If your tooth has broken and your dentist tells you you need a crown, count yourself lucky! Often, when a tooth breaks, the break can occur deep enough that the tooth needs a root canal before the crown, or it can break below the level of bone rendering the tooth non-restorable.
Once that tooth is extracted, it is usually recommended to replace it with an implant or bridge that costs thousands of dollars. That crown is starting to sound pretty good, huh? A dentist will often recommend crowns for teeth that they see are at risk for fracture, such as teeth that have very large fillings, or teeth that show fracture lines especially if the patient has a history of grinding or clenching.
Large filling: Every time you get a cavity in a tooth, more tooth structure needs to be removed in order to fill it. Thus, if you have a tooth that has been filled multiple times over the years, there is often very little tooth left for us to work with.
If there is very little natural tooth surface area left, the bond will be weak and the filling will fail. Also, the composite material is not nearly as strong as the materials used to make crowns gold or porcelain , so the chances that the filling or the tooth will break are much higher with very, very large fillings.
How long to they last? What are the types of crowns? What is a crown, anyway? Don't be afraid to ask about estimates on how many patients the practice treats with fillings versus patients that receive crowns.
And all team members should be willing and able to describe the dentist's position when it comes to keeping the natural tooth intact. Ask about their equipment, their criteria for deciding when a crown is necessary, their continuing education and professional development, or anything else that seems relevant.
After all, it's your teeth. Avoid snacks like popcorn, gummies, licorice, and other foods that stick to or get stuck between your teeth. Eliminate habits like crunching on ice and hard candies. Nostalgic for that everlasting gopper stopper or jawbreaker? Chomping down on these goodies can push a weakened, compromised tooth over the edge.
Finally, the best thing for your teeth is preventative care: Brush at least twice a day, floss at least once, use an ADA-approved dental rinse, and have your teeth professionally cleaned at least twice a year.
Linger uses a conservative approach to tooth restoration and employs the operating microscope for all restorative procedures. By doing so, he can now apply fillings to teeth which may have required a crown just a few years ago. Linger reserves the placement of crowns for when the health of surrounding teeth is endangered. Besides working extensively with the operating microscope, he specializes in using a caring approach to dentistry, keeping the patient's comfort a priority.
If you have any questions about restorative treatment or would like a free consultation in Charlotte, NC, don't hesitate to contact us. Sign up for updates on our blog to receive them: instantly, weekly or on a monthly basis.
Get the latest dental health tips and advice delivered to your email. We want to be your full-service dental office. Linger has been a trusted, reliable, and popular top rated Charlotte dentist for the past 20 years. The support team that we have built inside the office includes the best dental assistants, hygienists, patient comfort specialists, and cheerful front office professionals.
Financial Assistance Available. Because they can be manufactured in a very thin layer without losing their solid and robust properties, metal crowns require the least tooth structure to be removed compared to other types of crowns, which preserves the core of the tooth for maximum strength and retention.
Metal crowns provide a strong bond to the tooth, and withstand biting and chewing forces very well. Due to their single-component construction and the superior strength and durability characteristics they possess, they last the longest in terms of wear.
They also have excellent biocompatibility properties. The drawback and disadvantage of these crowns is the metallic colour, which does not have the quality of a natural aesthetic appearance.
However, they are a good choice for out-of-sight molars the teeth at the back of your mouth , especially where space is minimal between teeth. They are also a good option if you have a severe habit of teeth grinding or jaw clenching.
Instead, they are made using specific types of metal alloys. An alloy is basically a blend of materials. Alloys are useful because they combine the best characteristics of the elements used to make them, which creates a resulting metal that is more chemically stable and with superior properties than the pure elements could have alone.
This means alloys can be specially engineered to possess the ideal physical qualities for specific purposes, such as in dentistry: greater strength, resistance to corrosion and wear, and the structure to be easily fabricated and adjusted by the lab technician and dentist. In general, there are three basic categories of dental alloys that can be used to make crowns.
They are: high noble alloys precious metal , noble alloys semiprecious metal and non-noble or base alloys nonprecious metal.
Noble metals are resistant to corrosion and oxidation in moisture or air, are not easily attacked by acids, have high biocompatibility, and retain a shiny metallic surface when under heat treatment. The noble metals used in dentistry are gold and those from the platinum group, most commonly platinum heavy category and palladium light category.
Precious metals are defined as rare, naturally occurring and of high economic value. They are also extremely malleable able to be bent without breaking and ductile able to be stretched. Noble metals have the advantage that they are the easiest and most predictable to work with, ensuring the most accurate fit and bond. The rest of the alloy is made up of base metals such as tin, copper and iron which help form an oxide layer to provide a chemical bond to the tooth.
