Dental Crown

an image of a tooth - how to place a crown on it



What is the best material for making veneers, crowns, bridges? Why there is so much different information on this subject on the internet and why dentists opinions are so divided? Is it so difficult to unequivocally say what is a better solution and what are the advantages and disadvantages of individual materials? What are the costs of individual work and why the difference is so significant?

People very often look for information on: what crowns or bridges to choose: zirconium, porcelain or ceramic? What is the best/ the cheapest/ideal for me? We will try to bring you closer to the above topic so that you will be able to understand more what exactly your dentist recommends you to do.

First of all: porcelain and ceramic crowns and bridges are the one and the same thing. Porcelain is the highest quality ceramic, therefore when speaking about ceramic crowns or porcelain crowns we mean exactly the same thing.

Secondly, Zirconia crowns, bridges or veneers do not exist. There are, however, porcelain crowns on Zirconia base and that it a fundamental difference. Therefore, if we need to decide on the material which our teeth will be made of, it is important to remember that the outer part is always made of porcelain, while the base (foundation, skeleton, inner part), can be made of metal, zirconium or porcelain (once also of gold, however currently due to its higher price, this material is rarely used).

All metal crowns are the ones used the longest and despite their huge durability, they have one major downside - colour of metal itself, which is relatively dark. It does not let through and reflect the light, just like natural teeth do, therefore very often it is eliminated from the beginning due to this aesthetic reason. The solution with using this material on reconstruction of front teeth will not 100% guarantee their white natural appearance. Moreover, very often when having crowns or bridges on the metal base, an effect of bruised gums might appear. However, there are no medical contraindications to use this material ‘on the front’ and some patients do decide to go for this option due to its price - this solution is simply the cheapest. Mostly, however, these types of crowns are selected for lateral teeth reconstruction, where the above ‘cons’ will not be visible.

If we count on a very natural effect, we need to consider then crowns on Zirconia or Porcelain base (meaning all-porcelain crowns). These are two solutions that we highly recommend for the reconstruction of the front teeth, due to the fact that the colour of the base will be white in both cases, therefore the bruising effect (as in case of all-metal crowns) does not occur and the teeth look very natural due to the fact the the light is reflected very much like the natural teeth. There are people who say that these solutions can be applied regardless of the place in the mouth. We, however, tend to say that the crowns on Zirconia base can be applied on and used in ‘the whole mouth’ while these on the porcelain base, in the front part only. This is due to the fact that the durability of porcelain is 3 times smaller than Zirconia strength, therefore there is no point in risking cracking or breaking such crown by placing it in a place where the loads and forces are too strong for porcelain to withstand.

There are also patients, who for some reason do not want the all metal crowns, even when it regards molar or premolar teeth (lateral). An alternate solution then, would be using porcelain crowns on the Zirconia base (just for the reminder that zirconium despite being mistakenly taken as non-metal, belongs to the group of transition metal).

Zirconium is strong enough to withstand the strains which lateral teeth struggle with during chewing and crushing of food. We do not recommend, however, an application of all-porcelain (all-ceramic) crowns on lateral teeth, due to the fact that this material is not sufficiently strong. However, if someone insists on the above solution regardlessly, this could be applied as well, but we do inform the patient with the full honesty about these ‘teeth’ being much more delicate.

Summing up, very often what we are inclined to do, is in case of teeth restoration, crowns or bridges of the front teeth are reconstructed on porcelain or Zirconia base, while the lateral teeth can be easily restored on the metal base. In our opinion, this is an ideal combination, which will allow you to achieve a perfect aesthetic effect, and what is most important for the good price. Of course, if someone’s ‘whole mouth’ or simply more teeth need reconstruction, the costs are quite high, so in order to optimize them, in the best possible way, it will be worth considering a combination of solutions, i.e. invest in the best (prettiest) crowns in the most visible places (in the front), while the lateral teeth, which are not as visible, even with a wide smile, can be easily replaced with all metal crowns. Without a doubt, the decision about the material and the entire implementation belongs only to the patient, who depending on financial situation, as well as personal preferences, chooses what suits him best!

A topic about veneers needs to be discussed as well. The only option would be making them of porcelain, because veneers are nothing else than thin (2-3mm) flakes ‘glued’ to the outside of the tooth (polished delicately previously). Veneers must be made of porcelain because this gives the highest aesthetic effect, and yet veneers are used only to improve the aesthetic effect of your own teeth.

Why do individual solutions differ in price so much? It is simple, all metal crowns are the cheapest purely because their base in ‘only metal’. All-porcelain (all-ceramic) crowns and on Zirconia base are much more expensive but only caused by the price of the material itself, but above all because of the TIME and TECHNIQUE necessary for their implementation.

How long does it really take to have teeth reconstructed?

Do you think about your teeth reconstruction, a metamorphosis of your smile? Are you wondering how long this might take? Are metamorphoses possible in 1 day? How to plan leave so that nothing will surprise you? First of all, let’s point out that duration of individual treatments/reconstructions may vary in different clinics and especially in different patients. Medicine is not like mathematics, not everything can be predicted, not every treatment might be planned in 100% from A to Z, and most importantly - every patients is an individual case. There are many different types of reconstruction. We will describe here ones chosen by patients most often.

