Fabdent

Crowns

What is a dental crown?

A natural tooth is comprised of a root and a crown. The crown is the piece of the tooth that we see in our mouths and is dependent on the esthetics of our smile. If a natural tooth has undergone significant decay to the extent where a standard composite filling is not suitable, then a crown may be the best restorative option. Prosthetic crowns are permanently cemented which means they cannot be removed from the oral cavity. Crowns not only have a restorative function but they can also improve tooth shape, size and colour. Prosthetic crowns also play a vital role during dental implant treatment as the implant restores the root segment of the tooth, whereas the crown is responsible for restoring the function and esthetic appearance of the tooth.

Why might I need crowns?

Indications for crowns include:

• If your tooth has undergone significant decay and there is not enough tooth structure remaining to support a filling or an inlay and maintain functionality.
• If a large portion of your tooth has fractured and it cannot be built up using traditional composite bonding techniques.
• If you have a large cavity and opt for the additional protection a crown offers to your tooth over a large composite filling or an inlay.
• If you have had a dental implant to replace a missing tooth, a crown will be fitted to the abutment of the titanium implant.
• Following root canal treatment, a crown is often needed to strengthen the tooth.
• If you grind your teeth and have a poor diet, acid erosion may reduce your teeth to a point where the only option available is to crown them.
• For cosmetic reasons, such as severely discolored teeth or to cover misshapen teeth, to esthetically improve your smile, you may opt for all porcelain cosmetic crowns.

Are dental crowns always the best option?

Dental crowns are only used in cases where there is no other means of creating a long lasting reconstruction of a tooth crown. Crowns are the best option to strengthen a permanent tooth, improve its functionality and esthetics or rebuild a missing portion of a crown on the patient’s own tooth root or implant.

What materials can crown be made from?

Dental crowns can be made from several materials. Acryl and composite is used to make temporary crowns. Permanent crowns can be made from all-metal, porcelain fused to metal or all-ceramic.

All metal – crowns have been the foundation of prosthodontic restorations for many years due to their durability and strength. In modern practice all metal crowns are rarely used due to their unappealing esthetic character.

Porcelain fused to metal (from steel or gold) – thanks to the combination of porcelain which boasts a high esthetic appearance and metal which is responsible for durability and resistance, makes these crowns a very popular restoration choice in modern prosthodontics. The cores of these crowns are most commonly made from steel alloys of special nature, which are safe for the human body and are characterized by extreme durability and resistance. Patients allergic to non-noble metals may alternatively utilize gold alloys, which are also used for greater esthetic results. Porcelain fused to metal crowns may be used along the entire tooth arch, but in order to attain the best esthetic result it is recommended to make all-ceramic crowns in the front teeth.

All-ceramic – crowns differ as they are the most esthetically pleasing thanks to a zirconium base which is characterized by excellent durability and mechanical resistance. They may be used in both the front teeth and side teeth. More information about all-ceramic LAVA™ crowns..

What are the steps in making a dental crown?

In our clinic making a dental crown is usually carried out with two office visits. The first visit involves a thorough examination and preparation of the tooth and the second visit involves cementing the final crown into place.

First visit: Examination and preparation of the tooth

On the first visit our dentist will make an x-ray in order to check the status of the root or roots on which the crown will be placed as well as the surrounding bone. If the dentist notices large carries, a big risk of infection, or damaged pulp, the tooth will first have to undergo a root canal treatment which may lengthen the prosthodontic restoration process. More information about root canal treatments.

After receiving a local anesthetic the dentist will file down the tooth receiving the crown along the chewing surface and sides to make room for the crown. Our dentists know exactly how much tissue must be filled down in preparation for the dental crown. If however, a large portion of the tooth is missing and the tooth will not be able to support the dental crown, a root crown post will have to be made. More information about root crown posts below.

After filling the tooth and choosing the appropriate colour, the dentist makes a precise impression of the filled tooth with a special silicone mass. Impressions of the teeth above and below the tooth to receive the dental crown will also be made to make sure that the crown will not affect your bite. The impressions are sent to a technician’s laboratory and the new dental crown returns to the clinic usually after 5 days. On the first visit our dentist will also make a temporary crown in order to secure the filled tooth. Temporary crowns are made from acryl and are secured in place with temporary adhesive cement.

Second visit: Cementing of the permanent dental crown

On the second visit, the dentist will remove the temporary crown, check the colour and shape of the new dental crown. If the patient is satisfied and accepts the restoration, the new crown is set in place with special permanent dental cement.

What is a root crown post?

A root crown post is a stud-like structure that is cemented to the root of a tooth, which strengthens a partially or completely broken tooth. In situations where the amount of remaining tooth structure is little, making a filling with composite, crown or bridge, puts the tooth at an extremely high risk of fracture and most commonly this is completely not possible. In this case, it is necessary to create a root crown post that will transfer the forces of chewing directly to the root of the tooth.

Root crown posts can be made from metal (steel or gold alloys) or fiberglass. Prior to making a root crown post of the patient’s choice it is necessary to perform a proper root canal treatment, at which point a root crown post can then be made. Since root crown posts are only made in teeth that have been treated endodontically i.e. dead teeth; the procedure is painless and does not require anesthesia.

Is the dental crown procedure painful?

Some of the steps in the preparation of the tooth for a dental crown may be painful of cause discomfort but our dentists always inform our patients prior to the procedure and provide a local anesthetic, which successfully eliminates any uncomfortable sensations. Adhering the final crown with special dental cement is not painful and does not require anesthesia.

Which type of crown should I choose?

The best esthetic dental crown is achieved by all-ceramic crowns on a zirconium base, however these types of crowns are more expensive then porcelain fused to metal crowns due to the material and technology they are made with. As a result, commonly patients choose porcelain fused to metal crowns on a steel base in the side teeth and all-ceramic crowns on a zirconium base in the front teeth. An intermediate option can be porcelain fused to metal crowns on a gold base, which are more pleasing esthetically compared to crowns on a steel base and simultaneously they prove to be an alternative for patients whom are allergic to non-noble metals.

What types of crowns are made on implants?

In our clinic we make porcelain fused to metal crowns on a steel base or all-ceramic LAVA™ crowns on a zirconium base. The costs of crowns placed on implants are higher due to the abutment which is the element which links the crown to the implant.

Also see:

• All-ceramic LAVA™ crowns
• Bridges
• Veneers
• Teeth Whitening