Stump inlay for a crown: types and prices for the service

A stump inlay is a microprosthesis, which is a tooth stump made of metal, ceramics or zirconium dioxide. It is used when there is significant destruction of the crown part of the tooth and the root is intact. The prosthesis fills the resulting void and creates a support on which an artificial crown is placed. Before installing the inlay, the tooth must be depulped.

A tooth stump inlay is a reliable prosthetic method. With a well-sealed canal and the choice of high-quality materials (for example, gold), it lasts up to 15–20 years.

At the Mitino Dental Center you can get advice from a qualified orthopedic dentist, as well as perform any type of dental prosthetics.

Stump tab for a crown: what is it?

Stump inlays in dentistry are a special type of solid-cast structures that are used in the process of restoration of heavily damaged units. If there is significant tissue destruction, a conventional pin cannot be used, since its installation can create excessive stress on the tooth root, which can cause it to crack, which can lead to subsequent removal of the tooth unit. Under such circumstances, the stump tab is installed.

A stump inlay is placed directly into the root canal and this allows you to properly strengthen the tooth in order to subsequently qualitatively restore the unit by installing a crown on it. Externally, the inlay resembles a dental stump that has undergone a grinding procedure and that is why it has the name “stump inlay.”

What is the difference between an inlay and a veneer

The manufacturing process of these structures is identical, so many patients often confuse one with the other. In both cases, after treatment, an impression is made, and at a follow-up visit, the inlay or veneer is installed on the tooth.

An inlay is, first of all, a restoration of the shape of a tooth, and a veneer is an aesthetic restoration. They can be made from the same materials - ceramics, composite, etc. Due to the fact that veneers are placed only on the front teeth, it is necessary that their color perfectly matches the color of the enamel. Inlays are typically used on chewing teeth, so their aesthetics are not as important. This is why they are made from any materials, veneers are not made from gold or metal.

Indications and contraindications

Indications for the use of a stump inlay as a prosthetic method are severe destruction of dentin, in which its restoration is impossible with composite materials and pins. The crown on the core tab will hold quite firmly and at the same time not exert strong pressure on the root. Stump inlays are also used to create a high-quality foundation for the installation of dental bridges.

However, like any other medical procedure, the installation of stump inlays has not only indications, but also a number of restrictions on its implementation. These restrictions include:

• The patient has an individual allergic reaction to the material used to make the stump insert.
• Identification during examination of cysts and other formations in the root system.
• Excessively thin dental walls, abnormally short roots of the dental unit.

The procedure for installing a stump inlay for periodontitis, as well as poorly treated dental canals, is not carried out. Depending on the individual characteristics of the case, the dentist may offer the patient different types of stump inlays for installation. The cost of the stump tab and tooth restoration services using it will depend on the type of structure.

Stump tab

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Contraindication to the procedure

This restoration method has limitations and contraindications:

• An allergy to filling materials is an absolute contraindication.
• Very thin, winding channels. They make restoration using an inlay difficult and sometimes impossible. Thin canals can be sealed under a special microscope, but no one will give guarantees for treatment.
• Canals that are not completely sealed. This is a temporary limitation - the issue is easily resolved in the office of a therapist who reseals the canal.
• Periodontal diseases – periodontal disease or periodontitis. These diseases lead to destruction of the supporting part of the tooth and its loosening. This means that until they are cured, installing a tab is a pointless waste of money and time, since it will not stick. However, therapy for such diseases is a long process and is fraught with relapses. There is a possibility that during the treatment period the need for prosthetics will disappear.

The procedure should be performed with caution for people suffering from seizures and pregnant women.

Types of stump inlays by design

Based on their design, a distinction is made between solid and collapsible stump inlays. Cast core inlays are made by a dental technician in the laboratory and consist of two main parts - a root and a coronal element. Most often, a microprosthesis obtained by casting is used to restore teeth that have 1-2 roots. Collapsible structures are made of metal alloys and are designed for the restoration of dental units with a large number of roots.

This stump tab is equipped with special fixing elements that are pulled out from its base. The legs are needed to secure the structure as firmly as possible in the canal of the tooth, the walls of which have undergone complete destruction. It is impossible to remove a collapsible type stump inlay after its installation.

