Crowns, Crown & Bridge Procedures



CROWNS
What Are Crowns?

A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening
and improving the appearance of a tooth. Prosthetic crowns are made of metal, porcelain fused to metal
substrates, or new all-white restorative materials. Crowns are necessary when a tooth is generally broken down
and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so
the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the
tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, cover badly shaped
or discolored teeth or protect a root-canal filled tooth with compromised strength.

How is a crown placed?

The tooth is numbed and prepared for the crown by removing any decay or weakened areas. The remaining tooth
structure is then reshaped to meet proper crown preparation design. If necessary, a restorative material, usually
a composite resin, is added to the remaining tooth structure to ensure that the prosthetic crown will have a good
 foundation. This procedure is called a "build-up."

If the dental decay is found to have gone deep to an extent where the living portion (dental pulp) is affected, root
canal procedures are essential prior to completion of the crown / bridge procedures. This is to avoid
complications from pulpal infections after the procedures have been carried out.



After the tooth is prepared, impressions of teeth and gums are made and sent to the dental laboratory for the
crown fabrication. On the next visit, the dentist cements the permanent crown onto the tooth. During the second
appointment, the new crown is placed on the tooth. Adjustments may be required to exact the perfect fit, so that
the crown will feel comfortable in the mouth and will conform to the bite. When the crown fits seamlessly and
contacts the neighboring teeth correctly, the crown is cemented on the tooth.

Will it look natural?

Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take an
impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape, and
length of your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain
cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is
complete, your teeth will not only be stronger, but they may be more attractive. Metal (vitallium) crowns will
have a metallic finish. However, it will resemble a normal tooth in shape and size.

What is the difference between a cap and a crown?

There is no difference between a cap and a crown.

How long do crowns last?

Crowns should last approximately 5-8 years. However, with good oral hygiene and supervision most crowns will
last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice, or fingernail
biting may cause this period of time to decrease significantly. The type of material used in crown fabrication also
affect the life of crowns.

How should I take care of my crowns?

To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects. You will also
have to avoid teeth grinding. Besides visiting your dentist and brushing in the correct manner twice a day,
cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and
sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that
area can cause dental decay and gum disease. Regularly scheduled examinations and hygiene appointments
must be adhered to, or the same bacterial assault, which causes decay and makes dental care necessary,
may cause the restorations to fail.












Porcelain Fused to Metal (PFM) Anterior Crowns




Metal Free Ceramic Anterior Crowns

 
More on Metal Free ceramic / All ceramic Crowns

 

A BRIDGE
What is a bridge?
A bridge is a dental appliance, made up of multiple crowns. It generally helps replace one or more natural
missing teeth, thereby "bridging" the space between two teeth. Bridges are cemented into place on the
"abutment" teeth i.e. the surrounding teeth on either side of the space or span, from which the bridge takes
support. Teeth called “pontics” which connects the crowns on abutment teeth together replace the missing
teeth. Unlike removable partial dentures, bridges cannot be taken out of the mouth by the patient.

Who should get a bridge?

A person with missing teeth and committed to maintaining good oral hygiene practices, is a good candidate for
a bridge. A bridge is the most natural choice to fill the space in the mouth left by missing teeth. If left unfilled,
this space can cause the surrounding teeth to drift out of position and can cause teeth and gums to become
more susceptible to tooth decay and gum disease that can cause further tooth loss. Bridges not only correct
an altered bite, improve the chewing ability and speech, but they also safeguard the appearance by preventing
the collapse of facial features that can cause premature wrinkles and age lines.

What types of bridges are there?
Besides traditional bridges, another popular design is the resin bonded or "Maryland" bridge, primarily used for
the front teeth. This is usually the most economical choice when the abutment teeth are healthy and don't
contain large fillings. The pontic is fused to metal bands that can be bonded to the abutment teeth with a resin
cement and hidden from view, reducing the amount of preparation on the adjacent teeth.

A cantilever bridge may be used if there are teeth on only one side of the span. This involves anchoring the
pontic to one side over one or more natural, adjacent teeth. If there are no adjacent teeth to act as anchors,an
implant is recommended--a metal post that is surgically embedded into the bone and capped with a crown as
an abutment. In some cases where the span is large, a removable partial denture is recommended or even an
implant-supported prosthesis.
 
What is the procedure of its fabrication?
For a traditional fixed bridge, the first appointment consists of the dentist reducing the adjacent abutment teeth
that will act as anchors. Impressions are made, from which a metal framework, including the pontic, is created.
By the second appointment, the final bridge is fitted over the teeth. The total treatment time is usually around
one week, depending on the type of bridge. However, because it is often difficult to match the natural shade of
your teeth, the treatment time may be longer.
 
How do I care for a bridge?
With a bridge, it is more important than ever to brush, floss and see the dentist regularly. If buildup of food debris
and plaque -the sticky film of bacteria formed from food acids-is not controlled, the teeth and gums can become
infected, requiring further treatment and resulting in possible loss of the bridge.We recommend using floss
threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums.
Crowns on the bridge cover most of the exposed portion of your tooth and decay does not affect a bridge since it
is made of metal and /or porcelain. However, where the natural tooth meets the crown of the bridge can become
decayed. If optimal oral hygiene care is maintained,a bridge can last for many years.

Suggestions and precautions


Adjustment period: It is ok for the bridge to feel a little out of place for a few days after cementing. This is
because the teeth around this area are adjusting to new forces both in between the teeth and upon biting.
 
Preventive Procedures: To provide optimum longevity for your restorations and to prevent future decay and
supporting-tissue breakdown, please use the following home care tips:
Brush after eating and before bedtime around the bridge with a soft toothbrush, especially where the crown or
bridge meets the gum line (margin). At this margin area harmful bacteria can be harbored to cause decay and
gum disease. An electric toothbrush is highly recommended over manual to help you keep this area clean
Floss at least once to twice a day. Use the proxy brush, floss threader or automatic flosser to remove plaque
under and around these areas to maintain good oral hygiene. On a bridge you must clean under as well as
around the bridge. If you do not control the buildup of food debris and plaque your teeth and gums can become
infected.

Water Pik can be used with an antibacterial, alcohol free mouthwash at the gum line and under the bridge to
keep this area healthy

Fluoride rinse is to be used before bed. Swish the fluoride rinse vigorously in your mouth for at least one minute.
 
Do not swallow any of the rinse and do not eat or drink anything for 30 minutes.

Use a proxybrush (interdental brush) to clean around the area after each meal
 
Chewing: Do not chew hard foods on the restorations for 24 hours from the time they were cemented to attain
optimum strength, the cement must mature for approximately 24 hours Also avoid eating or chewing on hard
objects, food or ice

Limit snacks, if high in sugar brush this area or swish with water
 
Sensitivity: Do not worry about mild sensitivity to hot or cold foods. This sensitivity will disappear gradually over
a few weeks. Infrequently, sensitivity last longer than six weeks.
 
Recare: Inadequate return for examination is the most significant reason for prostheses failure. Visit us at
regular six-month examination periods. Often problems that are developing around the restorations can be found
at an early stage where they can be corrected easily and will be more affordable. Waiting for a longer time may
require re-doing the entire restoration.
 
Problems: Call us immediately if any one of these conditions occurs: If the tooth is the first tooth to hit when
you bite down after a couple of days, contact us for an adjustment; a feeling of movement or looseness in the
restoration; sensitivity to sweet foods; a peculiar taste from the restoration site; breakage of a piece of material
from the restoration or sensitivity to pressure.