Dental Crowns & Bridges


Dental Crown Procedures Dental Crowns and Bridges are cosmetic dentistry restorations that preserve the functionality of damaged teeth while addressing the aesthetic needs and overall health of your mouth. 

If the surface of a tooth has become too badly damaged to be fixed with a filling inlay, or onlay, but the root structure beneath the gumline is still strong, your dentist can cement a crown or “cap” onto the damaged tooth. This crown will completely cover what is left of the existing tooth, and will be sized and shaped like the original healthy tooth.

Dental Crown Materials
Crowns can be made of tooth-colored material, metal, or a combination of both. Some metal-free crowns incorporate stress-bearing materials to make them stronger and wear longer. Crowns replace the entire visible structure of the damaged teeth and are virtually undetectable, leaving no tell-tale black lines along the gums. Crowns made of new, natural-looking porcelain or pressed-ceramic materials mean there are no more metal "margins" at the gum line. Porcelain fused to metal full crown is used for strength and long-term function in aesthetically sensitive regions of your smile. Cast-gold onlay is used for maximum strength, function and durability in non-aesthetic areas. Your dentist can explain which type of crown makes sense for you based upon your unique needs, as each material has its own advantages.

 

  • Metal Crowns Crowns made of metal are extremely durable and can be applied with less removal of the natural tooth than all porcelain or ceramic crowns. They are used primarily for repairing decayed or damaged back teeth. Metal crowns may consist of various materials, including gold alloy, palladium, nickel alloy, or chromium alloy. Gold is an excellent material for crowns as it is extremely workable, providing an excellent fit between the crown and the existing tooth. As with other metal crowns, gold requires the least preparation of the existing tooth, keeping more of the original tooth structure than is possible with other methods. Chipping does not occur in gold crowns and gold crowns also are not as likely to cause wear on other teeth as with porcelain crowns. The downside of gold crowns (and other metal-based crowns) is that it contrasts with existing teeth. In the back of the mouth, where gold is often used, this may not be an issue.
  • All Porcelain or All Ceramic Crowns  The popularity of all porcelain or all ceramic crowns is due to their very natural life-like appearance, allowing them to be created to perfectly match and indistinguishable from the surrounding natural teeth. For this reason, ceramic crowns are often used for front teeth cosmetic restorations. This type of crown requires more preparation than metal crowns.
  • Porcelain over Metal Crowns This crown type provides an excellent combination of aesthetics and durability. The porcelain is color matched to your existing teeth and fused to a metal base. With a metal center, this type of crown can never match the translucency of a natural tooth or an all porcelain crown, (and a thin darker line may develop where the crown meets the gum), however porcelain-over-metal crowns look very natural and are exceptionally strong and durable.

Typically, crown procedures are completed in two stages. On your first visit, a portion of your natural tooth’s structure is removed to accommodate the crown.The prepared tooth will be the base for the finished, permanant crown. Impressions of the prepared tooth and surrounding teeth are then taken and sent to a dental laboratory to be used as a model for creating the new crown. While waiting for the the permanent crown, your dentist will place a temporary crown on the prepared tooth to protect it and provide your mouth with a natural look and feel. On your next visit to the dentist’s office, the temporary crown is removed and the new, custom, permanant dental crown is securely cemented in place.
 

For some patients with special requirements, the procedure is altered to meet specific goals. For example, if crowns are being used to anchor a dental bridge or as a dental implant restoration, the steps in the crown placement procedure will be slightly different. If the tooth is extremely damaged, your dentist may perform a root canal before proceeding with the crown restoration. With new dental technology, in some cases it is now possible to complete crown placement procedures in a single office visit.

Dental Crowns vs Dental Veneers
Metal, ceramic, or porcelain crowns improve both the appearance and function of injured or damaged teeth. Dental veneers, on the other hand, typically address only cosmetic concerns (e.g. stains, minor chips, misalignment, or other imperfections) and are applied to otherwise healthy teeth. Also, because they cover less of the natural tooth, less tooth structure has to be removed to accommodate dental veneers. Dr. Glueckert-Reinicke can provide more information on crowns vs veneers and help determine which treatment is best for you based on your specific needs.

