Crowns & Bridges
Crowns are used to restore teeth with too much missing tooth structure to hold a filling or if there is sensitivity due to a crack in the tooth structure. Endodontically treated teeth (root canal therapy) are also typically restored with a crown for protection, even if there is good tooth structure due to the drying out and increasing brittleness of the tooth after a root canal.
Crowns are most often done in two basic materials: gold or porcelain baked to a metal shell. The gold is somewhat more durable and usually less expensive and so often preferred by patients on very back teeth that don’t show. However, today’s porcelains are much harder and more durable than twenty years ago and can be used even on molar teeth with a high degree of confidence.
For front teeth, where esthetics is a much greater concern, another alternative is porcelain without the metal shell. With today’s bonded cements, these porcelain jacket crowns are much more reliable than they used to be and look more realistically like teeth due to the lack of metal backing.
Bridges (or what we call fixed bridges) are used to replace missing teeth with a fixed cemented bridge rather than a removable partial denture. They are more comfortable and cause less stress on the supporting teeth than the removable appliance and usually look much better. Materials and procedures are the same as for crowns (except that porcelain without metal can’t be used for a bridge).
The procedure for crowns and bridges takes usually two visits to the office. On the first visit, decay removal and any bonding to strengthen the teeth are accomplished. The teeth are shaped for the crown, impressions taken and temporary crowns placed. On the second visit, usually two weeks later, the temporaries are removed and the permanent restorations tried in, any adjustments in fit done, and then cemented with a permanent bonded cement for a new beautiful tooth (or teeth).
