Crowns & Bridges
Crowns and bridges are examples of prosthetic dentistry (Prosthodontic). Crowns are used to replace parts of teeth and bridges are used to replace whole teeth that are missing from an arch. Each involves taking models and sending them to a dental lab where crowns and bridges are custom fabricated for each patient. Because these are custom prosthetics, crowns and bridge can be expensive.
A crown or cap is usually placed because the remaining tooth structure is not capable of adequately supporting or retaining a regular filling. In addition, a crown will help hold together and support the remaining tooth structure, thus minimizing the chance that a tooth could fracture.
A crown will not eliminate the possibility of decay. Though the crown itself will not decay, the tooth could decay along the edges of the crown if not properly maintained.
Placing a crown usually involves two visits after decay and old filling are removed. In the case of a severely damaged tooth, a core may be needed to hold the crown in place.
The first visit involves preparation (shaping) of the tooth to make room for the crown, making an impression (mold) for the lab to fabricate the crown on, and placement of an acrylic temporary to keep the tooth and gums in place.
A second visit is needed to fit and permanently cement the crown after we get it back from the lab.
Porcelain fused to metal are the type usually placed in our office.
Bridges are used to replace missing teeth. Why is that important? Because teeth in front of space will drift back, creating spaces in between front teeth. Teeth behind the missing tooth space will tilt forward. And the tooth above the missing tooth space will grow down (erupt) down into the tooth space.
Because these teeth drift out of position, several conditions may occur: severe occlusal (bite) problems that could lead to clicking of the jaw, headaches, and jaw pain ; hard to clean areas are created which will lead to tooth decay, gum disease, and bone loss; a change in facial appearance.
There are several ways to place or secure a bridge. Some of the more common types are:
A fixed bridge is either cemented in place over the adjacent teeth just like a single crown or bonded to adjacent teeth, depending upon the circumstances. (see graphics)
They are not removable. As in a crown, a bridge can be made of white porcelain, gold, a silver colored metal, or a combination of these.
A removable partial is designed to be inserted and removed by the patient. It is held in place by metal clasps surrounding your natural teeth. It can be used in place of a fixed bridge or in cases where a fixed bridge cannot be used.
In most cases today, implants are a good choice for a tooth. Implants are very predictable and successful. They avoid having to drill on adjacent teeth.
There are two phases:
- Surgical, where a titanium fixture is placed into the jaw bone. This is usually done by an oral surgeon.
- Reconstruction after healing (3 to 6 months), where
the replacement is fabricated over the integrated titanium fixture.