Crowns
Overview
If you have missing or damaged teeth, a dental crown (single tooth) or bridge (multiple teeth) can help restore the function and aesthetics of your smile. Even for patients who are diligent about their home care, it is not uncommon to need a tooth repaired or replaced at some point. If problems should arise with your smile, you can rest assured that we will restore your teeth with only the finest dental materials so you will have strength and durability you can trust, and the aesthetics you want. Our team has extensive experience with restorative dental treatments and can easily provide you with a beautiful dental crown that looks and feels completely natural.
If you have a tooth that needs repair or replacement, it’s a good idea to consider treatment as soon as possible to avoid further damage to your smile. Contact IVY DENTAL today for more information and to schedule your dental appointment.
| DENTAL CROWNS
A dental crown is a false tooth made of ceramic porcelain that is designed to cap and cover your entire remaining tooth structure and protect it from further damage. These prostheses may be necessary if you have a severe cavity that is too large to treat with a composite filling. If a cavity is too large, attempting to fill it may compromise the tooth structure and simply cause more damage. After root canal therapy, a dental crown is necessary to protect and cover your tooth. A dental crown is also necessary to complete the implant process.
Typically, a dental crown is recommended when a tooth has become seriously damaged due to tooth decay or an oral injury, but they can also be used for cosmetic purposes. For example, if you have a tooth that is healthy but small or misshapen, a dental crown can be used to create a seamless, beautiful smile.
When your dentist recommends a tooth crown, it is typically for these reasons:
For a decayed tooth that is more than a filling can repair
For a severely cracked, fractured, or broken tooth
To strengthen a tooth treated with root canal therapy
For a single tooth replacement for a dental implant
To cover chipping, discoloration, or other cosmetic imperfections.
We design a crown to cover your entire tooth structure, fitting over your remaining tooth like a “cap.” Usually, we make it out of ceramic porcelain, which is customized to match your teeth and blend flawlessly with your smile. However, sometimes, gold is recommended for durability for molars at the back of your mouth that take the brunt of your biting force, and you won’t see when you smile.
| DENTAL BRIDGES
A dental bridge can be a solution for replacing one or multiple missing teeth that are adjacent. Using a crown on each end as an anchor, an artificial tooth or teeth are placed in between to fill in the gap. A bridge is fixed, which means that we permanently place it, and it is not removable.
At IVY DENTAL we typically use porcelain or porcelain fused to metal to create dental bridges that are seamless and complement your smile.
Whether you need a tooth crown or dental bridge to restore your smile, the process to complete your restoration is nearly the same. It will require two visits with your dentist and a couple of weeks to complete.
During your first appointment, your dentist gets your tooth ready for your new restoration, takes impressions of your teeth for the dental lab, and creates a temporary restoration for you to wear until we complete your final one.
A trusted dental lab will handcraft your restoration, which typically takes one to two weeks. When it’s ready, you’ll return to our dental office to have it permanently placed and adjusted to fit your bite correctly. Now you can enjoy all the benefits of eating and smile with your newly restored teeth!
Tooth Crown Types
Your dentist will recommend the best type of crown for your dental restoration needs based on the chewing placement and structure of the tooth or implant that requires protection. There are three types of crowns. Each type has its own characteristics and qualities:
Full Porcelain
Porcelain is attractive, strong, stable, and highly resistant to wear. It offers a high level of biocompatibility because it does not contain metal.
A porcelain crown provides the best natural color match to the rest of your teeth and is an excellent choice for front teeth.
Full-Metal
Metal offers strength and endurance. A metal crown may be recommended for back teeth where the forces of biting and chewing are the greatest. A metal crown rarely chips or breaks. In addition, it requires minimal removal of tooth structure.
A gold or other high-noble metal crown offers biocompatibility. A base metal crown is often the least expensive treatment options; however, it lacks biocompatibility and may cause allergic reactions or gumline discoloration.
Porcelain-Fused-to-Metal
Porcelain-fused-to-metal offers the benefits of a natural surface color that resembles the rest of your teeth and the strength of a metal substructure.
While there are several advantages to selecting this type of crown, it requires the removal of more tooth structure than other types of crowns. This means that there is greater potential for patient discomfort during the treatment procedure.
Patient Experience
After a thorough exam of your teeth, gums and supporting bone structure, your dentist will discuss treatment options with you and answer your questions. If the agreed upon-treatment is a dental crown, your dentist will apply a local anesthetic to prepare your tooth or dental implant.
After your tooth or dental implant has been prepared and shaped for a crown:
A putty-like material is used to make impression of your prepared teeth. Your crown will be fabricated for a precise fit based on this impression.
