the specialist’s office for preliminary temporary fixation of the structure.

Temporary fixation of the crown is an event necessary to check the quality of the crown installation. The specialist will also evaluate the tightness of the prosthesis to the ground teeth and make sure that the closure of the crown with the opposing teeth occurs correctly. When temporarily fixing dental crowns, permanent cement is not used, and this allows you to quickly remove the structure if any defects are detected during its operation.

The assessment of the quality and convenience of the crown during temporary fixation is carried out within a certain period of time, which on average is 2-4 weeks. If no defects are identified during this time period and the patient does not complain of discomfort, the crown is fixed with heavy-duty permanent cement. This completes the prosthetic process.

Calculate the cost of treatment by taking a short test in 20 seconds!

Do not delay your treatment, because in this matter time plays against us.

What is preparation

At its core, the preparation process involves removing part of the hard tissue. This layer, represented by enamel (the outer shell) and dentin (these are the internal tissues), must be equal to the thickness of the prosthesis. Armed with a bur, the doctor cuts off the excess and gives the crown the shape on which the prosthesis will easily and reliably fit. It is important to ensure maximum density and absolute accuracy of its fit. As a rule, the shape of a natural tooth is a cone or cylinder.

Relatively speaking, you will have to “cut off” the amount that is equal to the thickness of the prosthesis. For example, zirconium dioxide will require minimal grinding, but metal-ceramics (after all, there are both ceramics and metal) will require the removal of a thicker layer of living tissue.

Preparation is also carried out during filling, but in this case only inflamed tissues are removed, while healthy ones are preserved. If you need to install a prosthesis, even living tissue will have to be removed.

Is it possible to get dentures without grinding?

Table of contents

• Methods of dental prosthetics without grinding
• Features of the technology
• Adhesive prosthetics without turning: technology
• Procedure
• Nylon dentures
• Implantation and dental onlays
• Advantages of contacting MEDSI

Traditional methods of prosthetics involve depulping and grinding of adjacent teeth.
For this reason, over time, the supporting elements collapse and fall out. This leads to the need to install a new structure. Fortunately, modern technologies make it possible to perform prosthetic teeth without grinding the adjacent ones. This ensures the most productive recovery with faster speed and less discomfort. As a result, oral health risks are also reduced.

Methods of dental prosthetics without grinding

Restoration is possible using removable and non-removable structures.

Microprostheses (inlays and lumineers)

Such products can be used without grinding adjacent teeth. At the same time, inlays and lumineers essentially replace filling materials (liquid composites). Products are made from durable ceramics and zirconium dioxide using the milling method. Thanks to inlays and lumineers, it is possible to restore natural tooth crowns if they are destroyed by no more than 50%. Moreover, the products last 15–20 years and are distinguished by the highest levels of strength. Inlays and onlays fit perfectly to the surfaces of the teeth. There are not even microscopic gaps left between the materials and the crown, which reduces the risk of secondary caries.

Important! Lumineers are used to restore front teeth, and inlays are used to restore back teeth.

Pins and stumps

Products such as single crowns are relevant when the visible part of the tooth is severely damaged.

To strengthen them, special rods are used - pins.

made of translucent fiberglass. It is this material that provides reliable support for the future crown. There is no need to prepare adjacent teeth.

Important! The pin does not withstand severe chewing loads. Its service life usually does not exceed 5 years.

Stump inlays

more durable and reliable. With their lower part they are installed in a healthy root. The upper part of the tab is located above the gum and acts as a support for the crown or bridge.

Adhesive dental bridges

Standard orthopedic structures in the form of bridges consist of 3–6 artificial crowns. All elements are firmly connected to each other. In this case, the 2 outer crowns are placed on the teeth, which are pre-prepared.

Adhesive prosthetics are carried out without turning. These designs differ in that they represent several combined crowns. On the sides of the outer ones there are special wings for fixation. Like a standard one, such a bridge is fixed to the teeth, but is not put on them, but glued. Thanks to this, it is possible to avoid the need for grinding.

Fixed locking prosthetics (CBW)

Crownless Bridge Work technology is similar in implementation to installing a bridge. But here there are no outer crowns fixed on supports. With such prosthetics, small male locks are implanted into the supports (which also avoids the need for turning). After this, a crown or bridge is created with matrix holes for the males. For greater strength, special dental glue is additionally applied to the fastenings. This prosthetic technique ensures high-quality distribution of the chewing load.

