Posts for tag: crowns
If you've lost a tooth, you have a number of options for replacing it. Perhaps the best choice in terms of lifelikeness and durability is a dental implant.
All implants have the same basic architecture: a titanium metal post imbedded in the jawbone to replace the root; and an abutment, a metal collar that links the post with a lifelike porcelain crown. But implants can vary in how the crown attaches to the abutment and post — either cemented to the abutment or screwed through the abutment to the post.
Either method will permanently secure the crown to the implant. But there are advantages and disadvantages for each.
A screw-retained crown may better facilitate any future repair that might be needed. For a skilled dentist it's a simple matter of removing the screw and then the crown from the abutment. There's less risk of damage to the implant during repairs or crown replacement. Many dentists also prefer screws for crowns placed at the same time they're installing the implant post (a procedure called immediate loading).
The screw access hole, however, could pose a cosmetic problem. Although we can cover it over with tooth-colored filling, it may still be noticeable and unattractive especially for a tooth visible when you smile (in the smile zone). There's also the possibility the porcelain around the access hole could chip.
By contrast, cemented crowns have a smooth, unbroken surface and are aesthetically ideal for smile zone teeth. But the cement could interact poorly with gum and bone tissue in some patients, causing inflammation and possible bone loss.
And unlike screw-retained crowns, cemented crowns are difficult to remove for implant repair. We may have to drill through the crown to access the screw between the abutment and the post, and then repair it cosmetically if we use the same crown. Again, the final result may not be quite as visually appealing.
In the end, it will depend on the implant's location, how your body reacts to the cement or your dentist's preference. In either case, though, you'll have a tooth replacement that's functional, life-like and able to endure for many years to come.
If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”
In the realm of restorative dentistry, dental implants are king. A dental implant can replace a tooth with a permanent, life-like restoration with a solid reputation for durability.
Implants are also known for one other quality — variety. Not all implants are alike, and they have varied applications for use. Available in various shapes and sizes, they can be used for a single tooth or as part of a multiple tooth bridge or overdenture. And while their basic architecture is the same, you also have two options for how the permanent crown (the visible tooth portion) attaches to the implant: screwed or cemented.
A screw attachment can securely fasten a crown to an implant without the need for cement; it also allows for easy removal for repair or replacement should the crown become damaged or worn. On the other hand, it could pose a cosmetic problem — even though the access hole for the screw may be covered with a tooth-colored filling, it could still be distinguishable from the rest of the crown. There’s also a slight risk of the crown chipping around the access hole.
A crown cemented to the implant won’t have this cosmetic issue with an access hole, and will look just like a natural tooth. But unlike a screwed crown, removing a cemented crown can be more difficult. The cement may also cause gum inflammation and potential bone loss in sensitive patients.
The condition of your mouth, the type of implant you’re receiving and other circumstances will all factor into determining which method is best for you. If we’re “immediately loading” the crown (meaning we’re affixing a temporary crown to the implant immediately after placement in the jaw), then the screw method may be more advantageous. Aesthetically speaking, though, a cemented crown may be a better option in terms of final smile appearance.
But whichever method is used, you’ll still benefit from what implants do best — help you regain the function lost from a missing tooth and change your smile for the better.
If you would like more information on your options with dental implants, 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 “How Crowns Attach to Implants.”
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.
The traditional way to restore a tooth with an artificial crown takes several weeks and multiple office visits: from tooth preparation and impression molding to crown production by a dental laboratory, followed by adjustments and cementing. Now, there’s an alternative that reduces this process to a fraction of the time, and all from your dentist’s office.
Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) is a digital system that enables dentists to create dental restorations with laboratory-grade materials in minutes rather than weeks. As it continues to innovate, you’ll see more and more dentists investing in the new technology for their patients.
A crown restoration with CAD/CAM begins like any other with decay removal and preparation of the tooth. It diverges, though, from the traditional in how an impression of your teeth and gums is obtained: instead of rubber-like molding materials to create a physical impression, we lightly dust the mouth interior with a reflective powder. Using a scanning wand, the reflective powder allows us to capture multiple, detailed images of your mouth that the CAD/CAM computer transforms into an accurate three-dimensional model.
We use the model to first assess if the tooth has been effectively prepared for a restoration. If so, the design feature of the system will provide us with thousands of tooth forms to choose from to match with your natural teeth. You’ll be able to view the proposed size and shape of the new crown via computer simulation before signing off on the design.
Next is the actual manufacture of the crown that takes place right in the dentist’s office. A pre-formed block of ceramic material is inserted in the milling equipment where, following the pre-determined computer design, the milling heads carve the ceramic block. After milling, we fine-tune the crown surface and apply stains or glazes fired to create a life-like color and texture that matches your natural teeth. We can then adjust the crown in your mouth and permanently affix it to the tooth.
While much of the CAD/CAM system is automated, ultimate success still depends on the dentist’s expertise and artistry. CAD/CAM enhances those skills with greater precision and in much less time than traditional crowns. It’s certainly a growing option for many people to restore the form and function of decayed teeth.
If you would like more information on computer-aided dental 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 “Creating In-Office Dental Restorations with Computers.”
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.”