Posts for tag: crowns
Dental crowns are an essential means for restoring damaged or unattractive teeth. A well-crafted crown not only functions well, it looks and blends seamlessly with the rest of the natural teeth.
Crowns are artificial caps that cover an entire visible tooth, often used for heavily decayed or damaged teeth or as added protection after a root canal treatment. Most crowns are produced by a dental lab, but some dentists are now creating them in-office with computer-based milling equipment. On the whole, the various crowns now available function adequately as teeth—but they can vary in their appearance quality.
In the early to mid 20th Century the all-metal crown was the standard; but while durable, it could be less than eye-pleasing. Although more life-like dental porcelain existed at the time, it tended to be brittle and could easily shatter under chewing stress.
Dentists then developed a crown that combined the strength of metal with the attractiveness of porcelain: the porcelain fused to metal or PFM crown. The PFM crown had a hollow, metal substructure that was cemented over the tooth. To this metal base was fused an outer shell of porcelain that gave the crown an attractive finish.
The PFM reigned as the most widely used crown until the mid 2000s. By then improved forms of porcelain reinforced with stronger materials like Lucite had made possible an all-ceramic crown. They’re now the most common crown used today, beautifully life-like yet durable without the need for a metal base.
All-ceramics may be the most common type of crown installed today, but past favorites’ metal and PFM are still available and sometimes used. So depending on the type and location of the tooth and your own expectations, there’s a right crown for you.
However, not all crowns even among all-ceramic have the same level of aesthetic quality or cost—the more life-like, the more expensive. If you have dental insurance, your plan’s benefits might be based on a utilitarian but less attractive crown. You may have to pay more out of pocket for the crown you and your dentist believe is best for you.
Whatever you choose, though, your modern dental crown will do an admirable, functional job. And it can certainly improve your natural tooth’s appearance.
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
A Crown is a Crown, is a Crown ...? NO!
Aren't all crowns the same? What difference does it make what a crown is made of? That’s a very good question!
Since the 1950's, dentists have used Porcelain Fused to Metal (PFM) and full Gold crowns. For the times, being able to crown a front tooth with a PFM and have it look like a tooth was a big deal. The gold crowns were used for the back teeth, as those crowns had been reliable and durable for chewing.
Fast forward to modern dentistry and we have a multitude of choices. I will discuss the differences between PFM, Gold and Zirconia crowns. Strength and durability can be very important, especially on back teeth. Gold crowns are the standard but they don't look like teeth and gold is an added expense. Most patients decline the use of gold crowns. On the other-hand PFM crowns have a thin layer of porcelain on a metal substructure. The thin porcelain layer can chip or fracture which is the most common reason for PFM crown failure. Zirconia crowns are extremely strong, as this type of material is not prone to chipping or fracturing.
Cosmetics are becoming more and more important to patients. Most patients don't want gold crowns, they prefer crowns to look like their natural teeth. Although PFM crowns can be made to look pretty good, they cannot match Zirconia crowns for a truly tooth mimicking appearance.
With PFM crowns, it is not uncommon, especially in cases of recession, to see a grey line at the gum line. The metal substrate of the crown gives a grey shadow. Zirconia being tooth colored through and through eliminates this problem.
To place a crown on a tooth requires the removal of some tooth structure to make room for the thickness of the crown. The amount of tooth structure removal required for a PFM crown is greater than for a Zirconia or gold crown. The thickness of the metal substructure and a thick enough porcelain layer needs to be accounted for. This means much less tooth structure needs to be removed for a Zirconia crown. Less tooth structure removal means less trauma to the nerve of the tooth, making it less likely that a root canal will be needed.
How compatible with the body a material is can be a big concern for some patients. PFM crowns have a metal substructure that can sometimes contain metals such as nickel, silver, beryllium, gold, palladium and others. Some of these metals can cause allergic reactions in some patients. The conduction of electrons from metal to metal can also increase tooth sensitivity. Zirconia on the other hand has no metal, it is an inert material, and it has been shown to be extremely bio-compatible.
Full Zirconia crowns are my restoration of choice. Strength, cosmetics, bio-compatibility, and conservation of tooth structure all combine to make for a great dental material. There are many other materials out there and all have advantages and disadvantages to their use. A frank discussion with the dentist is needed for the patient to make an informed decision for the specific situation.
For my patients, I love Zirconia crowns. That's the TOOTH and nothing but the TOOTH!
If you have any questions that you would like to have addressed, please email Dr. McGuffie at [email protected].
A crown is a dental restoration indicated when a tooth has become cracked, fractured or is in danger of cracking or fracturing due to a weakened state. A tooth with a crack can be temperature sensitive or give a sharp painful "ZAP" when biting. A cracked tooth can be crowned and hopefully the nerve of the tooth can be protected ,reinforcing the tooth so the crack does not worsen. If the crack is deep enough the nerve of the tooth can be affected resulting in the need to treat the nerve with Root Canal Therapy (RCT). If the crack is bad enough the tooth could even be lost.
Other things that can weaken a tooth are very large existing fillings that are failing, previous Root Canal Treatment, or a tooth with a large amount of decay. It's all about how much tooth structure is left and how strong that tooth structure remains. Bonded restorations (White Fillings) are excellent for reinforcing a fragile tooth but they do require strong walls to bond to.
So a crown is basically a "Helmet" that goes over the top of a tooth in order to reinforce and protect the remaining tooth structure. Other reasons a crown could be done for a tooth include cosmetics or to change the shape or size of a tooth.
I hope I have helped to inform those inquiring minds!