Dental Crowns & Bridges

When are Dental Crowns the Right Choice?

If you have a tooth that has sustained moderate or severe structural damage due to injury or decay, Dr. Duran may recommend placing a crown. In other cases, large fillings are better protected and offer enhanced esthetics with crowns placed. Other situations that may call for the use of a dental crown include:

  • Serving as the “restoration” or replacement tooth in conjunction with a dental implant.
  • Anchoring a dental bridge in place.
  • Masking severe staining or discoloration in teeth that do not respond to teeth whitening.
  • Protecting a tooth that has undergone root canal therapy.

How is a Dental Crown Placed?

The placement of a dental crown is very precise and generally requires at least two visits. During the first visit, the damaged tooth is prepared to accept the crown. An impression is taken, a temporary crown is placed, and Dr. Duran sends your impressions to a trusted dental lab where trained technicians craft your custom-fitted crown. At the second visit, the temporary crown is removed and the permanent crown is bonded onto the prepared tooth.

Types of Dental Crowns

At Daniel A. Duran DDS, PA, we offer three general types of dental crowns:

  1. Porcelain-fused-to-metal or PFM crowns. This type of crown is made of a metal core on the inside and covered in porcelain shell on the outside. The metal interior is made from gold or a mixture of metals and does not show. The core merely provides rigidity and support to the overlying porcelain. This type of crown is one of the best options for posterior (back) teeth.
  2. All-porcelain crowns. This is the newest and most life-like type of crowns. All-porcelain crowns are used primarily in anterior (front) teeth and although some porcelain materials, such as zirconia, are appropriate for use on the posterior (back) teeth. The porcelain crowns that Daniel A. Duran DDS, PA uses and recommends include:
  • IPS Empress – Da Vinci Porcelain. This is a great option for the patient who demands high esthetics. Empress crowns have the advantage of high light translucency, so when placed over similarly colored teeth they are very beautiful and natural looking. Empress crown cannot be placed over severely stained or discolored teeth as the discolorations will show through.
  • E.max CAD/CAM. This type of crown is designed in a digital environment and made by a computer which mills the crown from a solid block of porcelain. E.max crowns come in a variety of formulations, including zirconia and glass silicate.
  • Zirconia. This type of crown is very esthetic and can be used over a severely discolored tooth. This is due to the zirconia crowns dual layer construction. The very strong inner layer blocks the underlying tooth color while the beautiful porcelain layered on the outside offers enhanced esthetics.

3 All-metal crowns. All-metal crowns have provided a reliable and predictable dental crown option for literally thousands of years. Gold or titanium crowns are of a similar hardness to natural teeth and therefore they won’t damage the opposing tooth structure. Metal crowns are best used in the back of the mouth where esthetics are not as much of a concern.

A Closer Look at Dental Bridges

A dental bridge is a prosthesis that permanently replaces a missing tooth with crowns. A fixed bridge consists of two crowns cemented to abutment teeth, which are on either side of the missing tooth space. Crowns hold the replacement tooth, called a “pontic,” in place. Unlike a removable partial denture, the fixed bridge stays cemented in the mouth and can only be removed by a dentist. This means that fixed bridgework offers a more secure and stable option than removable partials.

Oral Health Benefits of Dental Bridges

Replacing a missing tooth has many functional and esthetic benefits. Replacing a tooth prevents other teeth from shifting and crowding or spacing out. It also improves your smile dramatically by filling in a dark space left behind by a missing tooth.

Who is a Candidate for Dental Bridges?

Anyone who has a missing or non-restorable tooth with two healthy teeth adjacent to it are candidates for a dental bridge. When a tooth is missing and an implant is not an option, a bridge can be made to replace it. The missing tooth is best restored when there is one or more teeth on either side of it because these teeth are used to support the bridge. Good periodontal health is important to the longevity of a bridge.

The Bridgework Placement Procedure

First, your dentist will evaluate the adjacent teeth to determine if a bridge is appropriate for you. An impression of the open space will be taken. This impression will serve as a model for a temporary bridge. The temporary bridge is used to protect the gums and teeth until the permanent bridge has returned from the dental lab and can be cemented into place. This treatment requires placing a crown on the teeth on either side of the missing tooth and attaching the missing crown in between them. The result is a single piece with 3 or more teeth connected to each other via a biocompatible framework. The bridge is then boned into place with permanent dental cement. The procedure can take anywhere between 2-3 appointments depending on your individual case.