How is a crown placed on an implant and can pain occur?

Professional prosthetics makes it possible to restore one or more elements of the dentition. Implantation using high-quality biomaterials allows you to restore the natural anatomy of the dentofacial apparatus and promotes uniform chewing load on the jaw structure. A high-quality crown on an implant is visually no different from natural dental units and has an impeccable and aesthetic appearance.

Orthopedic structures prevent bone tissue atrophy. As a result, the bone does not decrease in volume or become deformed. Timely prosthetics helps prevent changes in facial asymmetry and the formation of various bite defects. Throughout the entire service life of the installed implants, the naturalness of chewing sensations is maintained. Neighboring elements of the dental system do not suffer, taste sensations do not change, and oral hygiene is easy to maintain.

Types of crowns for implants

What kind of crowns are placed on implants? Like regular dentures, implant-supported dental crowns come in a variety of types depending on the material. Today, the most popular materials used in the manufacture of crowns on implants are ceramics and metal-ceramics. Their main difference, as the name suggests, is the presence or absence of a metal frame in the design. Recently, it has become popular, for example, to install zirconium crowns on implants - all-zirconium or ceramic restoration structures made on a zirconium frame.

• Ceramic
  Dentures made of ceramics are usually recommended to be installed in the area of ​​the front teeth. Such structures are highly biocompatible, which means they do not have any negative effects on the soft tissues of the oral cavity. Plus, they look exactly like natural teeth. Ceramic crowns are more transparent, so in this case an abutment will be made of ceramic or zirconium.
• Zirconium
  Implant Crowns made from this modern material are most in demand by specialists today. The secret of their popularity is simple: they combine good aesthetic qualities and high strength.
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• Metal-ceramic
  Metal-ceramic is perhaps the most common material used for the manufacture of dentures. Metal-ceramic crowns on implants for chewing teeth are inexpensive and reliable. They usually require a metal abutment.

Precautions for patients with bad habits

Already a year after implantation, almost all restrictions on lifestyle and nutrition are lifted from the patient. It is important to remember that artificial teeth require careful treatment. It is necessary to monitor the state of personal health so as not to provoke rejection of titanium roots.

Stop smoking

Resins, combustion products, carcinogens, and other chemicals stain dentures, causing them to lose their aesthetic properties. Under the influence of nicotine, the production of saliva is disrupted, due to which the protective properties are reduced. For smokers, the risk of developing periodontal diseases is higher, since trophic processes in the tissues worsen.

After implantation, the patient should not smoke for 2 weeks (before the sutures are removed) so as not to slow down tissue regeneration. After complete healing, smoking is possible, but not advisable. If a person cannot give up a bad habit, he should reduce the number of cigarettes, switch to less harmful substitutes, and also improve oral hygiene.

Limit alcohol consumption

Alcohol negatively affects the immune system, and therefore increases the risk of implant rejection. In a state of alcoholic intoxication, the risk of damage to dentures increases (from hard food or during hygiene). There is a higher likelihood of severe injuries to the oral mucosa and jawbone (during a fall or fight).

What is the best crown to put on an implant?

The answer to this question depends on the area being implanted and your budget. If we are talking about chewing teeth and the patient does not want to overpay, then the doctor will most likely recommend metal ceramics. Zirconium crowns for chewing teeth will undoubtedly be the best option. However, it is also more expensive. If prosthetics takes place in the so-called smile zone, then it is better to place a crown on a ceramic implant. She will look not only beautiful, but also absolutely natural.

Frequency of scheduled control

The patient is required to regularly visit the implantologist from the moment the artificial root is placed. The visit schedule for each patient is individual, but the average time frame is as follows:

• 3 days after implantation

  The doctor assesses the patient’s condition, the intensity of inflammation, and, if necessary, prescribes medication

• 10-14 day

  The implantologist removes the sutures and assesses the quality of tissue regeneration

• 4-6 months

  The doctor installs a gum former to make it look beautiful

• 7 months

  An implantologist installs an artificial crown

Installing a crown on an implant

Installing a crown on an implant involves putting a specially machined crown on an abutment that connects it to the implant - an artificial root, while crowns for traditional prosthetics are made from casts of ground natural teeth and installed on previously prepared teeth.

How long does it take to place crowns on implants? It all depends on the clinical picture. If immediately after installation the implant is stable and there are no indications for delayed prosthetics, then the implantologist places a crown on the implant immediately. In the area of ​​​​the chewing teeth, which are not visible when smiling, most likely, a crown will be placed several months after the final implantation.

