Restorative Dentistry

Crown Options

Restorative DentistryRestorative Dentistry: Crowns help strengthen and improve the appearance of heavily filled teeth. More extensive than a veneer, a crown completely covers the tooth to support and strengthen it.

We use 4 main types of crown: the full gold crown, the porcelain fused to precious metal crown, the porcelain fused to Zirconia crown, and the E-max crown.

  • Gold crowns are useful for strength and minimal tooth preparation, but are less aesthetic. They used to be regarded as material of choice for dentists.
  • Porcelain fused to metal crowns (also known as PFM, PBC or VMK crowns) are a tried and tested durable crown. They are tooth coloured but can look a bit flat and lifeless so are more appropriate for the posterior teeth.
  • Porcelain fused to Zirconia crowns are more aesthetic as well as being strong and are best suited to the anterior teeth.
  • E-max crowns are the most aesthetic giving a very natural look and are the best option for anterior teeth, although they are not quite as strong as Zirconia crowns. This porcelain crown is made from a single block of lithium disilicate ceramic.

The video below shows a PFM, looking a little lifeless, being replaced by a porcelain crown.

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Anterior crowns

A crown is an artificial restoration that fits over the remaining part of a prepared tooth, making it strong and giving it the shape of a natural tooth.

A crown is sometimes known as a ‘cap’.  Crowns are an ideal restoration for teeth that have been broken, or have been weakened by decay or a very large filling.  They can be made of porcelain with or without a metal substructure.

The procedure: the tooth is prepared and an impression taken.  A laboratory makes the crown from the impression, which is then cemented to the tooth.

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Crown margins

Over time the gum can recede away from the crown this is known as the crown margin.  The old crown can be removed and a new, deeper crown fitted to cover this area.

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Missing tooth options

When an anterior tooth is missing there are usually a number of solutions available to restore the gap.  You could have a false tooth made and fitted to a plate.  Alternatively a bridge can be fitted to an adjacent tooth.  Or you could have an implant placed, the advantage of which is that it doesn’t affect the adjacent teeth.

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A Comparative case – A missing front tooth from childhood

Sometimes a front tooth is lost when a child’s dental arches are still developing. This can leave the child with an asymmetrical smile into adulthood.
The following are 2 cases where this happened and the patients came to see me as adults to try to improve the appearance of their smile.

On the left (top & bottom) is a young woman who wanted to improve her asymmetrical smile without having to undergo orthodontics. We re-crowned her teeth to disguise the actual centre-line, to give a more balanced smile.

On the right (top & bottom) is a man who wanted to improve his asymmetrical smile but was happy to undergo orthodontic treatment. After the orthodontics was completed we removed the original crown and placed a 2 unit bridge, to give a more balanced smile.

Missing tooth options posterior

When a posterior tooth is missing there are usually a number of solutions available.  You could have a false tooth made and fitted to a plate.  Alternatively a bridge can be fitted to the adjacent teeth.  Or an implant may be the best solution.

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Missing tooth options when there are no teeth present

When a number of teeth are missing, there are various options available.  You may choose to have a denture.  But over time, your gums will recede and the denture may not fit as well.  You could choose to have implants to secure the denture.  One way is a small number of implants with a bar and magnets to hold the denture, another is a small number of Implants to which the denture is secured or a greater number of implants onto which a set of teeth and permanently fitted.

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Besides having dental implants, there are two main ways to replace missing teeth.  The first is with a removable false tooth or teeth – a partial denture.  The second is with a fixed bridge.  A bridge consists of a false tooth (or teeth) fused to one or more crowns, and can be made of porcelain or gold.

A dental bridge is usually used where there are fewer teeth to replace, or when the missing teeth are only on one side of the mouth.  There are two main types of bridge, conventional and adhesive, each with their own merits.

The procedure:  The adjacent teeth are prepared.  A bridge is made which exactly matches the space and is fitted across the gap.

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Adhesive Bridge

An adhesive bridge is non-destructive.  A bridge is prepared and ‘stuck’ to the inside of the adjacent tooth.

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Full dentures are made from acrylic resin and are the standard method for restoring normal appearance and function. BPS (Biofunctional Prosthetic System) dentures are our ‘gold standard’ and create very natural looking teeth as well as excellent fit and bite. Alternatively we can also make dentures using traditional techniques.

Partial dentures are used when several of your own teeth remain.  Plastic dentures can be heavy and also cover a large area of the palate effecting heat and taste sensitivity.  An alternative to a plastic denture is the chrome-cobalt denture which can solve all these problems and give good aesthetics and stability

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Implants are titanium posts that are screwed into, and fuse with, bone in order to replace missing teeth or to act as anchors for bridges or dentures.  We can advise when implants are suitable and can refer you to an implantologist for the placement prior to having the final crown or bridge placed at the practice.

The procedure:  a hole is prepared in the jaw bone in stages.  An implant is fitted and a healing cap inserted.  When the implant has healed, the healing cap is exposed and the implant abutment inserted.  A crown is then fitted to the abutment.

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