Restorative Dentistry

Crown Procedure

A crown is sometimes termed a "cap" or "jacket." A crown will restore a large filling or a cracked tooth to its original size, shape and tooth color. A crown may be recommended after root canal therapy has been completed, as the tooth tends to become brittle and is more likely to fracture. A crown can strengthen and protect the remaining tooth structure and improves the appearance of your teeth. With the advances in technology, we now have the ability to make ceramic crowns with no metal.

To place a crown, your dentist must reduce 1-2 mm of the tooth to make room for it. Your dentist will then use a piece of thread or cord or use a laser to push the gum down around the tooth, to take an impression of the tooth. The impressions are sent to the lab where the crown is made. During that time, you will have a temporary crown. These crowns are usually made of plastic and are made in your dentist's office on the day of your visit. They are not meant to last. If a temporary crown is left in the mouth, the cement eventually washes out and the tooth can decay. At a second visit, your dentist will remove the temporary crown and test the permanent one. Sometimes crowns need additional polishing, glaze or some other adjustment before they are placed. Once the crown is ready, it's cemented to your tooth.

Crown Aesthetics

If your smile is in need of a makeover, crowns can provide predictable results. Crowns can give an unattractive tooth back its beautiful shape and color. For smaller or worn down teeth, a crown can restore the natural size of the old tooth. A crown can replace either part of or the tooth's entire structure. For procedures requiring only the areas visible from the outside, a veneer may be an alternative option.

Types of Crowns

With today's advances in dentistry, there are several options when choosing a type of crown:

  • Porcelain outer surface with a metal base crown
  • Pure porcelain or composite crown
  • All metal crown, which is usually gold

They all differ in durability, strength, appearance and cost.

Full Porcelain Crowns

These are very aesthetic, bonded crowns. They are mostly used for front teeth because they are the most natural looking type of crown and are often used in "cosmetic" dentistry.

There are many types, but they all have a common feature - no metal. They can occasionally break, but dental technology has advanced far enough to make them quite strong.

Porcelain Fused To Metal Crown (PFM)

The most common type of crown and has a proven track record. PFM crowns are fairly aesthetic and they look like real teeth. However, the margins or borders may appear dark because PFM crowns have a metal substructure with layers of porcelain fired over the substructure. Porcelain is very hard, much harder than natural enamel and may cause excessive wear of the enamel of opposing teeth. Porcelain may break with extreme biting forces.

Fixed Bridge

A bridge may be used to replace a single tooth. A bridge consists of both a false tooth, called a pontic and the anchors (abutment crowns) that support the pontic. The entire structure spans the space vacated by the missing tooth.

Neighboring tooth structure is removed, shaping them to receive an anchor crown. An impression is then taken and sent to a dental lab where they fabricate the bridge.

The structure part of the bridge is created with a strong metal alloy that can handle the anticipated stresses.

Tooth-like porcelain is then fused to the structure. Once the bridge is tested for a correct fit, the anchor crowns are cemented to the neighboring teeth.

Replacing Old Fillings

There is now new technology that allows you to replace old silver and gold fillings with a more natural looking, composite filling. Composite fillings are bonded to the tooth and research has proven them to be about 90% as strong and healthy as natural tooth material.

Other Benefits:

  • Beautiful in appearance
  • Completed in a single visit
  • No filling leaks
  • Less chance of tooth cracking

Tooth-Colored Fillings

Composite fillings are today's modern filling choice. They are made to match your tooth's natural color to make them virtually invisible to notice and are placed onto the tooth by bonding the filling material to the tooth so they do not have the unlikely chance of falling off. Many patients choose to replace their old silver and gold fillings with composite fillings.

Other Benefits:

  • Beautiful in appearance
  • Completed in a single visit
  • No filling leaks
  • Less chance of tooth cracking

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