Crown & Bridge

What is a Dental Crown?

A dental crown is a tooth-shaped “cap” that is placed over a tooth — to cover the tooth to restore its shape and size, strength, and improve its appearance.

The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.

Why Is a Dental Crown Needed?

A dental crown may be needed in the following situations:
 
  1. To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
  2. To restore an already broken tooth or a tooth that has been severely worn down
  3. To cover and support a tooth with a large filling when there isn’t a lot of tooth left
  4. To hold a dental bridge in place
  5. To cover misshapened or severely discolored teeth
  6. To cover a dental implant
  7. To make a cosmetic modification

What Types of Crowns Are Available?

Permanent crowns can be made from stainless steel, all metal (such as gold or another alloy), porcelain-fused-to-metal, all resin, or all ceramic.

Stainless steel crowns are prefabricated crowns that are used on permanent teeth primarily as a temporary measure. The crown protects the tooth or filling while a permanent crown is made from another material. For children, a stainless steel crown is commonly used to fit over a primary tooth that’s been prepared to fit it. The crown covers the entire tooth and protects it from further decay. When the primary tooth comes out to make room for the permanent tooth, the crown comes out naturally with it. In general, stainless steel crowns are used for children’s teeth because they don’t require multiple dental visits to put in place and so are more cost- effective than custom-made crowns and prophylactic dental care needed to protect a tooth without a crown.

Metals used in crowns include alloys that have a high content of gold or platinum, or base-metal alloys (for example, cobalt- chromium and nickel-chromium alloys). Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color — and the high price of gold — is the main drawback. Metal crowns are a good choice for out-of-sight molars.

Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown’s porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth as well as long bridges where the metal is needed for strength.

All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns. 

All-ceramic or all-porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metal allergies. All-ceramic crowns can be used for front and back teeth.

Temporary versus permanent. Temporary crowns can be made in your dentist’s office, whereas most permanent crowns are typically made in a dental laboratory. Typically, temporary crowns are made of an acrylic-based material or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by a lab

If you’re missing one or more teeth you have multiple options for replacing these missing teeth, including dental bridges.
 
Here are four types of dental bridges that your dentist may recommend.
 

1. Traditional Dental Bridges

Traditional bridges are the most popular kind of bridge. These bridges consist of one or more pontics (fake teeth) and are held in place by dental crowns. These dental crowns are also called abutments, and they are cemented onto the teeth adjacent to your missing tooth.
Traditional bridges can be used when you have natural teeth on both sides of the gap created by your missing tooth. Bridges are even strong enough to replace molars. The downside of traditional bridges is that your dentist will need to prepare the adjacent teeth by removing their enamel to make room for the crowns that will be cemented on top. Since enamel doesn’t grow back, these teeth will always need to be protected with crowns, even if you later choose a different type of bridge.

2. Cantilever Bridges

 
Cantilever bridges are another option for replacing missing teeth. They are very similar to traditional bridges, but the pontic is supported by an abutment on only one side, rather than on both sides. So if there’s only one natural tooth next to the gap, a bridge can still be secured.
 
 
Like traditional bridges, your dentist will need to prepare the adjacent tooth to support the bridge by removing its enamel. Because these restorations are only supported on one side, they may act as a lever in some cases, explains the National Institutes of Health (NIH). This may lead to complications like fractured teeth or loosened crowns.
 
 
 

 

3. Maryland Bridges

 
Maryland bridges are considered a conservative alternative to traditional bridges. These bridges consist of a pontic that is held in place by a metal or porcelain framework. This framework is bonded onto the backs of the two teeth adjacent to the missing tooth. Since this type of bridge isn’t held in place by crowns, the adjacent teeth don’t need to be filed.
 
While Maryland bridges are more conservative than traditional bridges, they do have their downsides. The strength of the bridge is limited by the strength of the resin that holds it in place, so it may not stay in place in areas of the mouth where the teeth are subjected to a lot of biting force, like the molars. The framework may also get in the way of your gums or your bite.
 
4. Implant-Supported Bridges
 

Implant-supported bridges are another option for replacing missing teeth. They can be used when you have more than one tooth missing. Instead of being supported by crowns or frameworks, these bridges are supported by dental implants. Usually, one implant is placed for every missing tooth, and this series of implants holds the bridge in place. However, the bridge may consist of a pontic suspended between two implant-supported crowns if placing one implant for every lost tooth isn’t possible.

Because these bridges are secured by implants, they feel very secure and comfortable, just like the natural teeth they replace. And just like your natural teeth, a quality toothbrush, is needed to keep your mouth healthy. One downside is that two surgeries are required to place the implants – the first to place the implants and the second to place the bridge – so expect to wait at least five months to get your finished bridge.
 
Your dentist can close the gaps in your smile with dental bridges. With so many types of dental bridges available, you can feel confident that your dentist has an appropriate solution for your missing teeth.

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