What is a Dental Crown?
A crown is used to protect a tooth that has been weakened by cracks or decay. It is a strong cap over your tooth that restores the structure and strength of the original tooth.
Why Do Teeth Need Crowns?
The most common reason why you would need a crown or veneer is because your tooth is weakened, either from dental cavities or fractured. Crowns are also used in worn out or discolored teeth to achieve a more beautiful shape and to hide any discoloration.
These situations could be:
- Teeth with Large Fillings or Cavities
- Teeth with Cracks or Chipped
- Teeth that had Root Canal Treatment
- Teeth that have a odd shape or color different to the neighbouring teeth
Crowns can protect your teeth from further wear and cracks which may lead to extraction of the tooth.
What is a Dental Bridge?
A Dental Bridge functions to cover a gap between two teeth. It is made of 2 crowns on the supporting teeth adjacent to the gap, and a prosthetic tooth suspended in the middle.
Patients who want to avoid surgery or who are unable to have dental implants usually opt for the dental bridge option as it is a permanent option that is long lasting and natural looking. A dental bridge can be done on the same day after tooth extraction or if you already have a gap between your teeth.
Our dentists keep themselves up to date with international techniques that are effective and comfortable for you.
No Temporary Crowns
Temporary crown or bridge are usually rough and fall off easily. Instead, we make the final crown straightaway, minimizing your downtime.
100% Metal Free
All our crowns and bridges made in house are metal free, and do not contain mercury or other toxins.
Less Drilling, Less Sensitivity of teeth
Using modern ceramic materials allows us to conserve more tooth volume compared to traditional metal ceramic crowns or bridges
Modern advances in dental technology has allowed us to be able to make a crown in the clinic, under our full control. Unlike traditional dental laboratories, which are made off-site, we make all our crowns and bridges in house to ensure full quality control.
Genuine Materials Used
Only high-quality, genuine materials with long track record of success are used for our CAD/CAM milling.
Each crown or bridge is designed individually, hand stained, polished and finished and inspected to ensure quality before giving it to our patients.
Each crown and bridge is hand painted to create life-like aesthetics that match your teeth naturally
Fully Digital Workflow
3D Scanning of your teeth = No Dental Moulds for your crown or bridge.
Dental moulds are a part of traditional dentistry and are uncomfortable. We use digital scans instead which are fast, comfortable and more accurate.
Same Day, Emergency appointments available
CEREC CROWN X DENTAL DESIGNS CLINIC
What Happens During the Crown Visit?
1. The Crown Consultation
Welcome to our clinic! During your first appointment, we’ll do a detailed examination which includes tests to check:
- Which tooth is causing your pain or issues;
- The extent of the damage or decay on the tooth;
- The status of the tooth nerve (if it is alive and healthy, infected, or dead);
- The health of the gums that support the tooth
Based on this information, our dentists will take photos of your teeth and explain the treatments options available. As crowns are usually irreversible, we need to make sure that consent is granted and that all alternative options have been considered.
Our philosophy is for both our dentist and you to have a detailed understanding of the situation so that you can make the right decision for yourself.
2. Tooth Preparation and 3D Scanning
Once we have decided on a crown, it is time to start! To allow the crown to fit well, we would need to remove a layer of tooth structure. This will ensure that the dental crown is strong enough while preserving the health of the tooth.
Once the preparation has been done, we use a 3D scanner (CEREC) to create a 3D model of your teeth, instead of the usual dental molds which are messy and painful. 3D models are more accurate and allow us to start work on creating the crown immediately, resulting in a shorter visit for you.
3. Designing your custom crown
Using the CEREC CAD/CAM software, we create the shape of the new crown, taking into account the biting forces and how the crown fits with the neighbouring teeth. We want to ensure that it feels and looks like your natural tooth. It’s bespoke dentistry for your teeth!