Installation steps

1. After installation, an abutment is placed on the dental implant. Essentially, it replaces the tooth stump that is left after preparing the tooth before installing a conventional crown.
2. When the abutment is installed, the doctor takes an impression to subsequently make a permanent crown for the implant.
3. The final stage of installing a dental crown on an implant is fixing the prosthesis to the abutment.

What are custom abutments and how do they improve esthetics?

Such abutments are manufactured individually for a specific patient, taking into account the anatomical features of the oral cavity and the clinical situation. This provides high aesthetics, excellent functionality, and helps improve the sealing of the crown-abutment-gum interface, preventing unwanted substances from getting under the gum.

An individual abutment is made on a high-precision milling machine, because... any inaccuracies will lead to gaps when the crown “fits” on the abutment and to a decrease in service life.

Fixation of the crown on the implant: screw and cement

There are two ways in which you can place a crown on an implant - screw and cement. Screw-retained implant crowns involve drilling a hole in a prefabricated crown, which is later sealed. A screw is inserted through it, passes through the crown and is screwed into the abutment. All this happens outside the patient's mouth. When the crown and abutment are securely connected, the latter is secured in a special hole in the implant. Cement fixation of a crown on an implant is similar to the installation of a conventional crown: it is glued to the abutment using special cement - a composite material, while the abutment is already securely fixed in the implant, and the installation procedure takes place directly in the patient’s oral cavity.

All of the above applies to permanent crowns - those that are installed some time after implantation, when the first period of engraftment passes. But in most cases, implantation involves the possibility of instantly loading the implant with a temporary crown.

Hygiene products at different stages

At each stage of dental restoration, the doctor gives the patient recommendations for care and treatment, recommends devices and gives instructions for use. You cannot ignore the advice of an implantologist, because the engraftment of titanium roots and the service life of the products may depend on this.

Toothbrush

The brush is used for basic cleaning of the oral cavity. Immediately after treatment, only soft brushes can be used. After the implants have healed, the use of medium-hard brushes is allowed. It is important to change the device regularly.

Toothpaste

The implantologist gives recommendations to the patient regarding toothpaste for caring for implants. It should have a soft, uniform consistency, reduce inflammation and fight bacteria. Conventional pastes are not suitable. Some of them are abrasive. They can damage the orthopedic structure. It is better to give preference to medicinal pastes.

Irrigator

The irrigator provides high-quality cleaning of the surface of the teeth, as well as interdental spaces, gum pockets, and the pores of the material from which the prosthesis is made. The device operates on mains power or battery power. The principle of operation is based on the supply of liquid under pressure, due to which it reaches hard-to-reach places. You can use the irrigator only after the implants have completely healed. Implantologists recommend cleaning the oral cavity with clean water, as well as special solutions. In addition to cleaning, the irrigator provides a light massage of soft tissues.

Cleaners

Brushes are small thin brushes of various shapes and lengths. They are designed for manual cleaning of hard-to-reach places (interdental spaces, the inside of the crown). There are cylindrical and cone-shaped brushes. The products are best used to clean the areas between the teeth, as well as the top of the implants at the point of contact with the gums. Curved brushes are suitable for cleaning the inside of bridges.

Dental floss

Flosses can be used only after the gums have completely healed, in consultation with your doctor. Regular dental floss can easily injure soft tissue, so after implantation it is better to use a series designed specifically for this. Such threads consist of a guide tip, sections of spongy and classic dental fiber. They are safe for soft tissues and easily penetrate even the narrowest areas between teeth. Suitable for cleaning the abutment and crown surface.

Why are temporary crowns needed for implants?

Temporary crowns on implants are installed primarily for aesthetic reasons, so that the patient does not walk around with a “hole” in the mouth for the entire healing period. This is especially true for prosthetics in the smile area. In addition, the temporary crown, although not always fully functional, is still involved in speech and chewing. It is distinguished from a permanent crown by the material of production - light plastic, and therefore also by cost and weight. These parameters are important, since spending a lot of money on a temporary crown, which is not needed for a long period of time, is inappropriate, and loading a newly installed implant with a crown of full weight is dangerous. At the same time, externally, temporary crowns are practically indistinguishable from permanent ones, and therefore from natural teeth, their color is matched to the shade of the enamel of the surrounding teeth, all this allows you to hide the prosthetic process from prying eyes.

Why is it important to care for dental implants?