How are dentures made and installed?

The processes of preparation for prosthetics, creation of a zirconium dioxide microprosthesis and its fixation consist of the following stages:

• Stage 1 – diagnosis: also at this stage, contraindications are excluded, the condition of the tooth itself, as well as neighboring and opposite ones, is studied,
• Stage 2 – preparation: the dentist-therapist removes all carious tissues, if necessary, depulps the tooth and fills the root canals, leaves a cavity for a classic restorative inlay or forms it inside the roots,
• Stage 3 – taking impressions (impressions): for example, using wax or silicone (this depends on the type of future prosthesis), the color of the restoration is selected. In clinics with modern equipment, digital impressions of the oral cavity can be made using an intraoral 3D scanner - this is fast, convenient and very accurate,
• Stage 4 – modeling: a real model of the prosthesis is created based on impressions in a dental laboratory, and a virtual model is created in a computer program based on digital impressions. But the real model will also need to be digitized and worked out in a CAD/CAM system for the next stage,
• Stage 5 – manufacturing: production occurs by milling on a machine, because the material is so strong that it will not be possible to create a prosthesis by hand. Usually the workpiece is made 20-25% larger than the actual size, because After milling, it is baked - in this case, the material “shrinks” to the required parameters. If necessary, the microprosthesis is covered with a layer of colored ceramics. Next, the product is sent to an orthopedic dentist,
• Stage 6 – fixation of the zirconium inlay into the patient’s tooth.

Types of stump inlays according to production material

Various materials can be used in the manufacture of stump pin inlays. Designs can be produced:

1. Made from zirconium dioxide. A stump inlay made of zirconium dioxide will not only be characterized by increased strength and reliability, but will also have high aesthetics. Most often, zirconium core inlays are used to restore teeth that fall within the smile area.

2. Composite core inlays are created on the basis of a pin and a composite based on dental porcelain (ceramics). This design looks aesthetically pleasing, but it has the lowest strength indicators in comparison with stump spacers made of metal and zirconium.

A separate type of structure is stump inlays made of metal. A variety of metals, as well as their alloys, can be used to create metal inlays. The price of a tooth stump will depend on the type of metals used in the alloy.

Which metal is better?

The material for the core inlay must be selected based on many factors, the main one of which is what crowns will be made to restore the teeth.

• Metal or metal-ceramic crowns are made of cobalt-chromium alloy.
• Ceramic crowns are usually made from either a precious alloy (gold-platinum) or the precious alloy is lined with ceramic or zirconium dioxide. The most optimal in terms of its characteristics is a gold inlay for a crown.
• From the point of view of biological inertness, a titanium insert is much more preferable, however, titanium is characterized by fragility.
• Silver-palladium and silver alloys have bactericidal properties. But after using silver inlays for a crown, pigmentation of the gum surrounding the tooth is sometimes observed.
• Chromium-cobalt and chromium-nickel alloys have low shrinkage and high hardness.

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Features of the manufacturing and installation process of stump inlays

The process of manufacturing a stump tab and its subsequent installation is divided into several main stages:

1. The dentist carefully prepares both the roots and walls of the tooth for the installation of a core inlay. The tooth is ground down and a special base for the structure is formed in it. An impression of the patient's teeth is then made.

2. Based on the impression taken, the dental technician makes a model of the core inlay from plaster, after which the structure itself is modeled on a computer.

3. The stump inlay is made by casting or milling. The production technology will depend both on the type of structure chosen for the procedure and on its material of manufacture.

At the final stage, the finished stump inlay is tried on the patient, after which the doctor fixes the structure in the oral cavity. The dental core is fixed with special dental cement.

Installation steps

This type of prosthetics takes place in two stages - clinical and orthopedic. Orthopedic, in turn, is performed in stages.

Prosthetics begins with a consultation with an orthopedist. He decides on the possibility of using this method and agrees with the patient on all the details of the restoration.

Clinical stage

Performed in the dentist's office. A “living” tooth must be depulped and the canals filled. If the pulp is no longer present, an x-ray of the tooth is taken and the quality of the filling is checked. If it is bad, the channels are re-treated. This is a very important stage - the quality of canal filling determines how long your prosthesis will last.

