Dental Crowns: Purpose, Procedure and Important Facts
The use of dental crowns by millions of people from all over the world during the last century has been a mainstay in dentistry. Prior to the development of crown technology the primary treatment for decaying, weak, fractured, or discolored tooth-teeth was extraction.
What exactly is a crown?
Dental crowns, also known as caps were innovated and designed to help maintain the functionality of your damaged or diseased tooth-teeth. By using a custom design and specific materials, a manufactured crown can restore the strength, shape, size and natural appearance of your original tooth-teeth. The rationale for installing a crown is to fully encapsulate and protect the last bit of your own compromised tooth and tooth roots.
The procedure for preparing your tooth for a crown should be carefully performed by a competent dentist to insure a secure fitting crown. This can be accomplished by reducing its size by 0.8 – 1.5 mm (drilling it sideways), to create a balanced and stable tooth stump. If the process is successful there should be enough room for the crown to be placed securely on top of your tooth stump.
There are several decisions that your dentist will need to make during the process which will vary depending on the situation of the specific tooth-teeth being capped:
1. During the preparation phase it must be determined if your crown will be placed above or below the gum line?
The design of your crown and placement under or above the gum line depends on esthetics, stability of the fit and hygienic benefits of it final positioning. Great care must be exercised to insure your permanent crown prevents future complications or damages to the health of your remaining tooth, its root and surrounding gum tissue.
2. How much tooth reduction should be considered and allowed to achieve an optimal crown situation?
There are established clinical guidelines that dictate the maximum reduction limits which are based on conditional necessity to provide the longest lasting results.
Reducing less of your natural tooth surface while insuring a secure and perfect fit, is the purpose and intention with dental crown placements.
Deciding upon the appropriate material for your dental crowns is also a serious matter, as each option presents its own peculiar set of pluses and minuses. Some of the names of the various materials now used in crown design and manufacturing at WIC, include E.max, Empress, Lava, Bruxer, Titanium, Gold, Gold alloys, Zirconium and Prettau.
The right crown material will essentially depend upon the following 3 key factors:
- How much strength is needed? More strength sometimes compromises the quality of esthetics (translucency)!
- How do we want the crown to appear after the treatment?
- What type of retention and bonding strength will your crown provide?
Most of these considerations will be decided by your dentist! Keep in mind there are many options and the pricing structure varies considerably depending on the procedure selection and the materials used.
Some of the common reasons crown are recommended are as follows:
- To salvage and restore a badly worn down or broken-cracked tooth
- To protect a weak tooth from decay
- To save a decaying tooth which is not structurally sound to survive a filling procedure
- To support a tooth with a large filling that has minimal remaining surface area
- To act as an anchor for a multiple tooth dental bridge
- To conceal and cover a severely discolored or misshaped tooth or teeth
- To prevent a tooth from breaking after a root canal treatment
- To cap your dental implants
- To improve your signature smile for cosmetic purposes
- To protect primary teeth, if there is a high risk for decay as evidenced by your child’s poor hygienic and home care habits
The primary objective of your dentist should be the same as your purpose, which is saving your tooth from early demise and extraction.
Be aware of the following 6 complications that can occur with dental crowns:
6. Your tooth can become overly sensitive or painful: There is always a risk with every crown preparation and placement that your previously live but challenged tooth may die.
This can manifest slowly as a long sensitive, drawn out decaying process, or instantly as a tooth ache indicating other complications. Research shows this type of situation occurs in less than 2% of tooth preparations that are completed. Dr. An a prominent dentist on staff at WIC states, “A helpful hint for dentist is to not over prepare a tooth, it’s better to use new tools and sharp burrs with ample water flushes to cool the tooth. It’s often excessive heat exposure and, or too much previous damage to the tooth that leads to the death of your tooth-teeth”.
5. Your crown keeps coming off: Some stumps aren’t as retentive as others, if you have a short stump or divergent walls it’s easy for a crown to keep coming off. This can be avoided by making changes during the design process! Also, if you have a crown made that is fitted too loosely, it will then by relying too much on the glue – cement for retention.
At WIC we have our own onsite dental lab which was established by a German master lab technician. This is a real advantage and can save a ton of your time, money, and make the whole process of fitting and adjusting your dental crowns much easier, more exacting.
4. Your crown color doesn’t match your real teeth over time: Unfortunately, if you have a crown made today, it’s likely in 5, 10 or 20 years it will no longer match your own teeth. This is because your natural teeth stain and your crown tooth will not.
A good tip is to invest in some teeth whitening every year to keep your natural teeth from permanently getting darker.
3. Your crown collects a lot of food around it: Crown contours are designed to fit the sides of your adjacent teeth tightly to prevent food from getting caught during meals. Sometimes these contact points can expand creating food traps, this can occur if your teeth shift or move.
2. Your crown breaks or chips: Unfortunately dental materials like your natural teeth are subject to wear and tear. The good news is that crowns made from newer materials like Prettau and Bruxer are as strong as gold! Therefore, by using quality materials you can decrease your risk of breakage or a fracture.
1. Your crown develops a cavity or starts to decay: Crowns like teeth need to be smooth and fitted well so you can keep them clean. You also need to floss, brush often and see your dental hygienist regularly to keep crown margins absolutely clean.
Feel free to contact the WIC at any one of our 4 convenient locations in HCM City and Hanoi to schedule an exam and consultation, and to figure out what’s best for you.
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