Dental Crown and Bridge

When you need a Crown?

Tooth that is not possible to be restored with large amalgam may require a crown. Dental crowns can also conceal cracked, discolored, injured, or chipped teeth. Dental crown can look and feel like natural teeth and restore function of patient tooth, leaving the teeth more resistant to injury. Dental crown can be used to support a tooth that already had alarge filling. It can also be used to align a tooth that is out of position. There are also many other reasons for dental crown treatments; most often being because of insufficient remaining tooth structure like root canal treatment, large amalgam.

When you need a Bridge?

Dental Bridge can replace your missing teeth. Missing teeth can make you feel a difference when chewing and speaking. Normally, dental brdige crown is comprised of two dental crowns and one pontic in between. Dental bridge is used to replace missing teeth and help maintain the shape of your face, and alleviate the stress in your bite. A fixed bridge replaces missing teeth with artificial teeth, looks great, and literally bridges the gap. Once dental bridge are cemented, it will be permanently bonded onto surrounding teeth for support, filling the missing spots where missing teeth used to be. A bridge, when necessary, offers a great solution for a strong, natural-looking smile.

Dental Crown and Bridge Procedures

It normally takes 2-3 appointments to complete dental crown, the preparation appointment, the installation appointment and post treatment examination.

The first visit of the dental crown procedure is the preparation. The tooth will be reduced on all 4 sides plus the top in order to make space for the crown. This is also when any decay is removed and filled accordingly. The dentist will take dental impression of the tooth and make a temporary crown. The impression will be sent to model in dental lab, which take around a week until the final crown is seated on the 2nd appointment

The 2nd appointment of the dental crown and bridge procedure is for seating the crown and bridge. The temporary tooth will be removed and the permanent crown and bridge will be fitted onto the tooth instead. This normally involves some adjustments, and then the crown is cemented onto the tooth.  After an impression is made, your crown will be delivered at a second appointment and permanently bonded.

The 3rd appointment is for exam to make sure patient feel comfortable with new teeth. Minor adjustment as color or shape can be applied after this.

Dental Crown and Bridge Materials

Dental crown and bridge can be GOLD, PROCELAIN, or PORCELAIN FUSED TO GOLD/METAL (PFM/PFG) depending on patient preference.

GOLD Because the hardness of gold is close to natural tooth hardness, it does not wear against the opposing tooth. Because PORCELAIN is harder than natural tooth structure, it can wear down the opposing teeth. Gold crowns also require less reduction of tooth structure during the dental crown procedure, which in general is better for the longevity of the tooth.

In the current day of everyone wanting whiter teeth and looking more natural, gold is esthetically less acceptable, unless it is in the back of your mouth. Gold alloy is used when strength is desired and appearance is not a factor. There are many percentage of gold, like 52% or 87%.

Non-Precious Alloy Non precious metal crown is commonly used because it is yje lowest option but it also good in strength aspect. Because it does not contain any precious metal, cost is less. There are two basic types, one with nickel composition and one with nickel-free. Some people are concerned that nickel, beryllium, cobalt, chromium, and palladium may cause immune problems.

ALL PORCELAIN All Porcelain is used when appearance and wear resistance is the most concern factor. Porcelain is more fragile than metal and may be broken easily. Thus, porcelain alone is not normally recommended for dental bridges. As mentioned in the gold crown and bridge above, once porcelain bridge are completed, the preparation phase of the crown requires more tooth structure to be taking out to make more room space for the porcelain and metal replacement

Zirconia (Zirconium Oxide) Zirconia crown and bridge are like porcelain fused to metal crown excepting the metal substructure is primarily zirconia. Zirconia has white appearance rather than a silver or gold appearance. This make it much better in esthetic aspects but it may not be suitable for some posterior teeth that reqyure high stress resistant . Restoration of dental structures that is strong enough to withstand the forces of chewingby biocompatible materials is one of the most interesting in dentistry market. Recent technology make it possible now. Zirconia is a choice of a material that is esthetic, strong, pure, biocompatible and capable of being used for single and long span bridgewok.

Zircona ceramic primarily stands out due to its high crack resistance. Crack resistance is the resistance with which the material counteracts the spreading of cracks. If a material is stressed, it usually comes to excessively high tension within a defect area. While metal under high tension in the area of cracks, plastic deformation appears and the top of the tension can be reduced by rounding the cracks. For ceramics missing plastic deformation possibility the cracks will continue. The unusual feature of zirconia ceramic in comparison with other ceramics are that at the appearance of a high tension area a transformation of the crystal structure can take place. This process is also accompanied by a volume expansion.

In medical area, zirconia is used more and more as the material of choice especially for hip prosthesis. For years there has existed substantial clinical tests and examinations which confirm the high quality of zirconia.

ALL PORCELAIN vs PORCELAIN FUSED TO METAL

Like gold, the metal hardness is closer to that of natural tooth structure, so part of the tooth can be PORCELAIN (for esthetics) and part of it can be metal/gold (part that hits the opposing tooth). The metal is normally an alloy of gold, with the amount of gold and other metals varying depending on the type of crown.

Crown and Bridge Failures issues

After crown or bridge is placed, the tooth still needs to be flossed and brushed, because it is still possible to get cavities under a crown. There are other issues that can arise after crown placement.

• Decay: If you get recurrent decay under the crown/bridge, most likely the crown will need to be redone.

• Open Margins: This means that there is a space between the crown/bridge and tooth, and is not a good situation. If you have open margins around any part of the crown, the crown and bridge should be redone because leaving open margins can leave the tooth at a higher risk for getting decay. Open margins around new crowns can cause tooth sensitivity to hot, cold, air, or sweets.

• Occlusion: This is one of the more common reasons of new crown and bridge. If your bite feels "off" your dentist probably adjust the crown or bridge to feel better. Once tooth is contacting prematurely, it can cause a discomfort feeling , any opposing tooth, sensitivity to hot&cold temp or biting. Dentist need check if a patient is having problems with a new crown or bridge.

• Open Contacts: If dental crown teeth do not contact the adjacent teeth, you will likely get food particle in the space. This should be addressed before dental crown is fully cemented. If not, it may require to redo the crown and bridge, or do a filling or modify the adjacent tooth.

• Fractured Porcelain: If porcelain of porcelain fused to metal crown or bridge are fractures, the metal underneath porcelain can still protect ts tooth. Dental crown and bridge do not need to be replaced, as long as the margins of the crown are intact. Some people choose to replace their crown when this happens if esthetic is theirconcern or if there are open contacts.

Denture

Dentures are removable replacements for missing teeth. They are made from acrylic, stainless steel, and chromium-cobalt, but can be made of nylon, a gold alloy, or titanium. Most pink-colored acrylics and vinyls contain cadmium, which is considered toxic and/or immune reactive. The alternative is to use cadmium-free pink or clear materials. Metals are used to increase rigidity and increase retention of the prosthesis in the mouth during function. If metals are not used, the opposite is true, which is not desirable from a functional perspective.  If your dentures are well looked after, you will have a very natural looking smile. Your dentures will also help strengthen muscles controlling your expressions and you will be free of any speech problems which were caused by missing teeth. If you've lost, or are losing, all of your teeth a Complete Denture replacement could be the perfect solution for you.