Dental Crowns


Introduction

A dental crown is a restoration that covers or caps a tooth, restoring it to its normal size and shape while strengthening and improving its appearance. Crowns are necessary when the tooth is broken down to the point where a filling will not be effective.


Benefits of Dental Crowns

A dental crown can be used for various reasons including covering discolored or misshapen teeth, and in conjunction with bridges and dental implants. Other benefits of dental crowns may include:

  • Holding a cracked tooth together to prevent further damage
  • Covering and supporting a tooth with a large filling
  • Restoring a broken tooth

Dental Crown Procedure

The dental crown process takes place in two phases or appointments. At the first appointment, the tooth is prepared by filing or reshaping, so the crown can fit in securely and comfortably. The area around the tooth is numbed throughout the procedure with a local anesthetic. After the tooth is prepared, a state of the art digital impression is made. The data is then sent to a laboratory to make a custom crown, which usually takes two to three weeks. Patients are given a temporary dental crown until the permanent crown is ready.

At the second appointment, the new crown is inspected for proper fit and tooth color. The temporary crown is then removed and the new one is cemented onto the tooth.


Types of Dental Crowns

There are several different methods of crown restoration, each using a different crown material. Different types of crown material include:

Metal Crowns

Metal crowns are made entirely of a metal alloy that may include gold, platinum, palladium, or other elements. Compared with other kinds of crowns, metal crowns preserve more of the tooth structure. They withstand biting and chewing forces well and rarely chip or break. The biggest drawback of metal crowns is the metallic color and difficulty adjusting to a patient’s bite.

Porcelain-Fused-To-Metal or PFM Crowns

PFM crowns can be color-matched to the teeth. Second only to all-ceramic crowns in appearance, porcelain-fused-to-metal crowns look like normal teeth. In some cases, the metal underlying the crown’s porcelain can create a dark line. PFM crowns tend to wear down opposing teeth more than metal crowns. The crown’s porcelain portion can also chip or break.

Monolithic Zirconia Crowns

These crowns are the ultimate material to restore teeth with strength and esthetics. Zirconia is a powder at room temperature, but when heated and stabilized with a compound called Ytrria, it forms into a very strong and durable white material. Together with digital cad/cam milling, these crowns are the most accurately fitting crown available. Cemented with a resin cement, these crowns have the best prognosis for longterm reliability.

They are not as strong as PFM or gold crowns, and they may wear down opposing teeth more than metal or resin crowns. Because they are the most cosmetically pleasing, they are commonly used for the front teeth.


Complications of Dental Crowns

Pain Or Sensitivity When Biting

This usually means that the crown is too high on the tooth. If this is the case, the dentist will be able to fix the problem by adjusting the crown. With integrating digital bite technology, Dr Oshetski, commonly finds dental crowns inadequately adjusted or interfering with the bite causing many issues.

Chip of Fx In A Porcelain Crown

This is a common side effect of PFM crowns and usually the only way to repair it is to replace the whole crown. Chipping in porcelain crowns is a sign of a bad bite or patient that has a clenching or grinding problem. Dr Oshetski routinely treats and restores these patients back to a healthy bite and commonly uses Zirconia crowns in high force areas that can’t chip like PFM crowns.

Loose Dental Crown

If the fit of the crown is inaccurate, cavity and gum inflammation that can result. Cement washes out from underneath the crown, bacteria can then leak in and cause decay. This condition needs be detected soon before any irreversible damage to the tooth or bone results in tooth loss. If caught soon enough, the crown may be replaced with an accurate one as long as enough tooth is above the gumline.

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