The dentist initially makes a molded impression of the teeth to be sent to the dental lab. A temporary crown is then fixed to protect the tooth while the final restoration is being made at the lab. Once it is ready the dentist would cement or bond it to your tooth.
CAD/CAM technology is used in restoration by creating a tooth through milling of a ceramic block. Some dental clinics may have this technology, in which case, there will be no need for a temporary crown or return visit for the final cementation.
Fixed partial dentures, also known as dental bridges, are continued dental crown treatments given in order to restore missing teeth. Crowns are placed on the teeth that are next to the missing tooth or teeth and connected to a missing tooth-like replica. Though fixed partial dentures can help as a functional and esthetic restoration, people usually opt for dental implant in order to restore missing teeth. A dental implant replaces a missing tooth/teeth with a titanium root replica. A crown is then placed on the implant above the gumline. Dental implants are a popular choice which helps the person in biting/chewing and more importantly avoids the unnecessary crowning of adjacent teeth.
Crown Materials: Gold, Ceramic and Porcelain Crowns
The three predominant choices of restorative materials for the full coverage crowns are:
- All-ceramic (all-porcelain)
The material selected is determined by the clinical demands at hand, esthetic demands, strength requirements, material durability and restorative space available.
People looking for strong, durable and esthetic teeth usually opt for Porcelain-fused-to-metal crowns. For an esthetic and functional success of this type of crown, the dentist will have to ensure that the underlying tooth structure provides ample space for the right thickness of the material selected. It has to be noted that the artistic skill of the lab technologist preparing the crown would determine the esthetic success.
A disadvantage in the porcelain-fused-to-metal crown is that these crowns may tend to show the underlying metal or gold margin at the gum line as gums retreat as time goes by. Some people opt for this procedure and replace the crown after sometime in order to retain the esthetic benefit. Using a porcelain collar along with the porcelain-fused-to-metal crown can eliminate this problem.
The predominant material choice for all-ceramic crowns today is either zirconia or aluminous materials. They provide a metal-free esthetic option with a number of benefits.
The need for supportive metal core can be eliminated and an esthetic all-ceramic crown can be created which has a reduced thickness of material. This makes them a better option in areas where there is very little space. The elimination of the metal core has its esthetic benefits too. It allows for light transmission through porcelain for better optical and life-like properties.
All-ceramic materials continue to evolve in strength and durability, but caution should still be exercised for areas of the mouth requiring heavy function. Continuing research is exploring the significant vulnerabilities of the porcelain systems in such areas.
Gold crowns are not a popular choice for esthetic reasons. People with para-functional habits like grinding or clenching might opt for a gold crown. The traditional material provides a stronger support to the tooth structure. Gold crowns do come a long way and require lesser preparation when compared to the porcelain and porcelain-fused-to-metal crowns. People with gold crowns have lesser risk of wearing of teeth during chewing, since gold is less abrasive when to the opposing teeth.