Crowns and Bridges are example of prosthetic dentistry (Prosthodontic).
Crowns are used to replace parts of teeth and Bridges are used to
replace whole teeth that are missing from an arch. Each involves
taking models and sending them to a dental lab were crowns and bridges
are custom fabricated for each patient. Because these are custom
prosthetic crowns and bridge can be expensive.
A crown or cap is usually placed because the remaining
tooth structure is not capable of adequately supporting or retaining
a regular filling. In addition, a crown will help hold together
and support the remaining tooth structure, thus minimizing the chance
that a tooth could fracture.
A crown will not eliminate the possibility of decay. Though the
crown itself will not decay, the tooth could decay along the edges
of the crown if not properly maintained.
Placing a crown usually involves two visits after decay and old
filling are removed. In the case of a severely damaged tooth a core
may be needed to hold the crown in place.
The first visit involves preparation (shaping) of the tooth to
make room for the crown, making an impression (mold) for the lab
to fabricate the crown on, and placement of an acrylic temporary
to keep the tooth and gums in place.
A second visit is needed to fit and permanently cement the crown
after we get it back from the lab.
Porcelain fused to metal are the type usually placed in our office.
Bridges are used to replace missing teeth. Why is
that important? Because teeth in front of space will drift back,
creating spaces in between front teeth. Teeth behind the missing
tooth space will tilt forward. And the tooth above the missing tooth
space will grow down (erupt) down into the tooth space.
Because these teeth drift out of position, several
conditions may occur; severe occlusal (bite) problems that could
lead to clicking of the jaw, headaches, and jaw pain ; hard to clean
areas are created which will lead to tooth decay, gum disease, and
bone loss; a change in facial appearance.
There are several ways to place or secure a bridge.
Some of the more common types are:
A fixed bridge is either cemented in place over the
adjacent teeth just like a single crown or bonded to adjacent teeth,
depending upon the circumstances. (see graphics)
They are not removable. As in a crown, a bridge can
be made of white porcelain, gold, a silver colored metal. or a combination
A removable partial is designed to be inserted and removed by the
patient. It is held in place by metal clasps surrounding your natural
teeth. It can be used in place of a fixed bridge or in cases where
a fixed bridge cannot be used.
In most cases today, implants are a good choice for a tooth. Implants
are very predictable and successful. They avoid having to drill
on adjacent teeth.
There are two phases:
- Surgical, where a titanium fixture is placed into the jaw bone.
This is usually done by a Oral Surgeon.
- Reconstruction after healing (3 to 6 months), where
the replacement is fabricated over the integrated titanium fixture.