Posts for tag: crowns
All crowns are designed to restore functionality to a damaged tooth. But crowns can differ from one another in their appearance, in the material they’re made from, and how they blend with other teeth.
A crown is a metal or porcelain artifice that’s bonded permanently over a decayed or damaged tooth. Every crown process begins with preparation of the tooth so the crown will fit over it. Afterward, we make an impression of the prepared tooth digitally or with an elastic material that most often is sent to a dental laboratory to create the new crown.
It’s at this point where crown composition and design can diverge. Most of the first known crowns were made of metal (usually gold or silver), which is still a component in some crowns today. A few decades ago dental porcelain, a form of ceramic that could provide a tooth-like appearance, began to emerge as a crown material. The first types of porcelain could match a real tooth’s color or texture, but were brittle and didn’t hold up well to biting forces. Dentists developed a crown with a metal interior for strength and a fused outside layer of porcelain for appearance.
This hybrid became the crown design of choice up until the last decade. It is being overtaken, though, by all-ceramic crowns made with new forms of more durable porcelain, some strengthened with a material known as Lucite. Today, only about 40% of crowns installed annually are the metal-porcelain hybrid, while all-porcelain crowns are growing in popularity.
Of course, these newer porcelain crowns and the attention to the artistic detail they require are often more expensive than more traditional crowns. If you depend on dental insurance to help with your dental care costs, you may find your policy maximum benefit for these newer type crowns won’t cover the costs.
If you want the most affordable price and are satisfied primarily with restored function, a basic crown is still a viable choice. If, however, you would like a crown that does the most for your smile, you may want to consider one with newer, stronger porcelain and made with greater artistic detail by the dental technician. In either case, the crown you receive will restore lost function and provide some degree of improvement to the appearance of a damaged tooth.
Restoring missing or unattractive teeth can often be a lengthy process. Months may elapse between initial teeth preparation and final placement to allow time for tissue healing and permanent crown manufacturing. During that period you will likely wear temporary (provisional) crowns to protect the teeth while improving function and appearance.
In the past, provisional crowns were fairly uniform. Today, though, there are provisional crowns available that conform exactly to a patient’s individual mouth. These crowns not only enhance function and appearance, they’re an excellent way to “try out” your new smile before the permanent restoration.
Customized provisional crowns are part of a concept known as “smile analysis.” A new smile involves more than restoring affected teeth: we also consider the overall health of your mouth, the shape of your face, and your own desires and expectations. Your final smile design is a joint collaboration between you, our office and the dental laboratory that will fashion the final restoration.
There are a number of techniques for creating customized provisional crowns. Some techniques involve bonding tooth-colored materials like composite resin directly to the teeth. Others use impression models of your teeth to create an outline or shell that’s filled with an acrylic material and then affixed to your teeth. The aim with any of these techniques is to produce a provisional crown that accurately reflects the final crown’s appearance.
With these types of provisional crowns, we can see how the new teeth will look (their color, shading, shapes and proportions) against the gums, and if they appear to be in balance and harmony with the entire face, including your lips, jaws and facial contour. We can also evaluate how well the new teeth function as you chew, speak or smile.
It takes some extra effort to prepare customized provisional crowns rather than the more uniform version. But this effort is well worth it: by helping us anticipate more accurately how your new restorations will appear and function, customized crowns help ensure your new smile is an attractive and satisfying one.
If you would like more information on temporary restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Concepts of Temporary Restorations.”
So, you're about to have a tooth capped with a crown. Do you know what you need to know before you undergo this common dental procedure?
Here's a short true or false quiz to test your knowledge of dental crowns.
All crowns are the same. False — while all crowns have the same basic design — a life-like prosthetic tooth fitted over and bonded or cemented to a natural tooth — their compositions can vary greatly. Early metal crowns consisted mainly of gold or silver and are still used today. Porcelain-fused-to-metal (PFM) crowns — a metal interior for strength overlaid by a porcelain exterior for appearance — became popular in the latter 20th Century. Although still widely used, PFMs have been largely surpassed by newer all-ceramic materials that are stronger than past versions.