Orthopedic stage

Takes place in the office of an orthopedic dentist:

1. Using a drill, the doctor will unseal the upper part of the canal, into which the root part of the tab will go. A bed is created to accommodate it.
2. An impression is taken of the patient's jaws.
3. The impression is transferred to a technical laboratory, where dental technicians model and cast the prosthesis (or parts of it in the case of a collapsible design). If the innovative CAD/CAM method is used, the impression is scanned with a special device, the program creates a 3D model of the inlay, and then sends it to a milling machine, which turns it out.
4. The orthopedist performs the final adjustment of the stump “on the patient.” Then it is secured in the canal with glass ionomer cement or composite material.

Then comes the next stage - installation of the crown. It follows the same algorithm: taking impressions, manufacturing and fitting.

Recommendations for caring for the oral cavity after the installation of a stump inlay

Most often, immediately after installing the core inlay, a temporary acrylic crown is put on the tooth, which will protect the structure itself and the tissues in the area of ​​manipulation from the negative effects of external factors. However, if for some reason a temporary crown was made, then before installing a permanent prosthesis, the following rules should be followed when caring for the oral cavity:

• After eating, be sure to rinse your mouth thoroughly;
• When brushing your teeth, do not touch the stump with the brush;
• Do not eat excessively solid foods.

You should also treat the area of ​​the procedure daily with special anti-inflammatory gels. A specialist must give you detailed advice on oral hygiene immediately after completing all procedures.

How long does it take to install crowns?

Prosthetics with crowns is not done in 1 day, as it includes several mandatory stages. The time frame for phased installation of prostheses reaches 1–2 months.

The longest stage is the period of making dental crowns.

Dental prosthetics is the optimal solution not only for aesthetic problems. Crowns are installed to restore the integrity and necessary functionality of teeth. Modern technologies used in dental prosthetics make the process as painless and effective as possible.

Pros and cons of dental core inlays

If we talk about the advantages of installing stump inlays in the process of tooth restoration, then they include the lowest possible load on the soft and hard tissues of the oral cavity, the possibility of using stump inlays as a support for bridges, aesthetics and sufficient strength of the structure. Using a stump inlay will allow you to restore a tooth that has undergone serious destruction, and even if the permanent crown is damaged in the future, the structure can be reinstalled without removing the stump microprosthesis.

Also, the advantages of stump spacers include the absence of any harm to neighboring, healthy dental units and reliable protection of the restored tooth from the penetration of pathogenic microflora. But core spacers also have a number of disadvantages that should definitely be taken into account before choosing this restoration method. First of all, these will be long periods of therapeutic manipulations. The installation of a stump inlay cannot be carried out in one or two visits to the dental office, since it takes considerable time to carry out preparatory procedures and create the microprosthesis itself.

Please note that installing a core inlay will require grinding down a large amount of tooth tissue, as well as the fact that only an experienced dentist who is conscientious about his duties can carry out all the manipulations correctly. You can receive services for high-quality prosthetics with stump inlays by contacting our dentistry in Moscow - Vanstom!

Advantages of microprostheses made of zirconium dioxide

If the question arises, which is better - a zirconium restoration inlay or a filling, then the first has the following advantages:

• more reliable: it is made of the strongest zirconium dioxide, and the filling is made of liquid composite or cement. In the future, these factors seriously affect the service life,
• more durable: a microprosthesis made of zirconium dioxide can last more than 20 years, and a large filling - on average 3-5 years, maximum about 7 years,
• tighter fit to the walls of the cavity: the microprosthesis is created in the laboratory using special equipment, and in exact accordance with the dimensions of the cavity - therefore it adjoins it without gaps. And over time, the tab, unlike a filling, does not peel off from the walls,
• does not wear off or sag during use: let us remind you that the material is extremely durable, which cannot be said about the filling - it begins to wear out and sag within a year after installation.

There are 2 moments when the filling wins. The first is if the cavity is very small, i.e. the microprosthesis will not be qualitatively fixed in it. The second is the front teeth, since they have a very thin cutting edge instead of an extensive chewing surface (like premolars and molars). More often, front teeth with small defects are restored with fillings or veneers - they, by the way, can also be made of zirconium dioxide. Restorative (pinlay varieties) in some cases can be placed on the lingual surface of an incisor or canine.