Careful care of artificial teeth is important for the survival of titanium roots. After the implantation of the structures, a restructuring occurs in the bone tissue, and the body adapts to the presence of a foreign body. It is important that nothing interferes with the integration of the implant. Engraftment slows down due to chronic diseases, trophic disorders, and inflammatory changes.

Improper care after fixing the crown creates a risk of periodontal disease. Bacterial plaque accumulates in areas under the crown, which disrupts the balance of beneficial and harmful microflora in the mouth. When the latter predominates, inflammation develops. It passes from the gums to bone tissue with the development of periostitis or peri-implantitis. In these conditions, implant failure is likely.

Patients at risk need to be especially careful, since they have trophic or immune disorders even before the introduction of titanium roots. This negatively affects the healing of implants, slowing down the process. There is already a risk of rejection, but if hygiene rules are violated, it increases significantly. The risk group includes:

• pregnant women;
• patients with diabetes mellitus, low immunity;
• allergy sufferers;
• persons with alcohol, drug, or nicotine addiction;
• people exposed to chronic stress.

Which is better, a crown or an implant?

When asking a similar question, patients most often mean the installation of dentures based on their own teeth and implantation. What is the difference between a regular crown and an implant? In order to install a conventional bridge, it is necessary to grind down the healthy teeth adjacent to the defect, which will begin to decay over time and the bridge will have to be lengthened. This cannot happen with an implant. Its installation does not affect the “neighbors” in any way, and its service life is not limited. Only the crown will have to be changed. The service life of crowns on implants is about 10 - 12 years, and in many cases reaches 15 years, while with traditional prosthetics, the crown must be changed every 5 - 7 years, grinding the teeth in a new way.

When should you see a doctor outside of your plan?

After implantation of a titanium root, as well as for the entire life of the structure, the patient faces a risk of complications. Regular examinations allow you to identify early adverse signs and begin treatment. An unscheduled examination by a doctor is needed if:

• for no apparent reason the temperature rose, weakness, chills appeared;
• when touching the implantation area, discomfort and pain occur;
• there was a feeling of numbness;
• the temporal joint functions poorly (crunches, hurts, the mouth does not open);
• the prosthesis is damaged;
• the bridge or crown has moved;
• there is pain when chewing;
• gums are red and bleeding;
• there was an unpleasant odor from the mouth.

Implantation and alcohol

Remember that the effects of alcohol are very harmful to the entire body. Therefore, we insist that the consumption of drinks that contain even a negligible amount of alcohol must be limited and kept to a minimum.

• While intoxicated, you may perform inappropriate actions. For example, getting into a fight, which will lead not only to damage to the prostheses, but also to displacement of the installed implants,
• hygiene is difficult or impossible - when a person is heavily intoxicated, he cannot control his actions. If you carry out hygiene in this state, you can damage the gums around the implants, which can lead to the development of inflammation and subsequent rejection of the structures,
• appetite increases - you can damage the implants by eating prohibited, too hard food,
• your immunity will stop working at full strength,
• alcohol has a negative effect on the mucous membranes, especially if they are inflamed (you may not know about the presence of a problem if you have not had a preventive examination with a doctor for a long time),
• you forget that you need to visit a doctor: such situations arise in cases where the patient drinks alcoholic beverages for a long period of time,
• you may lose your warranty.

Drinking alcohol should not become an obstacle to living a full life and maintaining the results of expensive treatment!

General rules: what is allowed and what is prohibited

• air travel – fly and travel without restrictions, explore the world and taste new dishes (but with minor restrictions - more about them in the “food” section),
• physical activity – play sports and maintain your health. But exclude lifting excessive weights (in particular, when doing powerlifting) and sports activities that are associated with injuries to the maxillofacial area,
• visit swimming pools without restrictions, but use baths and saunas with caution (severe overheating is not recommended). The temperature of the steam room should be average, the length of stay should be minimal (no longer than 10 minutes),
• keep your body healthy. If you have been diagnosed with diabetes mellitus or diseases of the cardiovascular system, remember that if the condition worsens, metabolic disorders in periodontal tissues may occur, which carries a risk of rejection of structures. Be sure to take medications prescribed by your specialist and monitor your blood pressure and blood sugar.

Visit your doctor at least once a year for a preventive examination, and in case of unsatisfactory self-hygiene and doctor’s indications, more often - 2-4 times a year for professional oral hygiene. This will allow, firstly, to maintain healthy gums and achieve high-quality cleansing of pathogenic microflora, and secondly, to eliminate possible complications in the early stages and promptly eliminate them.

