PART 1: FIXED SOLUTIONS
Evergreen Dental is your specialist for all types of dental treatment, be it crowns, bridges, implants and bone augmentation, or complex total restoration or a perfect Hollywood smile. In this article we would like to examine the most common problems and the most common fixed solutions to them.
WHAT ARE THE PROBLEM TYPES IN DENTISTRY?
Basically, we distinguish between functional and aesthetic problems.
Functional problems can be:
- Missing teeth
- Painful teeth
- Sensitive teeth
- Inflamed teeth
- Moving teeth
- teeth grinding
Aesthetic problems can be:
- Partially damaged teeth
- Discoloured teeth
- crooked teeth
WHAT POSSIBLE SOLUTIONS EXIST FOR BAD TEETH?
The possibilities for the solution of painful, sensitive, inflamed or mobile teeth can be the following:
- root canal treatment
- drag + replace
If the patients is complaining about heavy teeth grinding a night guard should be worn to protect the teeth. Teeth grinding can lead to bruxism, which then requires complex treatment. Bruxism means that the surface of the teeth wears out and the bite “slips together”, which can lead to poor aesthetics, bad bite position and TMJ pain. The treatment of the deep bite is complex and requires two stages:
- first the correct joint position has to be found: either a splint made of hard material or long-term temporary crowns are made of plastic, which are worn for 3-4 months.
- the new bite position obtained in this way is finalized with definitive crowns of porcelain fused to metal or zirconia.
WHAT SOLUTIONS CAN BE MADE AGAINST MISSING TEETH?
The solution can be a bridge. These are anchored to natural teeth (or implants). As a rule, a maximum of 2 missing teeth can be replaced next to each other by involving the neighboring teeth (these serve as abutment teeth), and these hold the complete bridge over 3-4 teeth, so the missing teeth are replaced without their own root.
Another solution is to use an implant and attach a crown to it. Implants can also carry a bridge, just like natural teeth. With 3 or 4 missing adjacent teeth, 2 implants can support a 3- or 4- part bridge.
In case of bone deficiency, additional bone augmentation may be necessary or in the upper jaw a so-called sinus lift on the left or right side. If the bone loss is extreme and no implants can be placed, then this possible solution must be excluded.
WHICH SOLUTIONS ARE THERE FOR UNBEATABLE TEETH?
In cases of discoloration, bleaching (whitening of the teeth) is always worthwhile first, if that does not help then either veneers (porcelain shells) or crowns can remedy the aesthetic problems. In the case of tooth stagnation, it is usually necessary first to perform a tooth adjustment (for example with Invisalign) before the other aesthetic problems can be solved.
WHICH FIXED SOLUTIONS ARE THERE?
Application: For aesthetic problems, if the tooth material and the bite situation allow it.
Procedure: A maximum of 0.5 mm thick layer of the tooth surface is ground (enamel layer) and approximately 0.5 mm thick shells of pressed ceramic are made by the dental laboratory, which then glued – the shells have the strength of a contact lens
Material: e.Max pressed ceramic
Price: 350 €
Treatment time: Up to 5 pieces 5 working days, from 6 pieces 8 working days
Note: The polished layers are covered with a temporary veneer until the final ones are made. The price per piece is 20 €
Application: for functional or aesthetic problems, if the tooth is worn, broken off, ugly, etc., but the tooth root is stable, the tooth can be abraded and crowned. In the case of an implant crown, an impression is made by the implant, and a crown is made by a so-called abutment or implant head. This is an intermediate element between implant and crown. The finished crown is either cemented or attached to implants with a through-bolt. When crowning root-treated teeth, the root of the tooth is usually fixed with a root pin. In general, it can be said that the root-treated teeth are secured with a pin for greater bearing capacity.
Procedure: Tooth preparation (grinding) is performed, an impression is made in the dental office, and the crown is made in the dental laboratory based on the impression.
o Porcelain fused to metal: We no longer use casting technology! This is a very important message to the patient: Each metal framework, bridge is made using CAD CAM technology, which means digital design and laser sintering in the manufacturing process (virtually 3D printing). This innovative technology sets us apart from the competition as it allows a much more precise outcome. The metal framework is anatomically lined with ceramic in the end the tooth looks very much like the natural tooth. The patient can choose any color for the ceramic lining, we always recommend the most natural color.
o e.Max full porcelain: this crown is pressed from ceramic and then lined anatomically, just like porcelain fused to metal. Highly aesthetic, is mostly used in the front area.