4. 3D CAD/CAM Milling
The crown is designed and precisely milled with diamond drills in the CEREC MC-XL machine, ensuring a highly accurate fit of the crown with precision fit of 25 µm to the neighbouring teeth and optimum bite force.
The crown is milled from a single block of material which ensures that the crown consists of one single piece (monolithic). This reduces breakages and cracks from developing due to laminal stresses in the material.
4. 3D CAD/CAM Milling
The crown is designed and milled in the CEREC MC-XL machine from Dentsply Sirona, ensuring a highly accurate fit of the crown with precision fit of 25 µm to the neighbouring teeth and optimum bite force.
The crown is milled from a single block of material which ensures that the crown consists of one single layer (monolithic). This reduces breakages and cracks from developing due to laminal stresses in the material.
5. Hand Finishing of the Crown
When the crown is milled, our in-house dental technician then adds his artistic touches to make the crown look realistic. After all, the crown needs to look like a real tooth to blend in with your other natural teeth!
Once we are satisfied with it, he then places the crown in the furnace that goes up to 1550°C for a pre-defined amount of time. This process strengthens the crown and also makes the stains on the crown permanent.
6. Crown Cementation
Once the crown have been decontaminated and conditioned, we will then proceed to place the crown onto your tooth permanently using modern dental adhesives that optimises the bond strength and minimises sensitivity. This ensures that the crown stays on for as long as possible, while conserving your tooth structure for maximum preservation of the strength of your tooth.
7. Review Check
We’ll see you in about a week later to make sure that everything went well. To be precise, we will check your bite, the stability of the crown and ensure that you are comfortable with it – just like your own tooth.
Bridge/Ceramic Filling/Crown Warranty
Well established for more than 30 years, with >250 scientific studies confirming the clinical safety of tried and tested CEREC tooth restorations. Worldwide, more than 30 million tooth restorations have been produced with CEREC.
Here’s what our patients feel about us:
1. What is a dental crown?
A dental crown is a tooth-shaped “cap” that is placed over a tooth — covering the tooth to restore its shape and size, strength, and/or to improve its appearance. It is normally made of a stronger material such as ceramic or metal. The crowns, when cemented into place, fully enclose the entire visible portion of a tooth that lies at and above the gum line.
2. Why do I need a crown?
The primary purpose of a crown is to cover or protect a damaged tooth. So, if you have had a root canal or a very big cavity, your dentist may suggest a dental crown to protect the remaining tooth structure. You may also need a crown as a part of a dental bridge or with dental implants.
3. What is involved in a dental crown procedure?
Dental crown procedures will vary depending on your individual case, however we will provide a general overview of what to expect. Before commencing any preparation work for your crown, the dentist will perform an initial examination of your tooth and overall mouth, which may include taking x-rays. If there is extensive decay found in the tooth, or a risk of infection is diagnosed, you may require other treatment first. Alternatively, if there is not enough natural tooth structure left to securely hold the crown in place, you may need a core, or a post-and-core to be placed first to create a foundation to support the overlying crown. Your dentist can discuss with you if you need any additional procedures.
The procedure for your crown will vary depending on whether your crown is going to be made at your dental surgery or in a dental laboratory:
- Traditional Crown
The typical crown procedure done by most other dental clinics will involve at least 2 separate appointments which are normally spaced 2 weeks apart. There will be manual impressions to take the mould of the tooth. In the meantime, you will need to have a temporary crown on the prepared tooth to hold the space. This temporary crown is prone to dislodging or breaking, and is usually rough as it is temporary. If there are any issues with the crown during the second visit, you will need to have another visit a few days or weeks later to place the crown again.
- CAD/CAM CEREC single-appointment ceramic crowns
At Dental Designs Clinic, as we have an in-house dental laboratory and we use the CAD/CAM (computer-aided design and manufacturing) CEREC system, the entire crown procedure will be completed in the same day or the day after.