Cable-stayed restoration

Such fixed prosthetics ensures the restoration of both one and several elements of the dentition. The technology consists of connecting the crowns with a strong aramid thread, which is fixed around the two outer supports. A thin groove several millimeters deep is created along the perimeter of the teeth. Together with the thread, it is covered with a protective composite for the strength and aesthetics of the structure.

If necessary, the thread can be removed along with the prosthesis. In this case, the grooves are easily masked with a filling compound.

The disadvantage of this dental prosthetics without turning is that over time the composite wears out and the thread shows through, which gives the supports a gray tint. In addition, the supporting elements are constantly subjected to increased loads, which weakens them over time.

Restoration using the Dante method

This technology consists of special laser processing of the teeth outermost from the defect and the creation of microscopic holes (perforations) in them. Then a carbon frame is created between the supports (nylon, nylon and fiberglass fibers are also used as a frame). On this basis, a composite crown is built up.

The technique is difficult to implement and has a high cost. In addition, uneven edges appear in the restoration area, in which food debris can accumulate and pockets of bacteria develop, which can cause local periodontitis or gingivitis.

Removable dental prosthetics without turning

Acrylic, polyurethane and other structures are indicated even with complete edentia (absence of chewing elements). They are also used when 1-2 teeth are missing. The structure is secured with clasp hooks made of nylon, soft plastic or metal.

Features of the technology

Adhesive and other options for prosthetics without turning differ in a number of features.

The main ones include:

• quick installation options
• maintaining the load on bone tissue and ensuring its normal nutrition
• preservation of the upper part of the crown and the neurovascular bundle of healthy neighboring teeth, which helps maintain their health
• no risk of significant tissue injury
• short period of recovery and adaptation to the design
• possibilities for installing a prosthesis on filled teeth
• aesthetics
• affordable price

Adhesive prosthetics without turning: technology

This technology is one of the most popular.

The procedure for such restoration includes several stages:

• creating notches in the area of ​​chewing molars
• determining the optimal length and impregnation of the reinforcing tape with special glue
• laying the tape in the recess, giving it the correct shape and polymerization
• modeling
• fixation on the formed prosthesis structure

The main advantage of the technology is its safety. In addition, this type of prosthetics is accessible.

Procedure

Any options for prosthetics without turning are implemented by an experienced doctor. The procedure includes several stages. This:

• Patient examination. First, the dentist examines the oral cavity and takes x-rays to assess the condition of the pulp cavity and dental tissue.
• Preparation. Prosthetics begin only after sanitation of the oral cavity, which involves treatment of caries and elimination of all existing foci of inflammation. After this, the doctor makes impressions and selects the shade of the crowns
• Positioning. Determining the location of the structure fastenings and their further installation
• Manufacturing and installation of the prosthesis itself

Important! The procedure for implementing the restoration method without turning largely depends on the chosen technology.

Nylon dentures

These products are also popular when there is a need for prosthetics without tooth preparation. The prosthesis can be either completely removable or conditional. Nylon, which is a thin and flexible material, allows you to restore several teeth in a row or an entire row.

The prosthesis is made from it according to a standard scheme with the creation of impressions, casting of the frame and fastening of the required number of elements to the base.

Unfortunately, such products do not last long, but at the same time they are comfortable to wear, hypoallergenic, durable and do not require complex care.

Implantation and dental onlays

Implantation is considered the most effective method of prosthetics without turning. Suitable for restoring one or all teeth at once.

Implant installation is carried out in several stages:

• Survey
• Bone tissue augmentation (in case of its deficiency)
• Deepening of the gums and implantation
• Abutment installation
• Taking an impression of the jaw and making the required number of crowns

Today, there are several options for such prosthetics (including those with one-stage loading, when immediately after removal an artificial root is implanted and a crown is placed on it). The appropriate technique is selected by the doctor, who first carries out the necessary diagnostics and takes into account all the individual characteristics of the patient.