O Zirconia: this crown is made with CAD / CAM (computer aided design and manufacrue) meaning it is digitally constructed and then milled with a milling machine from a zirconium block, and anatomically lined at the end just like the other crown types.
o Long Term temporary crown: A composite crown (made of special plastic) with CAD CAM technology in case the teeth need to be spared for a long time but the final crown can not be made immediately for instance if the bite needs tob e lifted first.
o Telescopic crown (see Removable dentures, Telescopic tooth set – Part 2)
Price of the crowns:
Porcelain fued to metal: 250 € (280 € on implant)
e.Max full porcelain: 350 € (not made on implants)
Zirconium: 350 € (380 € on implants)
Long-term ptemporary crown: 75 €, same with metal reinforcement 95 €
up to 8 pieces 5 working days,
10-14 pieces 7 working days,
from 14 members 10 working days
Note: Until the final crowns are finished, temporary crowns are placed on the abraded teeth. Price per piece is 20 €. Its purpose is to reduce the sensitivity of the teeth and to protect the stump. This is not necessary for implant crowns. The crowning of a root-treated tooth usually requires the insertion of a so-called “root pin”, which gives the crown additional stability. It costs 160 € (material: fiberglass)
Usage: Used to replace missing teeth and can be used in case adjacent teeth are good enough to overhang. At most two adjacent dental defects can be replaced by a bridge this way. It is therefore called a 3- or 4-part bridge, in which the intermediate teeth are called bridge elements. A bridge can be attached to natural teeth or implants.
With natural teeth: the teeth are prepared (abraded), then the dentist takes an impression, the dental lab prepares the bridge on the basis of that impression.
With implants: an impression is taken from the implants and the bridge is made by inserting a so-called abutment or implant head per implant at the dental laboratory.
Material: metal ceramic, zircon
o Metll ceramic: the same procedure as a crown
o Zircon: the same procedure as a crown
o Resin teeth made of composite on a metal framework: This solution is always made for a toothless jaw, if it is not possible to produce a tight metal-ceramic / zirconium bridge due to insufficient bone, allowing only 4 implants. The advantage is the light weight and therefore it can be arriecd by 4 implants. The solution of this kind is called All-on-4.
o All-on-4: Synthetic teeth made of composite on a CAD-CAM metal framework and akrylic artificial teeth. It is a fixed denture on 4 implants. The denture is attached to the implants with screw-retain. If necessary, the set of teeth can be easily removed in a dental office for cleaned or repairing.
– porcelain fused to metal: 250 € / tooth (The crowns, the supporting elements of the bridge need a temporary tooth, the cost fort hat is 20 € per tooth. Extra 30 € are charged for crowns on implants.)
– Zirconia: 350 € / tooth (The crowns, the supporting elements of the bridge need a temporary tooth, the cost fort hat is 20 € per tooth. Extra 30 € are charged for crowns on implants.)
– All-on-4 full-bridge: 2890 €
up to 4 units 5 working days,
10-14 units 7 working days,
from 14 units 10 working days
Note: As for the crowns on teeth so-called temporary crowns are applied on the abraded teeth within the bridge until the final bridge produced, these cost € 20 each. This is not necessary with implant crowns. When crowning a root-treated tooth, a so-called “root pin” is usually required, it gives additional stability. Price: 160 € (Material: fiberglass.)
We speak of a total bridge when the bridge restores the entire arch (12 or 14 units = teeth). There are several variants with a production time of 10 days each.
Porcelain fused to metal: 250 € / crown or bridge elemnt + 20 € temporary crowns)
Zirconia: 350 € / crown or bridge element
A zirconia crown is only an option if the posterior teeth are present (at least at position 6), and there are nowhere more than two missing teeth side by side
All-on-4: Fixed, screw-retained denture (with plastic or acrylate teeth) on 4 implants:
In case of complete lack of teeth, the two posterior implants are inserted at a 45 degree angle to withstand the load. Price: 2890 € + implantation costs
Ceramic bridge on 6 implants.
Price for metal ceramics: 6 x 280 € (implant crown) + 6 x 250 € (bridge element) = 3300 €
Price for zirconia: 6 x 380 € (implant crown) + 6 x 350 € (bridge element) = 4500 €
You can read about the surgery and related costs in detail here.
There are many possible solutions, in our series of artciels Dental treatment in Hungary we present you everything. If you have a dental problem, then get information and a non-binding offer from our friendly team.