What kind of dental crowns are there
Fixed dentures: the dental crown
A tooth crown looks very similar to a real tooth. It is worthwhile to find out more before the dentist's appointment.
If you are about to crown a tooth, many questions arise: What are the requirements for a crown as a denture? What materials are there? What costs should I expect? And how is the treatment going? You can get answers here. You will also learn that
- The gums and roots must be healthy and stable for a crown attachment.
- Tooth decay is the most common reason for a crown.
- 2 dental appointments to come to you if all goes well.
- Zirconium crowns can hardly be distinguished from natural teeth.
What is a tooth crown?
When it comes to dentures, the term “tooth crown” describes the artificial replacement of a damaged natural tooth crown. If a tooth is very badly damaged, for example by caries or an accident injury, simple fillings are often no longer possible. The carious or broken teeth must then be provided with a crown. This includes parts or the complete rest of the tooth. So it is placed on the tooth stump like a hat. In this way, it restores the original tooth shape and thus stability, aesthetics and chewing function. Important prerequisites for a tooth crown are a firmly anchored tooth root and healthy gums.
Reasons for a dental crown
By far the most common reason is tooth decay. Sometimes dead, root-treated teeth are crowned for stabilization. After an accident, broken teeth can be replaced with a crown. Aesthetic misalignment of teeth in the visible area can also be remedied with crowns. This is often the case when orthodontic treatments are out of the question.
Tooth substance can also be lost in height and width when grinding (bruxism). The solution: a crown. When using bridges and prostheses, crowns are also often required. In this case, they are used for attachment to the remaining dentition. Your own tooth is covered with a crown for protection.
Types of dental crowns
Even if there are many different types of tooth crowns, they have one thing in common: They are artificial replacements for natural tooth crowns and serve to preserve teeth. Dental crowns can be classified according to the following factors:
- According to the color (metal or tooth color)
- According to the expansion or size (partial or full crown)
- After anchoring (glued, cemented, with a pin)
- According to the materials
The partial crown covers only a portion of the tooth, e.g. B. the chewing surface. The transition to the inlay or onlay is fluid. The full crown, on the other hand, covers the entire tooth like a thimble.
Crowns can be anchored to the remaining tooth in various ways. Metal and veneer crowns are usually cemented, ceramic crowns are glued. In the case of severely damaged or root-treated teeth, the dentist attaches the crown with a pin.
Which material is the right one?
The choice of material depends on the tooth. Every tooth has to withstand different loads and therefore requires a different level of stability. Molars are z. B. exposed to greater stress than incisors. Incisors, on the other hand, are in the visible area. With them, the question of aesthetics plays a bigger role.
In addition to stability and aesthetics, the choice of material is also a question of cost. More expensive variants often look more realistic, last longer or are more suitable from an allergological point of view. However, all materials are subject to the German Medical Devices Act. Even cheaper options are therefore harmless to health. The following materials are suitable for dental crowns:
- Precious metal-free metals such as chrome-cobalt alloys (abbreviation EMF = precious metal-free)
- Metals containing precious metals such as gold alloys
- Fully cast crown, also metal or gold crown
Full cast crown (also metal or gold crown)
Full cast crowns are made of metal, either from precious metal alloys (e.g. gold) or from non-precious metal alloys (e.g. chrome and cobalt). They are made from one piece and are mainly used in the invisible area of the posterior teeth. Your advantages: They last particularly long, are relatively cheap and have thin crown walls. This means that only a small amount of natural tooth substance has to be removed.
A disadvantage of full cast crowns is that they can transfer heat and cold to the tooth. This is particularly uncomfortable with sensitive teeth. A metallic taste can also occur immediately after the crown has been inserted. In addition, cast crowns differ significantly from natural teeth because they are metallic in color.
Full ceramic crown (also mantle or jacket crown)
The all-ceramic crown is by far the most expensive variant. But it offers a lot of advantages: It is tooth-colored, looks very natural and is therefore particularly aesthetic. Bacteria cannot settle on this material. Ceramic is also extremely compatible. This means that neither allergic nor electrochemical reactions occur. If you have sensitive teeth, you don't have to worry about temperature sensitivity. Because ceramic is a good thermal insulator.
However, the durability of this material is limited. Most types of ceramic are less stable than cast metal crowns. With the exception of zirconium: the stability of this ceramic variant comes close to that of metal crowns. Accordingly, it has its price.
Full plastic crowns
Full plastic crowns are very cheap. But that's their only advantage. They are fragile, wear out quickly and can discolour. Therefore, they are used more as long-term temporary restorations than as full-fledged dentures.
