Chipping is a common issue with various ceramic dental restorations. This can include chips in the veneering of metal-ceramic constructions, zirconia-based crowns, as well as ceramic inlays and veneers. Naturally, many patients wonder: is it possible to reattach the chipped fragment?
Theoretically, this is feasible, but how durable will such a restoration be?
The problem lies not so much in the strength of the ceramic material itself but in the function of the chewing muscles. If a dental crown is subjected to increased chewing load over a prolonged period, certain areas of the material experience stress, leading to chipping.
A patient might say, "But I haven’t eaten anything hard." However, even consuming soft food can negatively affect the condition of the ceramic.
Let’s delve deeper. The chewing muscles are among the strongest muscle groups in the human body, capable of exerting forces up to 300 kg/cm². After a dental crown is placed, there might be discomfort or the feeling that the tooth interferes when closing the mouth. Dentists typically advise waiting for a while for the crown to "settle in," and indeed, the unpleasant sensations usually go away soon after.
This happens because the crown may be slightly higher than necessary. Over time, the chewing muscles adapt to this, but the bite remains elevated (known as premature contact), which puts extra stress on the crown. In such cases, the load is distributed unevenly, focusing primarily on the crown. Certain areas of the veneer are constantly under tension, resulting in chipping.
What happens if you try to glue the chipped piece back in place? Most likely, the chip will reoccur in the near future.
Even if the premature contact is corrected by grinding, the joint between the crown and the chipped piece won’t withstand normal chewing pressure. A similar situation arises when the crown doesn’t interfere with closing, but the patient feels the tooth “catching” during jaw movement.
“But I don’t clench my teeth or eat hard food! Where does the excessive load come from?” – asks the patient.
Perhaps during the day, you don’t apply excessive pressure on your teeth, but during sleep, the chewing muscles are actively working. This phenomenon is known as bruxism and occurs in 99% of people. Bruxism can be triggered by a crown that elevates the bite. Additionally, teeth grinding is a natural stress response and happens unconsciously.
Bruxism can lead to increased tooth wear, muscle pain in the jaw, and tension in the head and neck muscles, especially in the morning. A gnathologist can identify the processes occurring in the oral cavity during sleep, explain the causes of enamel wear, and the formation of chips on ceramic crowns.
Another consequence of crown placement can be the shifting of the lower jaw. This happens because crowns are not made to the individual shape of your teeth but based on average anatomical indicators. As a result, the bite is elevated, and the muscles gradually shift the lower jaw. Such a shift leads to changes in the temporomandibular joint structure. The lower jaw begins to click, and the joint itself becomes painful. In such cases, it is essential to consult a gnathologist immediately.
Gnathology as a science allows for the study of how your chewing apparatus functions and helps to understand the reasons for tooth wear, jaw clicking, and ceramic chipping on crowns.
Comprehensive diagnosis and subsequent treatment of tooth wear, chipping, and jaw clicking involve using specialized equipment that calculates the individual features of the dentofacial system for optimal restoration of the patient’s teeth.
As for ceramic chips, the most optimal and reliable solution is to replace the entire structure with a new one. This ensures a long service life and functionality of the dental restorations, as well as preventing recurrent chipping.