The main advantages of such prosthetics without grinding adjacent teeth include:

• long service life of the structure
• no risk of bone tissue atrophy
• strength of the resulting structure
• no discomfort for the patient during use

Advantages of contacting MEDSI

• Complete list of dental services.
  Our dentists provide both examination of the patient and installation of dentures. You can turn to them for sanitation of the oral cavity before restoring teeth, for a sinus lift procedure, etc.
• Experienced doctors.
  The clinic's dentists have the necessary knowledge and skills to implement various options for prosthetics without turning. At the same time, they are ready to select for each patient the technology that will correspond to his individual characteristics, wishes and financial capabilities.
• Modern techniques.
  Thanks to them, all procedures are carried out in a comfortable and safe manner with maximum efficiency. After recovery, the patient will not experience any discomfort and will be able to return to their normal lifestyle.
• No queues and the opportunity to visit the clinic at a convenient time

To clarify the conditions for prosthetics without turning and make an appointment with a dentist, just call +7 (495) 7-800-500. Our specialist will answer all questions. Recording is also possible through the SmartMed application.

What preparation is needed before turning?

In order to secure the future prosthesis well, the prepared crown must be strong, free of plaque and stone, and free of carious lesions (if any, the doctor will, of course, remove them first). Also, before treating the enamel under any prosthesis, it is important to remove soft and hard plaque.

Only until 15.01 South Korean implant Osstem - from 18,500 rubles.

Hurry up to sign up for a free consultation and lock in promotional prices.
Call now or request a call

Opening hours: 24 hours a day - seven days a week

Types of turning

The choice of technique depends mainly on the individual clinical picture, as well as on the volume of tissue that needs to be trimmed. There are types that are more extended in time, and there are very fast, safe and pass without the slightest pain. Let's look at all of them that currently exist. But keep in mind that the choice always remains with the attending physician, who will assess the situation and select the most optimal option.

Ultrasonic

This method involves the use of a special apparatus that produces high-frequency vibrations - ultrasonic. And the device itself is called a “scaler” or “scaler”. By the way, it is used to clean enamel from plaque. Also, instead of a scaler, a piezo device can be used - its action is again based on the use of ultrasonic waves, but they are more powerful, which allows it to be used on harder tissues.

During the procedure, the doctor does not touch the enamel with the instrument. Almost no heating occurs. So the risk of damage disappears. As for pain, it may well occur if there is increased sensitivity, so anesthesia will be appropriate. The method makes it possible to dissect only a small volume.

Laser

This is another effective non-contact turning method. The laser acts on the enamel pulsed, but again removing only a very small layer of enamel and inner dentin. By the way, unlike ultrasound, this method is safer, since laser beams have a wound-healing effect. The method is absolutely silent and allows you to quickly achieve the desired result.

Preparation with a drill

This technology involves the use of a good old drill and a diamond (or metal) tip . In fact, this is the most common and optimal turning option. The doctor can choose different speeds of rotation of the bur, but to prevent overheating, water must be supplied. In fact, the process is no different from drilling in the treatment of caries - everything is done in a similar way.

Watch the video at the end of the article - you can get an idea of ​​how the process of preparing a tooth cavity using a drill occurs.

Air abrasive method

This technique is based on the use of a jet of water and a composition with abrasive particles. Using an air-abrasive method, the doctor is able to smoothly grind off the required amount of tissue. The patient does not feel pain. There is almost no heating and vibration. But the technique makes it possible to remove, again, only a minimal amount of tissue.

Chemical turning method

This method involves using exclusively active acids. Penetrating into tissues, special compounds destroy them. The doctor will only have to remove the softened areas and give the crown the necessary shape so that it fits well under the future prosthesis or structure. The procedure is not quick. The method is considered outdated and is not often used.

On a note! Thus, in 99% of cases it is drilling with a drill that is used for prosthetics (and not for the treatment of superficial caries). It is this technology that allows you to remove any amount of tissue in an extremely short time. True, anesthesia will definitely be required (except for those cases when the tooth is already “dead”, that is, without a nerve).

Peculiarities of turning for different types of prostheses

The type of prosthesis that the patient and the doctor chose to install also determines the preparation technology. Let's consider the features of preparation for each type.

For veneers and lumineers

High-quality turning for veneers allows you to achieve good contact with the artificial plate. The patient will not then feel the pad in his mouth as something foreign. But here it is important to understand why exactly this procedure is necessary:

• for a good fit of the veneer (we will explain later how exactly the turning is done),
• so that the linings do not “stand out”, that is, so that the teeth are not excessively thick,
• so that the row can be leveled using veneers. For example, you will have to grind off the front part of the enamel if one of the elements is crooked and stands out in front. Of course, one overlay will be slightly thinner than the others. But it also has a limit on the minimum thickness - often in such situations the tooth is simply given a new shape.

