Crowns & Bridges

DENTAL CROWNS.

Permanent crowns can be made from stainless steel, all metal (such as gold or another alloy), porcelain-fused-to-metal, all resin, or all ceramic.

  • Stainless steel crowns are prefabricated crowns that are used on permanent teeth primarily as a temporary measure.
    The crown protects the tooth or filling while a permanent crown is made from another material. For children, a stainless steel crown is commonly used to fit over a primary tooth that’s been prepared to fit it. The crown covers the entire tooth and protects it from further decay. When the primary tooth comes out to make room for the permanent tooth, the crown comes out naturally with it. In general, stainless steel crowns are used for children’s teeth because they don’t require multiple dental visits to put in place and so are more cost- effective than custom-made crowns and prophylactic dental care needed to protect a tooth without a crown.

  • Metals used in crowns include gold alloy, other alloys (for example, palladium), or a base-metal alloy (for example, nickel or chromium).
    Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.

  • Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns).
    However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown’s porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.

  • All-resin dental crowns are less expensive than other crown types.
    However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.

  • All-ceramic or all-porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metal allergies.
    However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.

  • Temporary versus permanent.
    Temporary crowns can be made in your dentist’s office, whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by a lab.

  • Zirconia or milled crown which are digitally constructed either in an office that has the software and hardware to produce them or in a dental lab.
    Dental offices that have the software and hardware have the ability to produce a crown in one visit with no need for a temporary. These crowns require no impression.


DENTAL BRIDGES

Dental bridges are a good way to restore your smile and function of your teeth. They ease chewing and speaking. The remaining teeth are also held in place; the bridge will prevent them from drifting out of their positions.

About the procedure.

During the first visit, the abutment teeth are prepared. Preparation involves recontouring these teeth by removing a portion of enamel to allow room for a crown to be placed over them. Next, impressions of your teeth are made, which serve as a model from which the bridge, pontic, and crowns will be made by a dental laboratory.
Your dentist will make a temporary bridge for you to wear to protect the exposed teeth and gums while your bridge is being made.

During the second visit, your temporary bridge will be removed and the new permanent bridge will be checked and adjusted, as necessary, to achieve a proper fit.
Multiple visits may be required to check the fit of the metal framework and bite. This is dependent on each individual’s case. If the dental bridge is a fixed (permanent) bridge, your dentist may temporarily cement it in place for a couple of weeks to make sure it is fitting properly.
After a couple weeks, the bridge is permanently cemented into place.

Types of dental bridges.

There are three main types of dental bridges; Traditional, Cantilever and Maryland bonded bridges.

Most procedures involve traditional bridges and these are described further in the article.
Cantilever bridges are basically bridges that are fixed only on one side. They are less strong and resilient and are not suited for teeth at the back of the mouth. Maryland bridges use “wings” on the sides of the artificial tooth, which means that less or no damage to the adjacent teeth has to be done. The downside is that such a bridge is less strong.
Traditional bridges involve creating a crown for the tooth or implant both sides of the missing tooth, with a pontic (artificial tooth) in between. Traditional bridges are most commonly made made of either porcelain fused to metal or ceramics. While they can be bade from silver and gold amalgams, porcelain is used most as it looks natural.

During the first visit, the abutment teeth are prepared.
The abutment teeth are teeth that will hold the dental bridge. Abutment teeth should be healthy to be able to hold the bridge and absorb the forces. These teeth are recontoured – a small portion of tooth enamel is removed so that the crown can be fixed on them. This process is done with a local anesthetic. Then the dentist will make impressions of your teeth. These serve as a model from which the bridge, pontic, and crowns will be custom made in a dental laboratory.
The dentist will also take the shade of your teeth so that the laboratory can make the bridge to look as natural as possible. Your dentist will also make a temporary bridge for you. It is used to protect the exposed teeth and gums while your bridge is being made, to prevent any damage and pain that might occur otherwise. The permanent bridge should arrive within a few weeks.

During the second visit, the dentist will remove your temporary bridge and adjust the new, permanent dental bridge to achieve a proper fit.
Your dentist may require you to visit multiple times to check the fit of the metal framework and bite, depending on the individual and the complexity of the dental bridge.

Generally, two appointments are enough.
When the bridge fits properly and you are satisfied with the shade, the dentist will use dental cement to bond the bridge to the teeth. There may be some discomfort in the initial few days, but everything should quickly return to normal.

Dental bridges are a great way of achieving natural bite and tooth function. They look aesthetically pleasing, just like natural teeth. It is not very difficult to care for them, but care needs to be taken to clean under the bridge to avoid plaque build-up. Due to the nature of the bridge, it is impossible to floss between the teeth, but underside should be cleaned well daily. Flossing each day is recommended, along with brushing your teeth. They also last for a very long time and don’t need to be removed for cleaning. Most bridges last at least five to 15 years. If properly cared for, they should last for at least 10 years. Those with resin bridges should be more careful about which food they eat and how hard they chew; resin is weaker than the traditional, ceramic dental bridges.

A major drawback, though, is that parts of adjacent healthy teeth need to be removed for the bridge to fit properly. Should these teeth fail, the bridge may need to be extended or it, too, will fail. As there is no root below the bridge (pontic), the bone may begin to deteriorate and cause jaw defects. Dental implants do not suffer from these problems, but are significantly more time-consuming and more expensive. Dental bridges may also be attached to dental implants. The cost for dental bridges varies depending on the type of bridge selected. Most dental insurances cover at least a portion of the cost. Generally speaking, dental bridges are a good way of ensuring normal function of your teeth and should be considered if you have missing teeth and think you might benefit from this type of treatment.

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