Dentistry is an art as well as a science; 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 crown completely covers a tooth above the gum line. This is in contrast to a dental veneer, which only covers a tooth's front surface and needs 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.
There are 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 beat. 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), which have 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 for the creation of 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. At the second visit, your permanent crown will be attached to your tooth 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 space of the missing tooth 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 in between them; that third crown is referred to as a pontic. If more than one tooth is missing, more crowns will be needed to bridge the gap in between the abutment teeth.
The number of abutment teeth necessary to replace missing teeth is influenced by the number of missing teeth, the size and length of the abutment tooth roots, the amount of bone support each abutment tooth has, as well as where in the mouth the missing tooth is located. For example, if you have three missing teeth, four abutment teeth may be necessary, thereby creating a seven-tooth bridge. Engineering and designing of the bridge requires an understanding of how to replace teeth, as well as the biology of the supporting gum and bone tissue.
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 schedule of 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 your investment.
Diamonds Are a Dentist’s Best Friend
By Mary Cole, DMD and Ron Cole, DMD, Cole Family Dentistry
Are you tired of seeing metal when you smile? Do you have dark unnatural looking crowns? Do have chipped crowns or gold ones? Dentists can custom make a tooth-colored crown that looks even better than your original teeth. You can have that perfect, natural looking smile that you have always wanted.
Diamonds are a dentist’s best friend — the cubic zirconium diamonds are, at least. Dentists are moving metal out of the mouth with new crowns made out of zirconium. Zirconium is a gemstone and a white metal that has been used to make fake diamonds and artificial joints. In dentistry, we use it for crowns and implants. Over the past five to 10 years, zirconium crowns have rapidly replaced the porcelain fused to metal crowns and gold ones. These crowns have been shown on television shows such as “The Swan” and “Extreme Makeover.”
Most traditional crowns are made of porcelain, fused to a metal base. The metal becomes unsightly over time, revealing a dark line around the gums. These old crowns do not transmit light through them and look unnatural. The metal underneath the old crowns can conduct electricity and give your tooth a hot and cold sensation. Some people are even allergic to their old crowns because many of them contain nickel. Nickel is a highly allergenic metal. If you are sensitive to jewelry, then chances are you may be allergic to your old crown. The porcelain fused to metal crowns also tends to chip or break easily.
Other old crowns are made of gold, which tend to be more allergy-friendly but are expensive and unattractive to most people. Gold also is such a soft metal that it wears quickly. Most gold crowns will have a hole worn through them in a few years.
Zirconium crowns are beautiful, just like a diamond. They are 200 times stronger than porcelain and are almost indestructible. These crowns have that diamond-like translucency, which make them look natural. Zirconium crowns are strong but not bulky. No gray margin will ever show through because they never corrode. Zirconium is biocompatible and not rejected by the human body. It is safe to use in artificial joints and dental implants. Zirconium crowns are comfortable and have no electrical conductivity so you don’t feel hot and cold like the other crowns.
Dr. Ron Cole or Dr. Mary Cole shapes the tooth and scans it with a special computer called iTero. The scanner replaces the “nasty goop” impression. It is comfortable and great for “gaggers.” The scanner takes several pictures of your teeth. Your tooth will have a temporary crown made just for you. We then send your scan through email to the lab. The lab makes your zirconium crown with a laser, milling machine. The computer-generated crown is beautiful with an outstanding fit. We are accepting new patients. Please call Dr. Mary Cole at 217-877-1743 or Dr. Ron Cole at 217-875-4505 to schedule your appointment. We are at the Northwest Professional Building at 2727 North Oakland Ave., Suites 101 and 103, Decatur, IL, 62526.
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