When installing veneers, the enamel is ground down by the dentist in a special way. First, the doctor treats only the outer, “front” part, followed by the side and cutting surfaces. Very often, vertical and horizontal recesses are made in the front, which are filled with dental glue. All this significantly improves the fixation strength of the pads.

Don't know what type of prosthetics to choose?

We will help in the selection, advise where to read more information and compare types of prosthetics.
Consultation with an orthopedic doctor in Moscow clinics is free! Call now or request a call

Working hours: from 9:00 to 21:00 - seven days a week

It is interesting that to install, for example, thin veneers made of pressed ceramics or lumineers, such strong grinding is often not necessary (especially if your own teeth are straight). It is enough to simply grind the surface using an air abrasive method or a laser to make it a little rougher. This again will allow the lining to be fixed much better and for a longer period.

Under the tabs

Inlays are prosthetics that replace fillings. They are needed in situations where there are still too few indications for a crown, that is, it is too early to place it. Grinding under an inlay is slightly different from preparing for a filling. In order to install the product well, the doctor will only remove all inflamed (carious) tissue, after which he will carefully process the cavity and take impressions, because the inlay is created in the laboratory.

For crowns

A crown helps restore the integrity and beauty of any tooth, and also protects the fragile pulpless unit from destruction and the risk of caries. When preparing a tooth for a crown, it is important to create a special ledge (their types are listed below) - in fact, the future prosthesis will rest on it. Such ledges are most often located under the gum so that the entire tooth can be completely covered, as well as the transition between the crown and living tissues can be hidden.

Let's consider the features of preparation depending on the material of a single prosthesis:

• for cast metal: grinding starts from the sides, remove up to 0.7 mm,
• like plastic: they are more aesthetically pleasing than metal ones; They can be used to cover both front and side teeth. But here the rules are as follows: a plastic prosthesis is made thicker, especially if a metal base is added. So you will have to grind off quite a lot - more than 1.5 mm,
• for metal ceramics: remove up to 2 mm on each side. Such a prosthesis again consists of a combination of materials, so it turns out to be quite thick,
• under porcelain: the dentist gives the unit being processed a cone-shaped or cylindrical shape. Requirements for the ledge: it is made rounded and goes under the gum by 1 mm. Turning – up to 2 mm on each side. When using pressed ceramics - much less, up to 1 mm,
• for zirconium: it is important to obtain an accurate edge of a rounded or shoulder-shaped ledge. As a rule, it grinds down about 0.5-0.7 mm.

It is important to understand that these indicators are completely average. Everything depends not only on the material as a whole, but also on the specific doctor and laboratory equipment.

Complex on 4 OSSTEM implants with delayed loading - from RUB 170,000.

Complex implantation Osstem (South Korea) with delayed loading after 4-6 months.
Guarantee for the doctor’s work - unlimited Call now or order a call

Opening hours: 24 hours a day - seven days a week

This is interesting! Today, it is very common for metal-ceramic crowns to be created with “shoulder mass.” In terms of thickness, they are no different from ordinary ones, but they have a very big advantage: the outer ceramic coating covers the metal underneath, that is, the metal base does not come into contact with living tissues in any way. This eliminates allergic reactions and does not cause blue gums.

Accordingly, if you plan to install a bridge, then grinding down the supporting teeth will be carried out in the same way as when fixing single crowns. Because the bridge consists of them.

For removable dentures

Often, teeth need to be ground down in order to install removable dentures. But only if a reinforced fixation system is used. For example, clasps that are placed inside the crown part, or telescopic crowns that are fixed on top of living teeth.

When splinting

To prevent the patient's teeth from becoming loose (this also happens with advanced periodontal disease or periodontitis), splinting is used. To secure the splint, the enamel is prepared minimally - for this, a small depression is made on the inside of the entire dentition, inside which a special splinting thread is placed. However, in a number of situations it can be simply secured from above, so turning is not required.

Is it painful to grind teeth for crowns?

It is impossible to perform prosthetics without special preparation of teeth, which consists of grinding them down. It is used to level the surface of hard tissues. Many patients find this stage of prosthetics the most unpleasant due to the possible pain of the procedure. The following describes in detail the features of turning.

