Ceramic crowns and fillings

Dental care and prosthetics involve large amount of manual work. However, “digital world” is taking over this field of work, too. Lumen Dental Clinic uses CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) technology for digital modelling and preparation of fillings, crowns and bridges.

A beautiful and healthy smile affects us in two ways: it is an expectation of good health and boosts our self-confidence creating new possibilities in life.

Dental care is about correcting the defects in teeth, using various materials – glass ionomer-, composite- and porcelain fillings. Dental care also includes dental prosthetics that according to the situation means dental crowning or replacing the missing tooth with a dental bridge or an implant in order to restore chewing function.

In case of a small tooth defect, it is possible to restore it with a composite filling. Tissue-friendly composite fillings enable the observation of tooth color and give a great esthetic result.

 
       Before restauration                    After restauration

In case of a big damage, there are several drawbacks when recovering the tooth with a filling:

    • Wearing of the composite material is quite rapid that eventually causes lowering of the mastication surface and, in connection with it, changes in occlusion and possible functional problems with the jawbone;
    • With a big filling, it is very difficult for a doctor to restore the anatomical shape of the tooth and to achieve the matching of the mastication surfaces of the upper and lower mandible;
    • With a big filling, there is a risk that the parts of one’s own tooth might easily brake;
    • Filling material is never as strong as one’s own tooth tissue and therefore does not often withstand great mastication loads;
    • Since composite material is placed and hardened with light layer-by-layer, then, despite of the doctor’s carefulness, it is very likely that a microscopic gap will remain between the filling and the tooth’s surface, in which bacteria might eventually penetrate and start disintegrating the tooth once again, creating the so-called secondary caries.
Solutions

Nowadays ceramic fillings and ceramic crowns are used more and more in dental care.

Ceramic fillings are divided inlay and onlay according to the level of damage to the tooth tissue.

 
                     Inlay                                            Onlay

It is advisable to cover a tooth that has disintegrated a great deal and a tooth that has received root canal treatment with a crown. The crown restores the anatomical shape of the tooth, assures the strength of the restoration when chewing and durability to breakage.

Crowns_posterior
           Incorrect fillings                        Ceramic crowns

The esthetic look of the teeth has a major impact on a person’s spirits. For this purpose, it is advisable to cover the darkened or filled front teeth with ceramic laminates and change the unpleasant-looking and non-correct fillings for ceramic fillings.

 
Front teeth restored with ceramic laminates

 
Broken tooth restored with ceramic laminate

inlay-2
Amalgam filling replaced with ceramic filling

Advantages of the ceramic

Restoring teeth with ceramic material has several advantages over fillings:

    • Ceramic materials have undergone a rapid development, due to which some tooth tissue, which is physically very similar to a person’s tooth tissue, has been accomplished: durance to mastication pressure, small internal strain of the material, etc. Therefore, the result is long-lived.
    • It is possible to attain the shape that complies with human teeth, the result of which is a great match between the mastication areas.
    • The production method allows achieving the perfect match of the contact areas between the person’s own tooth and ceramic, therefore minimizing the risk of secondary caries.
    • Ceramic makes it possible to establish a look that is confusingly similar to the person’s own teeth.

CAD/CAM in dentistry

Dental prosthetics is an individual production that is a laborious process.

Traditional method composes of the simplified steps below:

    1. The doctor makes the arrangements for the restoration or tooth preparation.
    2. The doctor takes an impression of the patient’s mouth using an impression material.
    3. The dental impression is sent to the laboratory.
    4. Gypsum is poured into the impression material, therefore creating a gypsum model of the patient’s mouth.
    5. A restoration is made in the lab using the gypsum model.
    6. The lab sends the restoration back to the clinic.
    7. The doctor puts the restoration in the patient’s mouth.

In different branches of industry (e.g. mechanical engineering) CAD/CAM (Computer Aided Design / Computer Aided Manufacturing) solutions have been used for decades to automatize production. Similar solutions are used in dental care.

Lumen Dental Clinic uses Cerec CAD/CAM system, manufactured by Sirona that has been developed since 1985 and used in more than 25000 clinics all over the world.

Cerec_Omnicam

CAD/CAM technology makes it possible to prepare ceramic fillings (inlay, onlay), crowns, laminates and smaller bridges in a dental office.

The process is as follows.

1. The doctor makes the arrangements for the restoration or tooth preparation

   

2. The doctor scans the denture of the patient with an intra-oral camera.
Omnicam

3. The software builds a 3D model based on that, which shows the exact condition of a person’s mouth. The software constructs a crown (or a laminate, inlay, onlay) based on the anatomy of the existing teeth and the examples in the database. The doctor has the chance to adjust the result in a three-dimensional environment if necessary.

Cerec_Desing

4. If the result satisfies the doctor, then he sends the data to a computer-operated milling machine, which mills the crown from a monolithic ceramic block in about 20 minutes. We use CEREC, VITA and IVOCLAR-VIVADENT blocks.

5. The crown is characterized with colors according to the patient’s individuality.

6. The doctor places the crown on its place in the patient’s mouth and the patient leaves with a completely new and healthy smile.

The advantages of CAD/CAM solution compared to the traditional restoration:
    • Speed
      The result is achievable within one day – “One Day Dentistry”
    • Accuracy
      With the traditional method, the mistake grows with every step (impression – gypsum model – crown). Cerec CAD/CAM makes the accuracy of the whole process 19 – 55 μm. In comparison, a single human hair is approximately 80 μm. If need be, the doctor has the chance to make corrections to the tooth preparation.
    • Less anesthetic shots.
    • No need to take an impression with an impression material, which is uncomfortable for the patient.
    • No need for uncomfortable temporary dental crowns.
    • An all-ceramic (metal-free), esthetic and time-proof result.

The modern CAD/CAM technology in dental care allows all this.

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