There are usually three reasons for the placement of crowns (caps) and bridges:
- The first reason is that a tooth has been so badly damaged by decay or so heavily restored by fillings that it can only be saced with cast restoration.
- The second reason is that a tooth has been treated endodontically (root canal treatment). These teeth are almost always restored with a cast restoration because they have lost a great deal of tooth structure from fracture, decay, or the drilling process. These teeth are prone to fracture under normal and light chewing forces.
- The third reason a crown might need to be placed is that the tooth needs to be used as an abutment (anchor) for a bridge to replace missing teeth.
The procedure involves:
◇ Preparing the tooth in an appropriate fashion for the type of crown chosen.
◇ Making impressions of the prepared tooth, opposing teeth, and the occlusal (bite) relationships.
◇ Selecting a shade for tooth-colored crowns.
◇ Fabricating a provisional restoration that will remain in place while the crown is being constructed.
◇ Cementing or bonding the completed crown into position. If the work to be done is extensive, there may also be several appointments needed for preliminary seating (try-in) of the crowns or castings.
Crowns are made from many different types of materials. We have prepared written information describing the advantages and disadvantages of each. If you have not seen this information, please ask for it. If you have any known sensitivity to metals, please let us know prior to treatment. If you would prefer that no metals be used in the construction of the crowns, please let us know. We will discuss your options prior to preparation of the tooth (or teeth).
It is important for the ultimate success of the crown(s) that you understand and can perform thorough plaque removal. You should immediately begin following the oral self-care instructions that you have been given. It will make the procedure more comfortable and efficient, and the resulting restorations will look better. Final impressions cannot be taken until the gum tissue is healthy. Your cooperation is appreciated and necessary.
Maintaining Your Fixed Prosthetics
As is true with your natural teeth and especially with teeth that have been restored with any dental material, you should avoid chewing on excessively hard or sticky foods after the crowns have been cemented. It is especially important not to bite down on hard foods with just one tooth. The porcelain material can fracture from the metal substructure under extreme forces. Anything you chew that could break a natural tooth could break a crown!
Be sure to brush and floss daily as instructed. We also advise using a fluoride mouthrinse as part of your daily routine. Please be sure to return for your regular examinations and prophylaxis (cleaning) appointments at the time intervals we suggest.
After observing these types of procedures for many years, we note that the gingiva (gums) can recede from the crown margins and the surrounding tooth structure may become visible. This recession usually takes place over a period of several years and may require restoration replacements or a periodontal plastic surgery procedure to correct it.
We expect that you will receive many years of service from the cast restoration.