Necessity of the procedure

No person's teeth are perfectly shaped. The bulges present on them interfere with the production of comfortable crowns. Therefore, the dentist has to prepare or, as people say, grind the teeth.

The preparation stage is necessary to ensure that the manufactured dentures have the correct shape, fit well to the teeth and are firmly attached to them.

The tooth must be prepared by an experienced doctor, who will do this taking into account the thickness of the crown being installed. After all, the manufactured prosthesis should not interfere with talking and chewing food.

Grinding a tooth is often also a therapeutic procedure that removes tissue affected by caries. This stops the progression of the disease

Preparation methods

There are several methods used for preparing (grinding) teeth:

• Ultrasonic
• Using laser
• Chemical
• Tunnel
• Using an air abrasive device

An ultrasound machine performs grinding using waves that do not damage soft tissues or cause overheating of hard tooth tissues.

The amount of heat generated when exposed to ultrasound is minimal. The vibration of the device is low, so cracks do not occur during turning.

The procedure using this method is painless.

Preparation of tooth tissue for subsequent prosthetics using a laser does not cause discomfort or pain.

The advantages of the laser method include speed, noiselessness, safety and the absence of mechanical impact on the nerve endings, which irritates them

The ability of a laser to destroy pathogenic microflora makes additional treatment of the oral cavity with antiseptic solutions unnecessary.

The chemical preparation method takes longer. Special substances soften enamel and dentin. The use of anesthetics is not required, there is no heating of the tooth tissue, and there are no chips or cracks on its surface.

During air-abrasive grinding, sandblasting of hard tooth tissues is performed. Sodium bicarbonate and aluminum oxide serve as abrasives in this case. They are fed through the tip of a special apparatus onto the tooth and grind down the required amount of hard tissue without overheating it and maintaining its sufficient volume. The method is painless.

A turbine unit is used for tunnel turning. The speed of its operation is adjustable. Preparation is carried out with a diamond or metal tip

The classic method is the most painful and unsafe compared to the others.

Along with modern methods, the classic one is still used - grinding the tooth under a crown using a drill. This method is the most painful and unsafe compared to the others.

Unpleasant consequences can be a crack in the enamel or damaged gums.

But during such preparation, the doctor can control the volume of enamel removed, which is an advantage of this method.

It is necessary to choose a preparation method depending on the condition and structural features of the teeth of a particular patient.

He, for his part, before performing prosthetics, must familiarize himself with the technical equipment of the clinic and all the features of the procedure.

Features of teeth grinding

Before starting the preparation, the doctor usually takes an x-ray to clarify the characteristics of the pulp and its reaction to medications, the structure of the tooth, and also determine its condition.

If the nerves of the tooth are killed, then there is no need for anesthesia before preparation using the classical method.

Different types and materials of crowns require different grinding features.

For example, for metal-ceramics, the tooth is ground on all sides, for metal crowns - on the sides, so as not to injure adjacent units.

To install a zirconium crown, the tooth is ground to form a rounded shoulder. If the crown is made of porcelain, the tooth is given a cylindrical or conical shape.

If anesthesia before preparation was performed correctly, the patient does not experience pain during the procedure. It can only occur when a significant layer of dentin is removed or when soft tissue is compressed.

Types of ledges when fixing crowns

If you look at the photo below, it will immediately be clear what ledges are - they are needed to fix the crowns. Such ledges are located under the gum so that the border between the tooth and the prosthesis is hidden.

Accordingly, they also come in different shapes:

• knife-shaped: in fact, in such a situation there is no ledge - the top of the tooth will simply have the shape of a cone. Solid metal crowns are fixed in this way (but today this method is rarely used),
• rounded: used for attaching metal-ceramic crowns, but also not used often,
• shoulder: this is the most popular option, and it is also universal. Such a ledge, although large in thickness, is considered the most aesthetic. It has an angle of approximately 90 degrees.

Will it hurt when turning?

The word “grinding” used to sound scary coming from a dentist. Today, the preparation process does not last long and takes place without any discomfort or pain. Before starting the procedure, the doctor will “freeze” the mucous membrane with a special gel, and the patient will not feel the injection with a good local anesthetic at all. Anesthesia is used both in the case of working with living units (in order to “turn off” for a while the nerve that is sensitive to any manipulation) and with “dead” units in which the nerve is absent. After all, turning involves a very painful retraction of the gums.