Firstly the tooth and the area surrounding it will be numbed with local anaesthetic. Next any decay or failing old filling material is removed. The tooth is built up with a core to strengthen the internal structure. The tooth is then reduced down on all sides to create space for the crown to fit over the tooth.
A image is taken of the tooth inside your mouth with our digital scanner, and then a virtual design model of the crown is created, without needing to take impressions.
The data for the model is then electronically sent to our on-site milling unit, which uses a precise cutting tool to fabricate the restoration out of a block of porcelain material.
This can be completed in the same day to minimise any down time for you.
Once the crown is manufactured, it will be checked for fit and adjusted if necessary, before being permanently cemented onto your natural tooth.
This system eliminates the need for dental impressions, physical moulds, temporary restorations, and multiple dental visits. The modern technology is precise and accurate, and the restorations produced will match your natural tooth colour and blend in seamlessly.
4. What types of dental crowns are available?
Metal Containing Crowns
- Metals used in crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Typical metal crowns have lower gold content and more tooth needs to be cut away to fit the metal crown. Metal crowns with a high gold content need less tooth trimming and can withstand biting and chewing forces well. Also, metal crowns rarely chip or break and typically last the longest. The metallic color is the main drawback. Metal crowns can be a good choice for out-of-sight molars or if you are a heavy grinder. Cost is high in precious metal crowns due to the high gold content.
- Porcelain-fused-to-metal dental crowns need the most amount of tooth to be trimmed away as they have 2 layers: a metal interior and a porcelain layer over the surface to have a more tooth like colour. However, a perfect match to natural teeth usually cannot be achieved as these crowns appear more opaque to cover the dark metal inside. As it is a thin layered porcelain, it is weak and the surface porcelain tends to chip or wear off over time, exposing the internal metal portion. The metal underlying the crown’s porcelain can also show through as an unsightly dark line, especially at the gum line and even more so if your gums recede. These crowns can be a used for front or back teeth and are typically cheaper. The gums surrounding the metal portion may also become more inflamed and bleed easily due to slight metal allergies.
Metal Free Crowns
- All-ceramic or all-porcelain dental crowns are made from high strength ceramic, typically in a single homogenous layer. As they can be bonded permanently to the tooth, less tooth structure need to be trimmed to place the ceramic crowns. Ceramic crowns provide the best natural colour match than any other crown type and are hypoallergenic. They are technically difficult for the dentist to do and hence have a higher cost. All-ceramic crowns are a good choice for front teeth and back teeth.
- Zirconia dental crowns are made out of zirconium oxide, which is a very strong white silicate material used in many medical prostheses such as for the hip or ear. They are extremely high strength and are come in 2 types – solid zirconia and high translucent zirconia. Solid zirconia has a more opaque white appearance and is good for back teeth which undergoes high stresses. High translucent zirconia can be used where a more natural tooth aesthetic is desired.
5. How long do dental crowns last?
On average, dental crowns last between 5 and 10 years. The life span of a crown depends on the amount of “wear and tear” the crown is exposed to, how well you follow good oral hygiene practices, and your personal mouth-related habits (you should avoid such habits as grinding or clenching your teeth, chewing ice, biting your fingernails and using your teeth to open objects such as beer caps, or packaging).
6. Does a crowned tooth require special care?
While a crowned tooth does not require any special care, remember that the underlying tooth is still your natural tooth and is still subject to decay or gum disease. Therefore, continue to follow good oral hygiene practices, including brushing your teeth at least twice a day and flossing once a day and make sure there is no food stuck between the teeth.
7. What Problems Could Develop With a Dental Crown?
- Discomfort or sensitivity. you may experience some heat and cold sensitivity on your newly crowned tooth immediately after the procedure as the anaesthesia begins to wear off if the tooth that has been crowned still has a nerve in it. Your dentist may recommend that you brush teeth with toothpaste designed for sensitive teeth. This sensitivity is usually temporary and will go away in a few day. Persistent soreness or sensitivity that occurs when you bite down could mean that the crown is slightly too thick and is hitting the opposing tooth in some positions, and this needs to be highlighted to your dentist who can fix it.
