Joshua Leute, DDS - A Port Washington, Wisconsin General and Cosmetic Dentist

Porcelain Crowns

Protect and keep badly decayed or fractured teeth while maintaining a beautiful smile.

The Problem:

• Badly decayed teeth
• Fractured teeth
• Need to protect and strengthen teeth

The Solution:

A crown (sometimes called a cap) covers the damaged tooth and restores it to its original size and shape. After completion, the crown can be bonded or cemented onto the tooth to restore function.

Traditionally, the tooth is prepared by removing decay and then an accurate mold is made of the prepared surfaces. This mold can be sent to a dental laboratory where a porcelain or gold crown is created. A temporary crown is used to protect the tooth during the lab phase.

Today, most crowns can be fabricated in the office using state-of-the-art computer-assisted imaging and milling techniques (also known as Cerec or CAD/CAM). This technique saves time by allowing same-day completion of crowns and avoids having to use plastic temporary crowns.

Advantages:

Porcelain offers a fine alternative to other tooth restoration materials. Made to perfectly match the shade and shape of your teeth, it's durable, it's strong, and it's virtually undetectable.

Crowns are incredibly strong. This protects and strengthens the remaining tooth structure. In the hands of a skilled dentist, a crown will fit almost perfectly onto the prepared surface of the tooth, reducing the size of the seam between the crown and the tooth. This helps keep decay from eventually occurring under the crown.

Crowns should be placed before the tooth is so decayed that it may fracture. This can often help prevent the expense of root canal therapy in the future. It can also prevent the possibility that a fractured tooth may need to be removed, requiring the expense of a bridge or implant to replace the missing tooth.

Disadvantages:

Crowns are excellent restorations and have few disadvantages. They are highly durable, but they may eventually need to be re-cemented or replaced due to normal wear.

Occasionally, a tooth may still need root canal therapy after being crowned. However, this indicates that the interior of the tooth was already sick (infected) and would have eventually needed root canal therapy anyway.

Alternatives:

In the event that a tooth is so decayed or fractured that it needs to be removed, the best alternatives to a crown are bridges and implants that replace the missing tooth.

Porcelain Bridges

A great way to replace missing teeth.

The Problem:

• A missing tooth or teeth
• Potential bite and jaw joint problems from teeth shifting to fill the space
• The "sunken face" look associated with missing teeth
• Desire to improve chewing ability
• Desire for a more permanent solution than dentures

The Solution:

A bridge is a single appliance that is generally attached to two teeth on each side of the space where a tooth is missing. An artificial tooth attached in the middle of the bridge fills in the gap where the missing tooth was. The teeth on either side of the gap are prepared for crowns (see crowns) and a highly accurate impression or mold is made of the prepared area. This mold is used to create a gold or porcelain (tooth colored) bridge in a special laboratory. The bridge is then cemented onto the prepared surface of the teeth, effectively creating the appearance of a "new" tooth.

In some instances, a resin-bonded bridge may be used. In this case, the two teeth on each side of the gap are not prepared for crowns. Instead, the bridge consists of a false tooth with metal brackets on the back of each side of the gap. The brackets are attached to the backs of the real teeth on each side.

Advantages:

Unlike dentures, a fixed bridge is never removed. It is stable in the mouth and works very similar to natural teeth. By filling the gap and stopping the movement of other teeth, a fixed bridge is an excellent investment, providing better chewing ability, heading off jaw joint problems and saving money that might otherwise be spent on future dental treatment.

Disadvantages:

Fixed bridges are excellent restorations and have few disadvantages. They are highly durable, but they may eventually need to be re-cemented or replaced due to normal wear.

Alternatives:

In the event that the use of a fixed bridge is not feasible, the best alternative is a dental implant.