We get many patients with partially broken teeth which are not ready to be extracted but which cannot be repaired with simple fillings (which continually fall out). Restoration or reconstruction by means of dental incrustations is the perfect intermediate solution. It consists of reproducing in the laboratory the missing piece of the tooth and then cementing it to rest of the healthy tooth.
Nowadays dental incrustations are being used to restore the occlusal faces of the teeth affected by caries or treated endodontically (devitalized), as an alternative to a simple “filling”. En Cirugía Facial Benidorm, in our mission to always be at the cutting edge of the latest techniques available, we wish to introduce you to the most up-to-date materials used to carry out incrustations, as thanks to our laboratory we can work with milled materials which increase the fracture resistance of this type of restoration.
What are incrustations?
Incrustations are reconstructions which are carried out indirectly (in the laboratory) on back teeth when we wish to achieve a “sublime” esthetic. They are placed in fractured teeth; teeth which have been treated endodontically; with light, moderate or severe caries; to replace old fillings or as part of a complete occlusal rehabilitation.
Dental incrustations can be divided into three groups:
What are the incrustations made of?
As we have already explained in the article Dental Materials, in Cirugía Facial Benidorm we carry out the incrustations in a completely individualized way, dressing the incrustation depending on the occlusion characteristics of each patient. Each one is designed by computer in our laboratory, to give a perfect fit.
How is a tooth prepared for an incrustation?
Once the decision has been taken to undertake an incrustation in a tooth with caries or a fractured tooth, or to replace an old restoration the procedure is as follows:
- Eliminate the old filling or clean the structure of the tooth affected.
- Once the tooth is prepared for the placement of an incrustation an impression of the dentition is carried out (silicon molds of the patient’s mouth are taken) and a provisional filling is made. Photographs are taken of the inside of the patient’s mouth and of the occlusal faces of the adjacent teeth.
- Once the laboratory receives the impression, it is hollowed out and the hollow model is scanned, to enable later modelling on the computer. The milling of the block of material chosen for the incrustation is done and the incrustation is dressed (an expert makes a ceramic reproduction of the piece of tooth which is missing) depending on the information obtained from the photographs.
- In a second visit the provisional filling previously made is removed, and the adjustment and color are checked. If everything is correct the incrustation is cemented into place and occlusal adjustment made.
Advantages of dental incrustations
A dental incrustation offers many advantages, and not just for reasons of esthetics and adjustment.
- It allows us to conserve a larger part of the structure of the tooth.
- Due to the materials used they have a lower risk of breakage and of change in shape or size when subjected to occlusion and changes in temperature.
- It strengthens the tooth by around 75% due to the material used.
Practical examples of dental incrustations.
Real case 1.
The patient comes to the clinic complaining of problems with a tooth. 4.7. The patient comments that the tooth has had several “fillings” but that they always fall out after a few months.
We evaluate the situation intra-orally and discover a high degree of wear in the tooth. We inform the patient of the situation and propose different alternative treatments. The patient comments that they do not want us to touch any of the remaining dental structure, so we decide to restore the tooth through an inlay type of incrustation.
Real case 2.
The patient arrives in the clinic to ask about a fracture in the palatal cusp of the tooth 2.6. In the exploration it is noted that the tooth has been treated endodontically. The patient tells us that all the reconstructions carried out on the tooth have always broken.
The state of the tooth is evaluated by radiography and visual exploration. It shows a fracture at the cervical level in the palatal face. The patient is informed of the need to carry out an overlay incrustation to recover the cusp thereby avoiding new fractures in the conventional reconstruction.