- Chipped crown. Crowns made of all porcelain or porcelain fused to metal can sometimes chip. If the chip is small, a composite resin can be used to repair the chip with the crown remaining in your mouth. This is usually just a temporary fix. If the chipping is extensive, the crown may need to be replaced.
- Loose crown. Sometimes the cement washes out from under the crown. Not only does this allow the crown to become loose, it allows bacteria to leak in and cause decay to the tooth internally. If a crown feels loose, contact your dentist’s office.
- Crown falls off. Sometimes crowns fall off. Reasons include decaying of the underlying tooth and loosening of the cementing material used to place the crown. If your crown comes off, clean the crown and the front of the tooth. You can replace the crown temporarily using dental adhesive or temporary tooth cement that is sold in stores for this purpose. Contact your dentist’s office immediately. He or she will give you specific instructions on how to care for the tooth and crown for the day or so until you can be seen for an evaluation. Your dentist may be able to re-cement the crown in place; if not, a new crown will need to be made.
- Allergic reaction. Because the metals used to make crowns are usually a mixture of metals, an allergic reaction to the metals or porcelain used in crowns can occur, but this is extremely rare.
- Dark line on crowned tooth next to the gum line. A dark line next to the gum line of your crowned tooth could be present if you have a porcelain-fused-to-metal crown. This dark line is simply the metal of the crown showing through. While not a problem in itself, the dark line may be cosmetically unacceptable and you can request to replace the crown with an all porcelain or ceramic one.
8. Is There a Difference Between the Crown and a Real Tooth?
The dental crown will never stain or change color unlike natural teeth. Crowns containing metal usually appear different or unnaturally opaque compared to your other teeth. However, ceramic crowns can be made indistinguishable from your existing teeth.
9. What Are “Onlays”, “3/4 Crowns” or “Inlays” ?
Onlays and 3/4 crowns are variations on the technique of dental crowns. The difference between these crowns and the crowns discussed previously is their coverage of the underlying tooth. The “traditional” crown covers the entire tooth; onlays and 3/4 crowns cover the underlying tooth to a lesser extent.
Inlays are only possible when the cavity is less than 1/3 the size of the tooth and are an alternative to large fillings. They tend to have a better shape for cleaning and to prevent food getting stuck between the teeth, and last much longer than conventional fillings.
The advantage of onlays, “3/4 crowns” or inlays are that they involve much less removal of the tooth structure, while still protecting the weak areas of the tooth. Also, if the restoration fails in future, there is more tooth remaining which makes it more likely to survive rather than requiring an extraction.
10. What are the Alternatives to Dental Crown?
For tooth decay or fractures that are not as large, we recommend ceramic onlays and inlays as explained above.
However, if the tooth is badly damaged, we will need to place a dental crown.
The purpose of the crown is to protect the tooth by covering it, and it has to be made of strong enough materials to serve its purpose. Some people may think about using a normal filling material to directly place a large filling over the surface of the tooth. This may work in the short term, but as the normal filling material is not rigid enough to hold the tooth together, cracks will continue to progress and the filling will break. The tooth will still need to be prepared or drilled again to fit a dental crown, causing more issues.
Porcelain veneers or a combination of braces and teeth whitening for the front teeth can help you achieve a purely cosmetic treatment by changing the shape of the teeth.
A dental bridge or implant can replace missing tooth if you choose to extract the tooth rather than to do a crown.
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Shu-Hui Mou-Tsongi Chai-Juo-Song Wang-Yuh-Yuan Shiau – https://www.sciencedirect.com/science/article/abs/pii/S0022391302727376
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Andreas Bindl-Werner Mörmann – https://www.ncbi.nlm.nih.gov/pubmed/12375459
- Full-ceramic CAD/CIM anterior crowns and copings https://europepmc.org/article/med/11351494