1. A total restoration of teeth ‘from scratch’
If the patient has not teeth or some of them have left, but unfortunately they need to be removed and he considers a permanent solution ‘on implants’. We will describe two, often chosen options: fixed prosthesis screwed to implants - Toronto Bridge or porcelain bridges on implants.

If you choose the method All on 4© (All on 5 or All on 6©) and Toronto Bridge (screwed to implants), then options are available:
a) everything takes place within 3-4 days: patient’s remaining teeth will be removed (if the patient had some more teeth left), implants will be implanted and Toronto Bridge prosthesis will be made and inserted. However, in order for this to be like this, the patient must have a lot of own bones and moreover, the bone has to be strong (the base for implants must be solid)
b) the procedure is divided into 2 stages - due to a large bone loss or relatively weak bone:

1. stage 1 is removal of teeth and implantation, after which the patient is provided with temporary prosthesis, which he wears until the implants are fully integrated with the bone (3-6 months), the stage lasts around 3 days 2. stage 2 (after 3-6 months) in which a permanent prosthesis Toronto Bridge is made and inserted, the stage lasts around 3-4 days. Sometimes (very rarely though), the doctor decides about teeth removing, and only after a few weeks the implants are implanted.

In case of severe bone loss, if any other pre-treatments are necessary (in order for implantation to be possible), the entire process might take longer due to this reason.

Another solution mentioned already before - porcelain bridges on implants.

In case of selecting this type of prosthetic solution, a period from 3 to 6 months must pass since implants surgery was performed, to the moment of complete implants integration with the bone. This is because, porcelain bridges are made of a much heavier material than the previously mentioned Toronto Bridge prosthesis, and it is not allowed to burden implants with these bridges before a full integration of implants with the bone. It may simply cause an implant damage and its complete lack of integrity with the bone.
The implant surgery itself is usually a matter of a few hours. However, if the patient need a temporary prosthesis in a first place, then usually this stage lasts around 3-4 days. Of course, the patient does not need to send those few days ‘on site’ in the clinic. After the procedure he can return to hotel, and after 3-4 days when the denture is ready he arrive in and collect it. Sometimes, in some patients who have previously had a prosthesis, it is possible to fit their own prosthesis so that it serves as a temporary denture.

2. Prosthetic reconstruction based on patient’s own teeth.

Another, often-occuring ‘case’, are reconstructions based on patient’s own teeth. What does it mean? It means that the patient having enough of his own teeth for porcelain bridges to lean (it is impossible to clearly determine what number - everything depends on how teeth are placed inside the mouth) would only like to change his appearance without the need of implantation, simply because they look unsightly, damaged, crooked, discoloured…
If we deal with the patient who has his own teeth, even damaged but suitable for treatment, then the program looks more or less like this, that firstly he treats the teeth that require this the most, or possibly they are strengthened with inserts so that they are a solid base for porcelain crowns or bridges. Next, all the teeth must be grinded. On such prepared teeth, porcelain crowns or bridges are placed (a few crowns connected to one another create bridge). The minimum time of this type of solution depends primarily on the number of teeth that require treatment (very often patient’s teeth require root canal treatment, and as we know this kind of treatment on only 1 tooth can take sometimes even several hours). However, considering the patient, who does not need to treat ‘the entire mouth’, it can be estimated that the reconstruction based on the patient’s own teeth, without the need to implant, is about 1 week (this mainly involves time for the prosthetic to make a set of new teeth). The solutions described above do occur in practice. It should be remembered that the main rule is that almost all reconstructions performed ‘on implants’ require a longer time of completion (there must be a period of 3-6 months from the moment of implantation until a porcelain work is inserted).
The exception is Toronto Bridge prosthesis, because they are made of light materials (composite and acrylic) and under favorable bone conditions of the patient, there are chances for immediate implants placement (the whole treatment is about 4 days). Such prosthesis are (Toronto Bridge) not as burdening for them as porcelain bridges could be.
Works performed on the patient’s own teeth (porcelain crowns and bridges) are usually completed within around 1 week.

The main issue here is the condition of patient’s teeth as in some cases their treatment might take longer. In any case, however, the treatment period might be longer, if there is a significant bone atrophy, which does not allow an immediate implantation. In that case, the entire treatment process will be preceded by a procedure that will allow implantation later, such as bone augmentation or sinus lifting.

If you wanted to find out more, whether the treatment will take several days, weeks or maybe months, we do encourage you send a pantomography picture or computer tomography, which will be assessed by the doctor/implantologist and he will then present the initial plan of the treatment as well as the time needed for its completion.





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Why to choose us for your plastic surgery and dental treatment

1. The costs of the treatment significantly lower than in the UK, without reducing its quality (experienced, professional doctors and hospitals/clinics equipped with the newest technology devices and machines).

2. Reduced waiting time for the procedures with all inclusive packages available.

3. Very convenient travel with direct flights from all over the Europe (and World!) - only less than 2 hours flight from the UK.

4. Perfect place for post-operative recovery with many touristic and quiet places. Everyone will find something suitable for themselves.

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