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Crowns

Imagine doing all your chewing on just a few teeth. This is what often happens when one or more teeth are worn, damaged, missing, or have been so heavily filled they can no longer do their job. Losing the back teeth support can threaten the longevity of the front teeth. The health of other teeth can also be threatened. If teeth are not restored or replaced, this can progressively lead to bite changes, increased loading, wear and fracture of adjacent teeth, and even jaw joint and muscle problems, not to mention aesthetic problems.

What are crowns and bridges?

A crown is a capping that fits over and around a tooth to protect it. Some tooth structure must be removed to make room for it but, once it is cemented into position, it usually makes the tooth much stronger and more attractive than before. Crowns can also be done on implants. A bridge is where a tooth is missing and crowns on the adjacent teeth or implants (the "abutments") are used to support the false tooth (the "pontic") or teeth in between. Bridges restore aesthetics and stability after a tooth is lost. Our patient below has tooth mass loss from past dental caries and faulty restorations, resulting in discoloured, weakened tooth structural integrity that would affect tooth longevity).

When teeth are extensively restored, chipped, fractured or have compromised structural integrity, we consider crowns to restore teeth to optimal strength and aesthetics. Our patient here required ten upper porcelain crowns to restore function, harmony & aesthetics.

Reasons for having crowns

Large, worn, fractured or defective fillings. Crowns can work where there is not enough tooth structure to support a normal filling. Once a tooth is 65% filled, it probably needs a crown. Fractured teeth are caused by cracks, trauma, large unsupported fillings or habitual or accidental grinding and clenching. A crown can physically bind the cusps together preventing them from flexing under load.
Endodontically treated teeth (teeth which have previously had a root canal therapy). If a tooth is not restored promptly, bacteria can contaminate the root canal therapy or cause recurrent decay. Molars and premolars that are endodontically treated are at risk of root fracture. An appropriate post and core system and crown can give them an excellent long term prognosis.
Missing teeth. Shifting and tipping of adjacent teeth can lead to changes in the jaw muscles, bones and joints, and make chewing and cleaning harder.

Procedures

Preparation (usually one but often two appointments)

Removal of existing filling materials from the tooth or teeth to be crowned
Core or foundation build-up (composite resin)
Crown preparation (removal of 1-1.5mm of tooth structure from the top and sides of the tooth)
Provisional crown or bridge construction
Detailed impressions, bite registration
Cementing of the provisional crown or bridge

Issue (usually 2-3 weeks later, sometimes two appointments if modifications are required)

Removal of the provisional crown or bridge
Cleaning of the tooth and isolation of the margin

Designer Smiles Dental Centre: Cnr. Gerard and Winnie Streets, Sydney, NSW, Australia
Phone (02) 9953-5953 or (02) 9953-4189, Fax (02) 9953-4358
Cremorne 2090 Hours 7:15AM-6:00PM, M to F