 

Dental Bridges

Missing teeth can adversely affect the appearance and functionality of your smile. Missing teeth can cause a change in occlusion (bite) and /or a shifting of the teeth and may contribute to TMJ disorder, an increased risk for gum disease, tooth decay, and speech and chewing impediments. A dental bridge is a custom-made artificial tooth (or teeth) used to replace a missing tooth, literally "bridging the gap" where a tooth or a group of teeth may have been. A bridge can help maintain the shape of your face and restore your beautiful smile.

A dental bridge can be attached to the teeth on both side of a gap in one of three ways:

  1. Attached to dental crowns placed on both sides of the missing teeth
  2. Attached to the back of the adjacent teeth with wing-like appendages
  3. Anchored by dental implants

Types of Bridges
There are several types of fixed dental bridges used in dentistry today. These include conventional fixed bridgescantilever bridges and resin-bonded bridges. Conventional and cantilever bridges typically require re-shaping of the two teeth surrounding the missing tooth or teeth. Dental crowns are placed on these two teeth and attached to the artificial tooth or teeth (called a pontic). A resin-bonded bridge is often used to replace front teeth (provided that the gums are healthy and the surrounding teeth do not have extensive dental fillings). The dentist does a very minimal tooth preparation behind the tooth of the adjacent teeth and bonds a "wing" type retainer to the back of the supporting teeth, which is then attached to the replacement tooth. Because the wing appendages can be made of tooth-colored material, this type of bridge usually has a more natural apeparance. It's also a more conservative process as it requires less removal of the of the supporting tooth structure. However, a resin-bonded bridge may not be as strong as a conventional bridge.

An implant bridge attaches artificial teeth directly to the jaw or under the gum tissue through an in-office surgical procedure. Click for more on Dental Implants...

removable bridge is also called a partial denture. Removable bridges can be removed from the mouth for cleaning, and are less expensive than permanent or fixed bridges, though not as stable or comfortable. Removable dentures are attached to permanent teeth with metal or hight-tech platic clasps.

Whatever type of bridge your dentist recommends, its success depends on a good foundation for the bridge, which means keeping the remaining teeth healthy and strong.

The Dental Bridge Procedure
Your dentist first examines the health of your gums and other teeth to determine if you are a good candidate for a dental bridge. A bridge requires at least two visits for preparation and fitting.

During the first visit, you're given a local anesthetic so you can be relaxed, pain-free, and comfortable as the support teeth are prepared for the bridge. If the support teeth are decayed or badly broken down, they may have to be built up and strengthened before they can be used as support teeth for a bridge (depending on your situation, this may require an additional visit). An impression/mold of the prepared support teeth is taken with a putty-like material that's used to create a model of your teeth. This is sent to a dental laboratory where a skilled lab technician fabricates your dental bridge based on the model.

While your bridge is being fabricated, you're fitted with a temporary bridge so the prepared teeth and gums can be protected from damage until your permanent bridge is ready. To complete the procedure, the permanent bridge is fitted and cemented to the support teeth during a second visit.

DEntal Bridge Procedure

The procedure described above is for a fixed bridge. For some patients with special requirements, the dental bridge procedure is altered to meet specific goals. For example, if the dental bridge is to be anchored by an implant, the steps in the dental procedure procedure will be slightly different, as you will need to spend some time in having the implant put in place. If the supporting tooth is extremely damaged, your dentist may also perform a root canal therapy on it first before attaching the dental bridge.

For removable bridges, the procedure is similar, except that preparation of adjoining teeth is not as involved, or may not be needed at all. On the initial visit, impressions and models are made of your mouth, together with some measurements. You and your dentist also select a tooth shade to match your existing teeth. These specs are then sent to a dental lab (along with your impressions/models) for the fabrication of a partial denture. During the second visit, your dentist will let you try out the partial denture (with the replacement teeth set in wax---adjustments can be made as necessary to this model). When everything fits properly, the partial denture is returned to the lab for final fabrication. During a third visit, your dentist will make final adjustments on your finished partial denture to ensure that they fit in your mouth comfortably.

Caring for Dental Bridges
Bridges need the same meticulous care as natural teeth. To maintain the appearance and health of supporting teeth and gums, you need to maintain good dental care habits: regular brushing, flossing, and professional preventive treatments. For implant-supported bridges, you will need special flosses and cleaning instruments, which your dentist can provide. In taking care of partial dentures. It's best to remove it after every meal for cleaning. At night, it's soaked in water with an effervescent denture cleaning tablet.

For more information on Dental Crowns & Bridges, please call our office at (719) 597-6300 to schedule a consultation.