Porcelain Crowns and Bridges
 Modern porcelain crowning materials can be very aesthetic and many times are indistinguishable from natural teeth. Crowns are also commonly known as caps because a crown sits over your existing tooth, covering the entire outer surface similar to how a baseball cap would cover your head. A crown generally covers your tooth completely, fits snugly at the gum and protects what remains of the natural tooth. Bridges serve to replace missing teeth and consist of a crown on either side of the missing tooth to connect the replacement tooth. Dental implants can also be used to support porcelain crowns and bridges.
Crowns should not be the first treatment of choice just to improve the appearance of your teeth, because we need to grind a significant portion of the original tooth away. This tooth removal carries some risk of creating sensitivity to cold and hot or even nerve damage that could require root canal treatment. Although these risks are small, it makes more sense to consider less invasive alternatives such as bleaching, bonding and veneers. That being said, we provide crowns everyday as the preferred appropriate treatment primarily because of advantages of strength.
Why is a crown needed?
- To protect a weak tooth from breaking.
- To restore an already broken tooth or a tooth that has been severely worn down.
- To cover and support a tooth with a large filling when there isn't a lot of tooth left.
- To hold a dental bridge in place.
- To cover misshaped or severely discolored teeth.
- To cover a dental implant.
- To match adjacent teeth with existing crowns.
What types of porcelain crowns are available?
 Two basic porcelain crown types are in common use. One is called "porcelain fused to metal" and it is similar to a porcelain sink or bathtub, which has a core of metal to support porcelain, which is baked onto the metal. The other type is "all ceramic" which can be thought of as being like a porcelain coffee cup with no metal. There is a tendency to prefer porcelain fused to metal in situations where maximum strength is required and all ceramic where optimal aesthetics is the goal, but numerous exceptions exist to this generality. Furthermore, there are many different brands and types of metals and porcelains that are marketed with various claimed virtues. Additionally the laboratories that fabricate these crowns cannot afford to offer all the possible choices, so familiarity with products and laboratories figures heavily into the selection process.
Every year new materials are developed with the aim of improved characteristics in fit, strength and appearance. Here are a few "brand names" that reflect the diversity of products available: Feldspathic porcelain (by Williams, Shofu, Noritake, Vita and numerous others); Empress crown; Procera crown; Lava crown; Zirconia crowns; and Cerec crown. Next year there will be new names, new claims and new studies. That is part of the fun and confusion of being on the cutting edge in cosmetic dentistry. My dad was a physician and one of his truisms was "be not the first to try the new nor the last to give up the old". I try to balance that with the excitement that comes with being a pioneer. I've made mistakes both ways. I hope my patients mostly benefit from my interest in new developments.
What is it like to have a porcelain crown made?
 The crowning procedure is scheduled to take place in two visits, usually with a two-week time between appointments.
The first stage is to clean the tooth, remove any decay and reshape it using a dental drill with local anesthetic applied to maintain comfort. A one or two millimeter dimension all around the tooth and on top is removed to fit the crown while strengthening and preserving the remaining natural tooth structure. Once the tooth is shaped, an impression (mold) of your teeth will be taken with special dental putty. This impression is sent to a dental laboratory that will use the impression as a guide to fabricate the new crown to our specifications. It usually takes two to three weeks for a laboratory technician to custom produce your new crown. During this time we will fit you with a temporary crown to cover and protect your prepared tooth.
On your second visit we will remove the temporary crown and cleanse the prepared tooth to allow the dental cement to adhere adequately. We will sit the crown over your tooth to see that it fits properly and that it matches your smile correctly in shade and shape. Once we are both happy with the restoration it will be cemented firmly in place.
What problems could develop with a dental crown?
- Discomfort or sensitivity. Your newly crowned tooth may be sensitive immediately after the procedure as the anesthesia begins to wear off. Additionally, you may experience hot or cold sensitivity that could last for a few days, a few weeks or even a few months.
- Chipped crown. Porcelain crowns do sometimes chip. If the chip is small and not esthetically important we may leave it alone or smooth it or try to repair with bonding. If the chipping is extensive, the crown may need to be replaced.
- Loose crown. Sometimes the cement loosens up. This can allow bacteria to leak in and cause decay. If your crown feels loose please let us know.
- Crown falls off. Occasionally a crown comes off. If this happens it usually can be re-cemented, but if there has been decay or the underlying tooth has broken then a new crown may be called for.
How long do crowns last?
On average, dental crowns last between 5 and 15 years. The life span of a crown depends on the amount of "wear and tear" the crown is exposed to and how well you follow good oral hygiene practices.
Does a crowned tooth require any special care?
While a crowned tooth does not require any special care, remember that simply because a tooth is crowned does not mean that the underlying tooth is protected from decay or gum disease.
Other Cosmetic Dental Services
|