The veneer crown, also known as the metal-ceramic crown, is the most commonly used crown. It consists of a metal frame that is partially or completely covered with tooth-colored material. The facing is made of plastic or ceramic. The result is a relatively natural-looking and at the same time stable denture. Many veneer crowns are still intact after more than 20 years.
A disadvantage of this type of crown is the often visible metal edges. In addition, the veneer makes the crown wall wider. Therefore, more natural tooth substance has to be ground off than with a full cast crown. In the non-visible area, patients have to bear the additional costs of veneering themselves. In the visible area, on the other hand, facing is considered the standard benefit of the health insurance company.
If you can afford it, you should prefer ceramic veneering to plastic. Because ceramic is more stable and does not discolour. This recommendation is especially true for night crunchers. Because their teeth are exposed to higher loads.
The course of treatment: from preparation to crowning
The prerequisites for a crown are healthy gums and a firmly anchored tooth root without pathological processes. Therefore, a thorough examination with an X-ray must take place before the actual treatment. If pre-treatment is required on the damaged tooth, you should plan a waiting period before crowning. Because after that, treatments under the crown are difficult or impossible.
1st appointment: grinding, impression taking and temporary
At the first appointment, the dentist grinds the tooth stump. It removes up to 60% of the healthy tooth substance. This may be done under local anesthesia. If it is a ceramic or veneer crown, the dentist will determine the tooth color. In the case of dead teeth, he may put a pin in the root. Once the tooth stump has been ground, the dental technician takes an impression of the stump with an impression material made of silicone or hydrocolloid. Dentists often use retraction threads or rings to push back the gums. This makes an exact stump impression possible.
Crown production requires the highest level of precision. An impression of the opposing jaw is also often taken. This can be used to determine the height of the crown. The ground tooth is protected from chemical and thermal stimuli until it is crowned by a temporary plastic. This temporary restoration is only bonded with an easily soluble cement. You should therefore clean your teeth particularly carefully and avoid chewing gum and sticky foods.
2nd appointment: adaptation and crowning
After one to two weeks, the dental laboratory will have finished the crown. The dentist can now use them. He checks the fit and, if necessary, makes minimal adjustments to the height and shape. If the crown is too high, it causes bite pain. If it sits too low, an air space is created. The distance to the neighboring teeth must also be right in order to prevent food particles from biting in.
The crown and stump must therefore fit one another exactly. Because if a cavity arises, there is a risk of tooth decay and inflammation of the gums. If the crown then fits perfectly, it is glued on. A routine check-up often follows a few weeks afterwards.
Care and durability of dental crowns
With good oral hygiene, crowns will last longer. So brush your teeth regularly. Use dental floss and interdental brushes between the teeth. This prevents inflammation and prevents the development of tooth decay. Professional teeth cleaning is also recommended once or twice a year.
Also observe the edge of the tooth crown and gums. Then you will notice changes in good time and you can discuss them with your dentist. With plastic veneers, you should make sure to use toothpaste that is low in abrasives. Otherwise it can quickly happen that the underlying metal flashes through. Abrasives are small cleaning particles that are mainly found in whitening toothpastes. They support cleaning by sanding off the plaque. On the toothpaste tube you will find this z. B. as Hydrated Silica, Calcium Carbonate and Silica Sodium.
The durability of dental crowns cannot be predicted. It is often said to be 5 to 15 years. But crowns can last longer. This is how you contribute to it yourself:
- Careful selection of the dentist
- Conscientious oral hygiene
- Professional tooth cleaning
- Regular check-ups at the dentist
- Wear a protective splint in the case of bruxism, i.e. grinding your teeth at night
What does a dental crown cost?
Each crown is made to measure. The costs depend on the type of crown, the material, the dentist and laboratory costs. Your dentist will draw up a treatment and cost plan before treatment begins. Your health insurance company then has to approve it. It also sets a grant. Since 2005, your share of the costs has been calculated using a fixed grant system.
As a privately insured person, you also benefit from a treatment and cost plan. Because with this you have a total in front of your eyes and avoid surprises. Crowns generally cost between € 300 and € 1,000. Here are a few numbers for orientation:
- Full cast crown: € 250 to € 400
- Full cast gold crown: € 500 to € 700
- Full ceramic crown: € 700 to € 1,000
- Veneer crown: € 400 to € 600
Discuss with your dentist which type of crown is best for you from a dental perspective.
For the cost-conscious, full cast crowns are generally recommended for the invisible area. Veneer crowns are suitable for the visible teeth. If the price is not that important, you can consider an all-ceramic crown.
Are you afraid of an allergic reaction to the material? An allergy test at the dermatologist creates security.
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