Replacing defective crowns

 

There are many different types of dental crowns.  Crowns are indicated when majority of tooth structure is missing.  Most of the times a crown will be followed by a root canal due to the amount of missing structure. Crowns may also be used for a missing tooth. In this case three teeth will be necessary in order to restore the missing one. We call this a bridge

 

There can be different types of defective crowns.  The most common reason for the replacement of an existing crown is recurrent caries at the interface between the crown and the tooth.  Recession of the gingiva and mismatched color may also be a reason for replacement.  Lastly, the crown may simply be misaligned leading to a need for replacement.

 

A good crown is important for the integrity of the tooth, esthetics and the proper function during mastication. In this case, the crowns had an esthetic problem.  They were too white and without translucency.  The crowns were also misaligned with the rest of the teeth.  Lastly, recurrent decay was present around the interface of the crown and the tooth. Sometimes, the decay around the tooth is so extensive that it becomes impossible to replace with new crowns. In those scenarios dental implants will be indicated.

 

In this case two dental implants were recommended to replace these crowns. The teeth were extracted before placing the dental implants due to extensive recurrent decay. A soft tissue graft and bone graft was completed to regain gingival and bone architecture.  The final step was to place porcelain crowns to reestablish the esthetics and the function of this patient.

 

The maintenance of the crown bridge is a little more difficult. To assure the long-term success of this bridge it will be necessary to have a professional crown and bridge cleaning. At home you will need to use super floss that can go under the bridge at the interface of the tooth and crown. This floss is dispensable to use once the crown and bridge is placed.

 


Crown Sequence

 

For your initial consultation appointment we will need to perform a clinical and radiographic examination to first determine if the tooth is restorable.  If your tooth is restorable and you are a candidate for a crown we will start tooth preparation and have your new crown in only 2 short appointments.

2.     Before we begin preparation of the tooth, we will first numb the work area. 

3.     While we wait we will make a mold of your teeth prior to the tooth being modified.

4.     After, establishing anesthesia we will prepare the tooth for the crown. 

5.     Once the tooth is reduced, we will make an impression for permanent crown fabrication by the dental laboratory.

6.     Lastly we will immediately fabricate a temporary/provisional crown with plastic from the first molds we made.  This is a temporary tooth so you must take care not to eat very chewing foods as it is only glued with temporary cement and can come off more easily than the permanent would.

7.     It will take 2 weeks for the lab to fabricate a ceramic crown.  Therefore, we will schedule your appointment for when the crown has arrived to the office.

8.     For your second appointment we will again numb the area then remove the temporary crown and clean the prepped tooth.

9.     we will cement the permanent ceramic crown and restore your bite back to normal occlusion.

10. We will request to see you in 6 months for a follow up examination of the crown and a routine cleaning appointment.