Possible complications if you do not follow the recommendations

Violation of the rules for caring for implants is fraught with peri-implantitis. This is an inflammation of the tissues surrounding the artificial root. Inflammatory changes affect soft tissues and bone, which can lead to implant rejection.

If an artificial rod is rejected, long treatment and complex measures to restore the bone are required.

Lack of hygiene provokes the accumulation of plaque on crowns, changes in their color, and deterioration in the aesthetics of a smile. Even professional cleaning cannot cope with stains and mechanical damage, so the orthopedic design has to be changed.

Rules of nutrition after implantation

Your diet has long become complete - the period has passed when quite strict restrictions were imposed in terms of the hardness of foods and the temperature of dishes. However, even now, after the implants have completely implanted, you will still have to give up a number of products.

• Chew food thoroughly, using both sides - all installed implants should receive an even load. If there is discomfort and you notice that you are chewing food on only one side, consult a doctor immediately.
• introduce a maximum of healthy foods into your diet - food should be rich in various groups of vitamins,
• Do not bite off hard vegetables and fruits - they must first be cut into small pieces. It is better to grate carrots before eating, because... it's too hard to chew
• It is better to exclude shish kebab and hard fried meat - give priority to boiled, stewed meat, and cutlets. The veins contained in meat products get clogged under the prosthesis - it is very difficult to remove them,
• nuts are prohibited - the problem is not even that they are too hard. Like meat, they get stuck under the prosthesis and are very difficult to remove from under it,
• but at the same time, the food should not be soft - it is important to give a reasonable load to both prostheses and implants,
• it is important to drink as much water as possible, chilled herbal or fruit teas,
• exclude (or at least minimize) wine, beets, black tea and coffee, which lead to staining and permanent discoloration of the denture,
• also exclude foods and drinks that contain acids, bites - they can lead to irritation and inflammation of the mucous membranes,
• It is allowed to drink hot drinks and eat cold ice cream, but you cannot combine them to avoid sudden temperature changes.

Use your teeth only for their intended purpose, namely for chewing food! They cannot be used to open bottles, remove corks, or crack nuts. Although they are artificial, they will easily break under increased load.

Pros and cons of methods

Implantation

Advantages

• Lifetime service life and warranty in our Center
• No bone atrophy around the implant
• High chewing loads, no restrictions on food consumption
• High aesthetics
• Easy care

Flaws

• Requires surgical intervention, causes concern for patients
• Possible contraindications to surgery
• Rehabilitation from 2 to 6 months
• The cost is higher than restoration with crowns
• Possible rejection if recommendations are not followed

Installation of crowns

Advantages

• Non-traumatic installation
• Installed in 1-3 doses, if no prior treatment is required
• Virtually no contraindications
• Satisfactory aesthetics
• The cost is lower than when installing implants

Flaws

• Short service life - on average 7 years
• Do not load with too hard food
• If the condition of the root is unsatisfactory, its treatment is required - up to 1 month
• The likelihood of developing inflammatory processes under the crown
• If there is little tissue left, it is necessary to make a stump inlay, which increases the cost

Choosing the best crown

Let's decide which crowns are best placed on implants. A good solution in terms of price and quality are metal-ceramic ones, but in the frontal zone they can lead to “blueness” of the gums. Therefore, the best option is zirconium dioxide. Their price may seem high to some, but it is fully compensated by their service life. After all, while you are wearing a zirconium dioxide prosthesis, the metal ceramics will have to be changed at least once - this is extra money and time.

“I definitely won’t get metal-ceramics for myself anymore, because it makes my gums look very ugly. I don't want to smile. Therefore, when the old bridges became loose and I had to put in implants, I immediately told the dentist that we’d better use zirconium. Honestly, I’ve been wearing new teeth for 2.5 years now and you can’t tell them apart from real ones, and my gums are fine.”

Svetlana A., 42 years old, review from irecommend.ru

What to choose - to summarize

Implants are reliable and durable. They imitate the structure of an incisor or molar. The lifetime service life of the titanium rod can be guaranteed. But surgical intervention is a necessary measure; no implant can replace a natural root. The dentist’s task is to preserve even part of the element of the dental system. A well-treated tooth and a correctly installed orthopedic structure create conditions for long service life and high aesthetics.

On the other hand, a root without pulp can no longer be called complete. Without nutrition, tissue breaks down, leading to organ loss. Then, in order to pay twice, it is better to install the implant immediately.

The doctor will tell you what is best to choose after diagnosis and examination.