When enough tooth structure is lost as a result of a cavity or trauma, or a filling is no longer properly protecting the tooth, a crown (or cap) is needed to prevent further fracture or breakage of the tooth.
Who is a Candidate for Crowns?
- Patients who have lost significant tooth structure to a cavity
- Patients with a cracked or fractured tooth
- Patients with large, old fillings that are beginning to fail
- Patient who have had root canals on posterior teeth
- Local anesthesia is used to numb the area and provide the most comfortable experience possible
- Drill is used to remove failing fillings or unnecessary, decaying tooth structure
- Impression of the tooth is taken digitally or physically and crown is fabricated
- A temporary crown is placed to cover and protect the prepared tooth until the final crown arrives from the lab
- Final crown is tried in, adjusted, and finally cemented into place
The materials used in the fabrication of the crown depend completely upon the patient and the situation.
Three types of crown materials:
- PFM: Porcelain fused to metal crowns are most commonly used. They are mid-range in price and durable.
- All-Ceramic: This type of crown is the most expensive and aesthetic type of material. These are great for anterior teeth.
- All-Metal: This is the most cost-effective alternative, but it is non-aesthetic. All-metal crowns are most commonly used for posterior teeth and children.
A bridge is meant to replace one or more missing teeth by placing crowns on the healthy teeth on either side of the gap and infusing the prosthetic tooth, called a pontic, in between to fill the area where the tooth or teeth were missing.
For a bridge to be considered, the patient must have good general bone structure in the jaw, and the remaining teeth must be healthy and have supportive bone structure
- During the first visit, the teeth on either side of the gap are prepared for crowns
- A small amount of enamel is removed to allow room for the crown to fit over the tooth
- Impression is taken for the crowns, pontic, and bridge to be sent to the lab for fabrication
- Temporary bridge will be placed to protect the area
- During the second visit, the temporary bridge will be taken out
- Permanent bridge is fitted and adjustments are made
- After ensuring that the bridge fits exactly right (2-3 week period), patient returns to have the bridge permanently cemented in place