You will be fitted with a temporary crown to protect your tooth/implant and gums until your permanent crown has been fabricated.
During a second office visit, your dentist will fit your permanent crown and bond it to your tooth or dental implant.
Real Life Cases
If you made it this far it means you’re really interested! Let’s take a look a some completed cases.
Case 1
A tooth with a large cavity close to needing a root canal. With timely intervention, we can preserve the vitality (nerve) of the tooth and buy many more years with the tooth!
Caries removal, build up, and crown preparation/ impression/ delivery performed by Dr. Brian L. Vu
This patient presents with a mild- moderate sensitivity due to a large cavity on his premolar. Careful removal of cavities will be needed to avoid damaging the nerve inside of the tooth. During this visit, the infected tooth structure will be removed, built back up, and an impression made for a zirconia crown.
Two pictures showing the final cementation of the zirconia crown. Please note the precise fit of the crown and presence of healthy gums. The patient was able to AVOID a root canal and his sensitivity will decrease to normal levels in a couple of weeks.
Case 2
An aesthetically challenging case demonstrating large caries and tetracycline staining on four maxillary anterior teeth.
Caries removal, build up, and crown preparation/ impression/ delivery performed by Dr. Brian L. Vu
This patient presents with large cavities on her 4 front teeth. Her teeth have tetracycline staining so shade matching will be extremely challenging. To restore full functionally and aesthetics, full porcelain E-Max crowns are indicated. Pictured are the four maxillary teeth immediately after preparation (shaving) of the tooth.
After impressions are taken, temporary crowns are fabricated for the patient. What, you thought we were going to let the patient walk out the door with shaven down teeth? The patient is then scheduled for two weeks for final crown cementation.
Pictured are the final crowns cemented into place. Long term prognosis for these crowns are excellent.
Case 3
A posterior bridge case that involves a history of vertigo, sinus infection, and ENTs due to an infected second molar. See how Dr. Vu resolved and restored this patient’s infected tooth with a 3 unit porcelain bridge.
Surgical extraction, caries removal, build up, and bridge preparation/ impression/ delivery performed by Dr. Brian L. Vu
The extraction will not be shown due to the graphic nature.
The patient presents to IVY DENTAL with intense pain and swelling on her upper right cheek. She could not get emergency treatment at any other dental office and the nearest appointment was two weeks away. Traditional x-rays and a CT scan reveals a MASSIVE infection on a previously root canal treated second molar that extends into her sinus. Extraction of the second molar is needed - Implants are NOT indicated for this patient due to the presence of a large infection. As a result, Dr. Vu opted for a 3 unit porcelain bridge for the patient. Pictured is a three week followup of the extraction.
The patient was kept on temporaries for six weeks to allow for full healing of her bone/ gums before taking the impression for her final bridge.
Pictured is the final delivery of the patient’s 3 unit bridge. Please note the great healing of the patient’s gums and wonderful fit of the bridge. The patient’s swelling went away and the patient is able to chew on her right side again.
Case 4
A previously root canal treated tooth with a large restoration that when removed, reveals a large fracture line going straight down the tooth. This case demonstrates the importance of timely full coverage restorations on endontically treated teeth with large restorations.
Caries removal, post, core build up, and crown preparation/ impression/ delivery performed by Dr. Brian L. Vu
The patient presents with a previously root canal treated tooth with a large composite filling. The previous root canal was asymptomatic and looked great on the x-ray. It is clear that there is decay underneath the old filling that after caries excavation, would probably not leave much tooth structure remaining. There is also a CRACK on the backside of the tooth that may extend very DEEP. If the crack runs too deep, the tooth may not be savable, but we’ll never know how deep the crack goes until we open up the tooth. The patient was informed of the risks prior to beginning treatment.
After composite/ caries removal, we can see a crack that extends to the floor of the tooth. The tooth has no probing (no deep pocket or bone loss) and was asymptomatic. After informing the patient of the GUARDED prognosis due to the deep crack, it was decided to continue restoring the tooth.
A post space was prepared and the post screwed/ cemented in place.
The tooth was then filled back up and conservatively prepared for a porcelain fused to metal crown (PFM). An impression/ temporary was made, shade selected, and a two week appointment made for crown delivery.
Pictured is the final crown delivered. This case will have a GUARDED PROGNOSIS due to the presence of a deep crack. This case demonstrates the importance of a full coverage restoration on endodontically treated teeth. Just because the tooth doesn’t hurt (the nerve was removed during root canal therapy), doesn’t mean you can ignore it. Here’s hoping that the tooth lasts a long time.