Crowns & Bridges
Crowns
A crown is a covering that fits over a tooth and restores the tooth to its original shape and function. Crowns can be used to restore teeth that have had significant decay or tooth wear, fractured or broken teeth, and to add strength to teeth that have had root canal treatment. Crowns are made of porcelain, metal or a combination of the two materials. Porcelain crowns often have a metal substructure for added strength and durability, however for front teeth, all porcelain crowns can be constructed for a more natural and aesthetic smile.
The procedure for fitting a new crown is typically completed in two or three appointments. The first appointment involves re-shaping the tooth to provide an ideal fit for the crown and making an impression of the teeth. From this impression a temporary crown is constructed and temporarily cemented to the tooth. This same impression also provides the model for the dental laboratory to fabricate the actual crown. During the next appointment the permanent crown will be fit onto the tooth and after ensuring the crown has the proper look and fit, it is cemented into place. Depending upon the area of the mouth in which the tooth is located an additional appointment may be advisable to evaluate the contour and color of the temporary crown before work on the actual crown is completed.
Once the crown procedure is completed, proper oral hygiene and maintenance are required to prevent the development of gum disease around the crowned teeth or dental decay from occurring around and/or underneath the crowns. Similarly, proper preventative habits will ensure the longevity of your new crowns.
Bridges
A bridge is a non-removable (fixed), natural appearing dental restoration that is constructed to replace one or more missing teeth. A bridge helps prevent shifting of the teeth that can lead to bite (occlusion) problems, jaw (TMJ) problems, and resultant periodontal disease. Similarly, a bridge restores chewing function and helps to support the facial structures allowing for a more natural youthful appearance.A bridge is made out of porcelain with a metal substructure that provides added strength and durability. There are three main types of bridges:
- A fixed-bridge is the most common type of bridge. This bridge requires the support of the teeth adjacent (abutments) to the missing tooth space. The adjacent teeth are re-shaped to allow for the bridge to fit over the top with artificial teeth (pontics) filling the space in between.
- A “Maryland” bridge consists of an artificial tooth or pontic which fills in the missing tooth space and two “wings” that attach onto the back side of the adjacent teeth.
- A Cantilever bridge may be used when there are teeth on only one side of the missing tooth space. The last remaining teeth within the dental arch are used as abutments and the pontic tooth extends off of the abutment teeth filling the open space.
Cemented Bridge vs. Dental Implant Supported Restoration
There are two patients here with similar presenting circumstances, each missing a single front tooth.The first patient replaced the front tooth with a traditional cemented or fixed ‘bridge’ restoration where the teeth on either side of the space are prepared in similar fashion to a crown or cap (A, B). A custom-designed restoration is made with the appearance of 3 individual teeth and is cemented onto the teeth on either side of the area where the tooth is missing (C).
The second patient elected to have the restoration in the area of the missing tooth supported by a dental implant. The dental implant is essentially a titanium tooth root that anchors the portion of the tooth that is visible (D). The metal component between the two prepared teeth is an abutment that is attached to the dental implant (E). The crown is cemented in a manner similar to the procedure on a natural tooth (F). The dental implant supported restoration allows for all three teeth to take on the appropriate amount of chewing forces without overload.
