Dental Crowns
Dental crowns, also known as "caps," preserve the functionality of damaged teeth.
A dental crown may be used to protect a cracked tooth, restore
functionality of a tooth with excessive decay or replace a pre-existing
crown.
Consultation and Treatment Planning
The purpose of a dental crown is to encase a needy tooth with a custom-designed material. Dentists
today have a variety of conservative treatment options through which to
restore teeth. If possible, these options should be explored and
discussed before selecting the full coverage crown.
If tooth decay or damage is so extensive that veneers,
direct composite bonding or other conservative treatments aren't viable
treatment options — or if you have undergone root canal therapy — your
dentist will consult with you about dental crowns. Whether used to
restore a damaged tooth or to create a lifelike tooth replacement for an
implant, crowns can be fabricated in dental laboratories or in your
dentist's office, depending on the crown material
Part of your dental crown consultation may involve taking impressions of
your existing tooth (or teeth) as a basis for creating the shape and
size of your crown restoration(s). If dental crowns will be used as part
of a smile makeover, these impressions are used to make models for
designing the new length, shape and alignment of your teeth, so that you
can preview your new smile before committing to treatment. Your dentist also will describe the tooth preparation process, as well
as your options with regard to local anesthesia (to numb your teeth and
surrounding areas) and sedation dentistry, if necessary. If your dental
crown treatment involves placement of a temporary crown, your dentist
will advise you of how long you will need to have the temporary in place
and what hygiene steps to take to ensure functionality.
Dental Crown Procedure
During the dental crown procedure, your dentist prepares the tooth and
makes a molded impression of the teeth to send to a dental laboratory. A
fitted, temporary crown is created during this visit to temporarily
protect the tooth while the final restoration is being made in the
dental laboratory. Once completed, the tooth crown is cemented or
adhesively bonded at a later visit.
A recent technology, CAD/CAM technology
(computer-aided design/manufacturing technology) has evolved to display
a 3-D picture of the teeth. A restoration is then created through
milling of a ceramic block. If this technology is located in the dental
office (chair-side CAD/CAM), there will be no need for a temporary crown
or return visit for the final cementation.
After your permanent crown has been placed, your dentist will provide
you with information about caring for your new restoration. In general,
maintain proper oral hygiene habits by brushing twice daily and
flossing with dental floss or interdental cleaners (specially designed
brushes and sticks) once a day. These practices will help to remove plaque from the area where the crown meets the gum, and help prevent dental decay and gum disease.
Avoid chewing hard foods, ice or other hard objects, since this could
damage your crown. It also is important to avoid biting your
fingernails and grinding your teeth, which could significantly shorten
the life-span of your dental crown. If you habitually clench or grind
your teeth, your dentist may recommend wearing a night-time mouth guard
to help protect your crowns while sleeping.
The three predominant choices of restorative materials for the full coverage crowns are:
- Porcelain-fused-to-metal
- All-ceramic (all-porcelain)
- Gold
The material selected is determined by the clinical demands at hand; esthetic demands, strength requirements, material durability and restorative space available.
Porcelain-fused-to-metal crowns provide for a strong, durable and
esthetic treatment option. One of the key factors for the esthetic and
functional success of this type of crown is ensuring the preparation of
the underlying tooth structure provides adequate space for the
appropriate thickness of the material selected. Additionally, the
artistic skill of the laboratory technologist creating the crown will
determine its esthetic appeal.
E-mail: gerwig@gerwigfamilydental.com
