Crowns
Partial crowns or full crowns replace the outer layer of teeth, at least the enamel section, but also often to some extent large areas of dentine. If they are mainly fabricated for replacing lost tooth structure (tooth conservation), they can be considered a part of conservative dentistry but they often function as a component of restorations.
Crowns can be fitted on natural teeth (preparation) or the intraoral sections and abutments of implants. Crowns are retained by cementation and/or adhesion; it is also possible to fabricate screw-retained restorations on abutments. The long-term seal of the crown margin (marginal integrity) is very important for maintaining the health of the surrounding marginal periodontium and prevention of secondary caries.
Anterior crown preparations
Implant-borne metal-ceramic crown
Crowns are fabricated using a single material (full cast crown, all-ceramic crown) or by the combination of different materials (e.g. bonded crown). Very different procedures are used for this, e.g. casting (cast crown), milling, trimming, sintering (CAD-CAM), pressing (press-ceramic crown) or electroforming (electroformed crown). With a metal-ceramic crown a coping (framework) is first fabricated using metal and then coated with ceramic (veneered) to achieve optical similarity with the tooth. Historical techniques include soldering of crown parts (banded crowns).
Three metal full cast crowns
Prefabricated steel crowns can be used for treating severely destroyed deciduous teeth. Temporary (short, medium or long-term) custom-adapted prefabricated, frequently intraorally (direct) or extraorally fabricated temporary crowns (mainly using resins) bridge the period until a permanent crown is fitted.
Crowns fulfil various functions. As protective crowns they absorb masticatory forces to prevent teeth with weakened structures breaking apart and/or seal endodontically treated teeth against penetration of bacteria. They also protect the tooth against chemical and thermal irritation.
Anchor or abutment crowns retain bridges whereas support crowns anchor retentive and support elements such as rests and clasps. Connectors, e.g. attachments can also be integrated into the crown (attachment crowns).
Crowns can be fabricated individually (single crowns) or connected with other crowns (splinted crowns).
Upper anterior crowns
In the specific case of the telescope crown (conical telescope crown, parallel telescope crown) the crown consists of a fixed inner crown (primary crown) and an outer crown (secondary crown), which fits on the primary crown in the removable restoration. If a telescope crown is fabricated using the electroforming technique, it can be adhesively retained later in a tertiary crown fabricated over it.
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study period | Versuchsdauer, Versuchszeitraum |
Wax build-up technique Wax build-up technique The various anatomical structures (such as cusp tips and slopes as well as marginal ridges) are usually built up one after another by adding small portions of wax (often using differently coloured waxes for didactic purposes). The firm, special waxes first have to be melted at room temperature. This can be carried out by warming small portions on differently shaped working tips of hand instruments in an open flame (such as a gas burner) or using electrically heated instruments which provide for more accurate temperature control and avoid contamination (e.g. electric wax-knife, induction heaters, wax dipping units). The wax is applied drop-by-drop to ensure that the warmer molten wax added last fuses seamlessly with the firm, cooler material. After hardening, the wax pattern can be reduced by sculpting, milling guidance surfaces or drilling to add retainers. Modern procedures include flexible, occlusal preforms for adding contours to soft wax. In addition, wax preforms, such as for occlusal surfaces or bridge pontics, are available in various shapes and sizes. Recently, irreversible, light-curing materials have been introduced for use instead of reversible thermoplastic waxes. Wax preforms To ensure that the wax pattern can be released without being damaged, model surfaces, opposing dentition and preparations must be hardened/sealed with special lacquer (applied by spraying, brushing or dipping). These waxes are mostly relatively rigid/elastic after cooling. Attaching wax sprues to a removable framework supported on double crowns using a hand instrument When employing the lost wax technique, prefabricated wax sprues, bars and reservoirs are attached to the patterns. Once the pattern has been released and its sprues waxed onto the crucible former, it is invested in a casting ring with refractory investment material. The wax can then be burnt out residue-free and casting completed. Unlike standard wax build-up techniques, a diagnostic wax-up is not intended for fabricating an indirect restoration, but rather for simulating the appearance and/or external contouring for producing orientation templates. |