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Crowns & Bridges

Crowns & Bridges

Crowns

A crown (sometimes referred to as a Cap) is a covering for a tooth that is fabricated outside of the mouth. Typically, these are a permanent way to restore a tooth when a large portion of the tooth, above and or below the gum line has that has been damaged by trauma or a cavity or has been restored in the past with a large filling that may be breaking down. Crowns can also be used to treat teeth that have deep cracks running into the tooth or fractures in them. Crowns are also used over an implant abutment to replace a missing tooth. Many different materials can be used to make a crown including: Porcelain, Gold, Precious Metals, Resin Composites, Acrylics, or sometimes a combination of these together. All Porcelain crowns, have the ability to, closely match a natural tooth in appearance and are often the material of choice in esthetic zones.

The treatment procedure for a patient receiving a crown involves:
1. Placing anesthesia and removing a failing crown or restoration or decay.
2. Rebuilding the foundation of the tooth so as to provide a stable base for the crown.
3. Preparing the tooth for a crown by removing the outer layer of the tooth by about the thickness of a dime or quarter.
4. Taking an impression of the prepared tooth and sending this to a laboratory to have a custom crown fabricated (usually a dental lab) or optically scanning and milling a crown in the office during your visit.
5. Fabricating and temporarily cementing a provisional crown for 3-4 weeks.
6. Returning in 2-3 weeks to adjust and cement/bond in your permanent crown.

The entire process involves 2 separate appointments and typically about 3-4 weeks in between the appointments.

Crowns can last a lifetime if cared for properly. Typically, a crown can last anywhere between 5-20 plus years, if maintained. It is critical that the crown be cared for just like a normal tooth, so brushing and flossing around all sides of the crown and avoiding hard foods like ice, or hard candies are directly correlated with how long a crown will last.

Bridges

A bridge is a like a suspension bridge in design. The goal of a bridge is to permanently replace a missing tooth. It requires a healthy tooth/teeth or implants on either side of the missing tooth/teeth it intends to replace. In design, a bridge has one or more crowns on each support tooth on either side of the space where the tooth or teeth are missing. Typically, materials used for bridges are porcelain (zirconia), gold or other precious metals or a combination of these materials.

The photo above demonstrates a bridge that replaces the two front teeth and has two support teeth on either side of that space. In esthetic zones with more than one missing tooth, a porcelain bridge like the one above that we did in our office, look better than restoring the missing teeth with implants, especially if bone or tissue support are lost.

A bridge is a great option to help:
Prevent teeth from shifting or drifting into an open space. It helps stabilize the bite and reduce the risk of periodontal disease and or bite and jaw problems.

Replace missing teeth in a smile zone with something natural and permanent.

Bridges come in three different designs:
A Fixed bridge- this is the most common type, and consists of a pontic (replacement) tooth that is attached to two crowns, fitted over the existing teeth that hold the bridge in place.
A “Maryland” bridge is often used to replace missing front teeth and consists of a pontic (replacement) tooth that is attached to metal bands that are bonded to the inside of the abutment teeth. The metal bands consist of a white-colored composite resin that matches existing tooth color.
A Cantilever bridge is often used when there are teeth on only one side of the span. A typical cantilever bridge consists of one or more crowned teeth positioned next to each other on the same side of the missing tooth space. The pontic (replacement) tooth is then connected to the crowned teeth, which extend into the missing tooth space but do not link up with a crown on the other side of the missing space.

The treatment procedure for a patient receiving bridge involves:
1. Placing anesthesia and removing a failing crown or restoration or decay.
2. Rebuilding the foundation of the teeth to provide a stable bases for the bridge.
3. Preparing the teeth for a bridge by removing the outer layer of the tooth by about the thickness of a dime or quarter for each support tooth involved.
4. Taking an impression of the prepared teeth and sending this to a laboratory to have a custom bridge fabricated.
5. Fabricating and temporarily cementing a provisional bridge for 3-4 weeks.
6. Returning in 2-3 weeks to adjust and cement/bond in your permanent bridge.

The entire process involves 2-3 separate appointments and typically about 3-4 weeks in between the appointments. Sometimes a try in appointment is scheduled between the start and delivery appointments to ensure proper fit at delivery.