Crowns can differ in their artistic quality. True — all crowns are designed to replicate a natural tooth's function — in other words, enable the tooth to effectively chew again. But a crown's appearance can be a different story, depending on how much attention to detail and artistry goes into it. The higher the individual craftsmanship, the more lifelike it will appear — and the more expensive it can be.
With digital milling equipment, dental labs are obsolete. False — although technology exists that allows dentists to produce their own crowns, the equipment is not yet in widespread use. Â The vast majority of crowns are still produced by a trained technician in a dental laboratory. And just as you base your choice of a dentist on your confidence in and respect for them, dentists look for the same thing in a dental lab — good, reliable and consistent results.
Your insurance may not cover what your dentist recommends. True — dental insurance will typically pay for a basic, functional crown. Aesthetics — how it will look — is a secondary consideration. As a result, your policy may not cover the crown your dentist recommends to function properly and look attractive. A new crown, however, is a long-term investment in both your dental function and your smile. It may be well worth supplementing out of pocket your insurance benefit to get the crown that suits you on both counts.
If your tooth sustains damage that compromises its structure — typically through decay or trauma — you have several options depending on the extent of the damage: One of them is a crown. This method saves the tooth and its root and completely conceals the visible portion of the tooth, or crown, under a natural-looking cap made to mimic as closely as possible the size, shape and color of the original tooth.
Crowns also hide imperfections in the original tooth like discoloration, chipping, fractures, excessive wear (from bruxism, or tooth grinding, for example), or abnormalities in the way the tooth formed. And they’re used following root canal treatments, which treat infected pulp at the center (canal) of a tooth root by removing the pulp and replacing it with an inert, rubber-like material.
Saving the natural tooth has long been the goal of dentistry because normal micromovements of the tooth root, which is suspended in its jawbone socket by elastic ligaments, stimulate the surrounding bone to rejuvenate. Without that stimulation, the bone continues to lose old cells, but no longer replaces them. Crowns are also designed to restore tooth function.
The function and location of the damaged tooth can determine what material the crown will be made of. If the damaged tooth is clearly visible when you smile, porcelain, the most realistic-looking material, is almost always used. If the tooth receives significant bite force, a stronger material is considered — either, a gold/porcelain combination, or a high-strength ceramic. If you are restoring a second molar, an all-gold crown may be considered.
With the advent of dental implants, saving a damaged tooth is no longer the only option for preserving the health of the bone surrounding the tooth root. The implant — a tiny biocompatible, titanium screw-like artificial root — is placed in the jawbone and is then capped with a natural-looking crown of course!
If you would like more information about dental crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”
If you're in need of a crown to cover a damaged tooth, you have a lot of options. But before you choose, you need to know what you want. Would you be happy with an affordable, well-fitting crown that holds up well and allows you to chew comfortably? Or are you interested in a more expensive one that also provides the most attractive result?
Crowns have been a mainstay in dentistry for generations. The first were made of metals like gold or silver — durable and effective but not very attractive.
In time, a ceramic material known as dental porcelain began to make its appearance in crowns. Dental porcelain could be fashioned to resemble the color and texture of natural teeth, but it had a significant drawback: it could be brittle and subject to shattering under chewing pressure.
This problem was somewhat addressed with the innovation of a crown with a metal substructure fused with an outer layer of porcelain. These porcelain-fused-to-metal (PFM) crowns combined the best advantages of both materials: strength and life-likeness. Up until around the mid-2000s, PFM made up over 80% of crowns.
But later porcelains continued to improve in strength, beginning in 1993 with the introduction of a Lucite-reinforced material. Newer formulations like lithium disilicate or zirconium oxide (now considered the strongest porcelain) have made all-porcelain crowns a viable option. Today, an estimated 60% of new crowns are all-porcelain.
From an appearance standpoint, all-porcelain crowns achieve the best results. The most realistic crown can be costly — not because of the material but the level of artistry required. A skilled dental technician will spend several hours, including brushing on as many as fifteen coats of liquid porcelain to the crown, to achieve the most life-like outcome. Your insurance plan, if you have one, will most likely not pay as high a percentage for that type of crown.
In the end, it's your decision as to what type of crown you wish to have. We'll help you weigh your options and decide what's best for you and your budget.