Patients often ask which inlays are better – fiberglass or zirconium? You need to understand that the fiberglass pin is not a tab, but a thin rod (just like a metal pin). Let's see what important advantages zirconium dioxide core inlays have over conventional pins:

• made individually for the patient, so they fit tightly to the root canals,
• very durable: while fiberglass pins are less durable, metal pins are thinner, so they often break,
• do not shine through the prosthesis: because are white in color, and the metal pin is visible through the filling material,
• qualitatively transfer the load to the root and jaw bone due to the anatomical shape of the microprosthesis,
• serve for about 15-10 years: and the maximum service life of a conventional pin is 5 years, because it leads to overload and destruction of the tooth root.

Stump tab: price

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Differences from a filling

Any filling is installed using the direct method, so it can be placed on the same day you contact a specialist. Filling materials – paste or powder, mixed with liquid before filling. The filling hardens in air and under the influence of a special lamp. And the service life of even the best filling is no more than 3-4 years. Afterwards it will also stand, but you need to check the quality of the fit and its shape - it still shrinks under load.

The inlay is made by an indirect method - in a dental laboratory using casts of the jaws, or more precisely, the patient’s teeth. For such microprostheses, metals, liquid and lump ceramics, blocks of zirconium and aluminum dioxide, as well as composite compositions similar to fillings are used. These microprostheses are installed on the patient ready-made, i.e. fully formed and hardened.

Dental inlays compare favorably with conventional fillings in that they allow you to restore a badly damaged tooth for a longer period of time. For example, if deep caries was discovered, and after its treatment a large cavity formed, it is better to fill it with a microprosthesis, which is created individually in a dental laboratory. This method is more preferable, since saliva may enter when placing the filling, as a result of which the entire treatment process will be ineffective. And the patient himself is not very comfortable spending a long time in the dental chair during the formation and subsequent grinding of the filling. The inlay will also last many times longer than any composite restoration.

Service life and care

The service life of composite microprostheses is several years; ceramic and “dioxide” ones can reach 10 years. Products made by milling on a robotic machine have maximum accuracy and fit to the tooth, so they last longer than usual. First of all, the service life depends on the health of the teeth, since if caries occurs deep in the cavity, it will be necessary to remove the old “onlay”, treat the tooth and install a new one or (more likely) a crown. To extend the life of dental inlays, do not forget about simple hygiene procedures and regular visits to the dentist - during routine preventive examinations, he will be able to detect damage to the denture, since bacteria and microbes can penetrate under it through cracks and cracks.

Advantages and disadvantages

In many cases, it is better to use inlays instead of other restoration methods. Design advantages:

• restore teeth with a high degree of destruction;
• the crown can be precisely adjusted to the inlay;
• products are resistant to chemical and mechanical influences;
• reduce pressure on the jaw;
• they can be installed on multi-rooted teeth;
• have high strength due to the selection of shape and material;
• suitable for fixing bridges;
• prevent the penetration of harmful microorganisms into the cavity;
• if the crown is damaged, the inlay does not need to be changed;
• over time, the product does not shrink;
• does not affect the condition of neighboring teeth;
• there is no pain under the crown, since during installation the affected tissue is completely removed.

But the inlays also have some disadvantages associated with complex manufacturing technology. These include:

• long installation time, which is carried out in several stages;
• high cost of tooth restoration;
• Fixation can only be performed by an experienced specialist.

Quality assessment parameters

High-quality microprostheses must be produced with the highest precision and according to the individual parameters of a particular patient. Therefore, a good prosthesis can be made in 1-3 weeks, which includes not only the production itself, but also modeling, creating a blank, and trying it on to evaluate all the characteristics.

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Before choosing the type and material of a microprosthesis, the dentist must conduct a diagnosis. It also includes an X-ray examination to determine possible pathologies (caries, pulpitis, periodontitis, etc.). X-rays are also taken after prosthetics to assess the tightness of the fit to the walls and the absence of air cavities. By the way, during regular medical examinations the dentist can also take x-rays of the restoration - to identify the nuances and pathologies mentioned earlier.