Dentistry is an art and a science, and dental crowns offer a perfect example of this. A dental crown or “cap” is a covering that fits over a damaged, decayed, or unattractive tooth. It can even replace a tooth entirely as part of dental bridgework.
A dental crown completely covers a tooth above the gum line. This contrasts with a dental veneer, which only covers a tooth's front surface and needs a natural tooth structure to support it. Therefore, if a tooth is missing a significant amount of structure above the gum line, a crown would be the restoration of choice.
Crowns strengthen damaged teeth, allowing them to function normally again. When crafted from today's high-tech porcelains (dental ceramics), crowns are virtually indistinguishable from natural teeth. They can even be designed to improve upon a tooth's original appearance.
Other materials besides porcelain that we can use to make dental crowns, depending on what qualities are most important. For durability, cast gold can't be beaten. However, this is not always the most aesthetic choice — especially towards the front of the mouth. Other possibilities include porcelain-fused-to-metal crowns (PFM), a metal interior for strength and a porcelain exterior for a more natural appearance, and all-porcelain crowns with zirconia, representing the strongest ceramic. We would be happy to discuss the pros and cons of these various options with you.
Crowning or Capping a Tooth
Crowning or capping a tooth will usually take two to three visits. At the first visit, your tooth is prepared to receive its new crown. First, it is shaped to fit inside the new covering. This will involve some drilling to give the tooth a uniform shape. The tooth and the surrounding area will be numbed beforehand. If there is very little tooth structure left to begin with, the tooth may have to be built up with filling material rather than filed down to support the crown.
After the tooth is prepared, impressions of your teeth are taken, either digitally or with reliable, putty-like impression materials, and sent to the dental laboratory. There, the impressions will be used to make models of your teeth create a crown. The models will serve as guides to the highly skilled lab technicians, who will ensure that your new crown is designed to enhance your smile and function well within your bite.
Before you leave the office, a temporary crown will be attached to your tooth to protect it until the permanent crown is ready. Your permanent crown will be attached to your tooth at the second visit with either a resin that hardens when exposed to a special light source or a type of permanent cement.
Creating a Bridge
Crowns can also be used to create a lifelike replacement for a missing tooth. This is done with bridgework, which spans the missing tooth's space and requires at least three crowns. Two of those crowns will be placed over healthy teeth on either side of the missing tooth; these healthy teeth are referred to as abutment teeth. The two crowned abutment teeth become supports for a third crown placed between them; that third crown is referred to as a pontic. More crowns will be needed to bridge the gap between the abutment teeth if more than one tooth is missing.
The number of missing teeth influences the number of abutment teeth necessary to replace missing teeth. Also, the size, length of the abutment tooth roots, the amount of bone support each abutment tooth has, and where the missing tooth is located are figured into the engineering. For example, four abutment teeth may be necessary if you have three missing teeth, thereby creating a seven-tooth bridge. Designing a dental bridge requires a deep understanding of replacing teeth and the supporting gum and bone tissue biology.
Caring for Your Crowns & Bridgework
Crowns and bridgework require the same conscientious care as your natural teeth. Be sure to brush and floss between all of your teeth — restored and natural — every day to reduce the buildup of dental plaque. When you have crowns, it is even more important to maintain your regular cleanings at the dental office. Avoid using your teeth as tools (to open packages, for example). If you have a grinding habit, wearing a nightguard would be a good idea to protect your teeth and investment.
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