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.

What to do if there is pain after turning

It happens that after the anesthetic wears off, the patient experiences unpleasant sensations. They can be either a type of norm or a pathology. Teeth hurt after grinding for the following reasons:

• overheating occurred: the bur rotates at a very high speed, so if the doctor performed the procedure quickly, without stopping, tissue overheating could occur. In this case, the pain will be monotonous, but will go away on its own after a few days or weeks, less often - after a couple of months,
• During preparation, too much was removed: the dentin layer has become thin, the nerve is close, so it is completely normal that the tooth will react with pain. But this is no longer the norm - to prevent such situations from occurring, most doctors still suggest depulping before installing a prosthesis,
• the gums are injured: quite often doctors use special threads and metal plates to push back the mucous membrane. Therefore, slight inflammation and swelling of the gums after the procedure is normal, which disappears on its own within a few days.
• errors when grinding: what to do after the procedure for processing units if the painful symptoms do not disappear even after several days? This is a reason to visit the dentist. It is possible that the nerve was injured or the root split, which led to the development of an inflammatory process. In such a situation, the pain will be acute, tissue swelling is possible (and not only the gums, but even the face). This situation requires a prompt solution.

On a note! The important point is that after turning, a temporary prosthesis is almost always installed - be it a veneer or a plastic crown. After all, after preparing the support, impressions are taken, based on which the dental technician in the laboratory will work on the design of the prosthesis. To save the tooth and restore its aesthetics, the doctor will suggest a temporary replacement.

Stages of metal-ceramic prosthetics

The process of dental prosthetics with metal-ceramics can be divided into two large stages: preparation and prosthetics itself. An initial consultation with an orthopedic dentist allows you to determine the scope of work to be done, assess the condition of the oral cavity, and discuss options for restoring the shape and function of the tooth. According to the drawn up treatment plan, the patient is sent for diagnostics.

Preparing teeth for metal-ceramic prosthetics consists of the following:

1. Performing X-ray diagnostics. It allows you to determine the absence of inflammatory changes in the periodontal tissues and evaluate the quality of filling if endodontic treatment was previously carried out (the pulp was removed and the root canals were sealed). If the canals are sealed poorly - not completely or, conversely, with the filling material extending beyond the apex of the root, the doctor will unseal them and carry out repeated treatment.
2. Professional teeth cleaning and caries treatment, replacing old fillings, if necessary.
3. Depulpation - removal of a nerve. If the damaged tooth has not been depulped previously, the doctor performs this procedure in the following cases:
   the presence of inflammation at the apex of the tooth, pulpitis;
4. the need for prosthetic replacement of a single-rooted tooth - the pulp must be removed.

If prosthetics of a multi-rooted chewing tooth is required, the pulp can be left intact - but the final decision on this is made by the dentist, taking into account the individual characteristics of the condition of the oral cavity and the structure of the dental system.

In order to determine how dental prosthetics are done with metal-ceramics, it is necessary to take into account the degree of tooth destruction. Thus, a stump inlay for a metal-ceramic crown is made in cases where the tooth’s own crown is destroyed by more than half - at the root, or if only thin walls remain.

And if a larger volume of tissue is preserved, a pin can be used - it is screwed into the root canal, and an artificial crown is installed on it.

The actual stages of dental prosthetics with metal-ceramics are as follows:

1. Tooth preparation - grinding. The question of whether teeth are anesthetized during metal-ceramic prosthetics, as a rule, is not raised - of course, the specialist performs preliminary anesthesia to eliminate the patient’s discomfort during the procedure.

The doctor grinds the teeth and then takes impressions - this is necessary for the further production of artificial structures according to individual parameters. Turning is carried out in one of two ways:

• with a ledge - the orthopedic dentist forms a circular ledge along the lower edge, which protects the gums from contact with the metal frame and reduces the likelihood of possible complications - swelling, irritation from contact of tissues with metal. This method also allows the use of metal ceramics with shoulder mass - it is applied in the area of ​​the ledge to increase the aesthetics of the structure, and makes it possible to hide a strip of metal that can be visible through the ceramics at the base of the structure. Turning with a shoulder also makes it possible to extend the life of the structure;
• without a ledge - this method is outdated, so it is rarely used today. It has significant disadvantages - it does not provide enough space for a crown and can disrupt the contours of the gums. A space is formed between the structure and the gum tissue, in which dental plaque accumulates, and the edge of the denture looks quite unaesthetic. The design may cause irritation to soft tissues.