These are also referred to as base metal alloys. They are more reactive to atmosphere than noble metals and will oxidise, tarnish and corrode relatively easily when exposed to moisture, air or acidity. Examples of base metals include aluminium, copper, nickel and tin.
Base metals are more challenging for lab technicians and dentists to work with as they have a very high melting temperature, making soldering and casting difficult. They also exhibit shrinkage during casting which must be compensated for.
An advantage of base metals is that they are much harder and stronger than noble metals, and exhibit twice the elasticity. Therefore alloys can be made into thinner crowns whilst still retaining the rigidity required for dental applications.
However their hardness also makes them difficult to burnish and polish. Two common types are titanium alloys and alloys made from a mix of cobalt, nickel and chromium which increases corrosion and tarnish resistance. Nickel free can be used if a patient has allergies. An all ceramic crown is referred to as an ITEM you will see this on treatment plans and invoicing from your dentist.
All ceramic dental crowns provide a natural appearance and colour match that is amazingly lifelike and unsurpassed by any other type of crown. The lustrous, glistening optical quality of a natural tooth is generated by the way light passes through the tooth and is then reflected out. The goal in the creation of a ceramic crown is to mimic the light handling characteristics, and therefore appearance, of a natural tooth. Generally speaking, the best way to achieve this effect is to use very translucent porcelain in a thick layer.
All ceramic crowns are the most natural looking option for front teeth. They are also a good choice for patients who have allergies to particular metals used in other types of crowns. Some disadvantages of ceramic crowns are that they wear down opposing teeth more than metal and resin crowns do, but they are still less abrasive than porcelain-fused-to-metal crowns which we will discuss later.
They also require more tooth structure to be removed than for example metal crowns because of the thickness of porcelain required for sufficient crown strength with the exception of Zirconia crowns which are explained below. The major risk with ceramic crowns is that they can fracture, which can lead to infection and failure if not treated appropriately by a dental surgeon.
There are many different types of ceramic crowns and brands of materials available. Some of the main kinds are:. Feldspathic porcelain is the traditional, standard porcelain material that has been used to create crowns for many years. It is a luminous material that offers a very natural and translucent appearance. These crowns are created by custom layering the porcelain and can either be bonded directly to the natural tooth surface which transmits the underlying tooth colour through the porcelain , or layered over a pre-built core for example from Zirconia — see point 2 below.
Zirconia crowns are the hardest and strongest type of ceramic crown available. Zirconia is a type of crystal that is extremely durable and virtually indestructible, which is why these crowns are so long wearing and withstand biting and chewing forces exceptionally well. They are colour matched to the natural teeth, however are not as translucent and light-reflecting as other porcelain crowns due to the very opaque colour of the ceramic.
They can also be abrasive and there is greater risk of them wearing down the opposing teeth. Unlike Zirconia, this material is more porous and can therefore be acid etched before cementation, which creates a chemical bond between the crown and tooth making the adhesion very strong.
They are also the most aesthetic type of porcelain crowns available as they have excellent translucent light-reflective properties, which results in the closest match to natural teeth.
Procera, Empress and Emax are three different kinds of aluminous crowns and we will discuss them each below:. Procera crowns are made through a two-layer system. Then feldspathic porcelain is stacked in a superficial outer later to give the crown more translucent, lifelike aesthetic properties. Procera crowns are exceptionally strong. Empress is more like glass than porcelain. Unlike normal feldspathic porcelain which is baked, Empress crowns are cast and give a more precise fit.
The inner core is made out of medium-strength pressed ceramic, and then a highly customisable, superficial glass is layered over the top. Emax crowns are made out of a lithium discilicate glass ceramic that has exceptional strength, translucency and durability properties. They are very biocompatible in the mouth and have excellent long term wear characteristics similar to that of natural enamel the outer layer of your teeth.
They are strong enough to be made into very thin layers and still easily withstand biting and chewing forces. A porcelain-fused-to-metal crown is referred to as an ITEM you will see this on treatment plans and invoicing from your dentist.
PFM crowns are made up of two components. Porcelain which is a type of ceramic is then layered over and bonded to the metal base to give the crown its tooth-like shape and colour. In a way a PFM crown gives the best of both worlds for strength and aesthetics, which means they are a suitable choice for either front or back teeth. Next to all-metal crowns, they are the second most long-wearing choice.
The metal core is very hard and durable, and is able to be acid etched unlike Zirconia cores, which you can read about above for strong adhesion to the natural tooth. The porcelain that is layered on top to make up the visible portion of the crown creates a very attractive, lifelike result that is matched to the natural teeth colour. PFM crowns also have excellent biocompatibility properties.
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