When contacting the clinic, find out how dental prosthetics are done with metal-ceramics - using the first or second method. This will avoid possible troubles with further wearing of the structure.

• Making an impression. Using impression material, the doctor takes impressions of the ground teeth. In order to accurately reproduce the parameters of the teeth, the gums are shifted using rings or retraction threads.
• Installation of a temporary crown. Due to the fact that the production of a permanent structure takes a certain time - about 1-2 weeks, the doctor installs a temporary crown made of plastic. This is necessary to protect the tooth core from food and saliva, as well as to ensure aesthetics. While the patient wears a temporary crown, a metal frame is made in the dental laboratory, onto which ceramic mass is subsequently applied layer by layer.
• After the permanent crown is made, it is installed using temporary cement after preliminary fitting of the structure. If it does not cause discomfort, the doctor will fix the crown using other, permanent materials.

Is preparation always necessary?

The good news is that no, not always. If a minor correction of the defect is expected - for example, with the help of artistic restoration, then the dentist will simply limit himself to grinding. This will enhance the adhesion of the glue and material.

Dentists do not always treat enamel before fixing veneers[ii] - this has already been discussed earlier. No preparation is required when installing classic removable dentures, which are fixed to the supporting teeth using plastic or metal hooks. Teeth are also not injured when defects are replaced with implants - these are artificial analogues of roots, the installation of which in no way affects the position and condition of neighboring teeth. Even when you subsequently need to place a crown on top of the implant.

Important! It is necessary to understand that preparation will be required only if there is “something left” of the tooth. That is, if the top is destroyed at the root, there will be nothing to grind. In such situations, you need to build up the root - for example, using a pin or stump tab. And then fix the single prosthesis from above.

However, you still cannot do without the turning stage when installing a classic crown. Science has not yet come up with other ways to reliably fix such prostheses.

Indications for the procedure

Grinding of teeth in itself is not an independent method of dental treatment. This is one of the stages of orthopedic treatment of dental defects, which is sometimes simply impossible to do without. The absolute indications for the procedure are:

• Installation of dental crowns, including support ones for bridges.
• Installation of veneers.
• Preparation for installation of the stump tab.

With these types of prosthetics, grinding of teeth is a prerequisite that cannot be avoided. It is impossible to install a crown or veneer without giving the tooth a certain shape, since there will be no reliable fixation and precise fit of the crown.

But the patient should not be afraid of this procedure - as already mentioned, it is performed absolutely painlessly, under local anesthesia. At the same time, turning does not always require depulpation. According to modern methods, depulpation is carried out only if the tooth is significantly damaged and requires endodontic treatment. If we are talking about a healthy living tooth that needs to be prepared for an abutment crown for the installation of a bridge, depulpation is not required.

How much will the turning cost?

The cost of dental preparation differs depending on the economic policy of the clinic.
But in most situations, no one highlights it as a separate service - it is simply included in the overall price of prosthetics. That is, for example, if installing a ceramic crown costs 20 thousand rubles, this implies that the price also includes preparation. But sometimes you will have to pay an additional 500 to 2000 rubles for a temporary crown, which is placed on a ground tooth to protect it. Not all clinics operate on an all-inclusive basis, so you definitely need to clarify what exactly is included in the price of prosthetics. Belenchikov A. A., Biragova A. K., Epkhiev A. A. Assessment of changes in the microstructure of hard dental tissues after preparation with various types of burs. Journal of health and education in the 21st century, 2022. [ii] Vedernikova L. V., Zholudev S. E. Planning the aesthetics of ceramic veneers without preliminary tooth preparation, 2013.

Preparing to install dental crowns

Traditionally, crowns are placed on dead (pulpless) teeth, but sometimes there is a need to install a structure on living teeth. This has a positive effect on the final result of prosthetics, since living dental units are stronger and less susceptible to destruction processes, which ensures a long useful life of the crown. Usually, chewing teeth are not depulped during prosthetics. They have a significant area of ​​the natural crown and the distance from the enamel layer to the pulp is greater, which eliminates burns to the natural tissues of the oral cavity during prosthetics.