Crowns, sometimes referred to as “caps” are generally placed when there is 1) not adequate good tooth structure to restore a tooth with a filling, 2) a tooth that is deformed or unsightly as to shape, structure, color or to be used as an abutment for a fixed or removable bridge. They are preferable for most root canal treated teeth to prevent cracking. Crowns are fabricated for permanent restoration by casting metal or by casting metal and bonding porcelain. Also non-metal crowns are made with zirconia and porcelain and other porcelain type materials. These crowns have become more popular and useful.
Traditionally, metal is cast and porcelain is bonded to the metal producing an esthetic crown or restoration. These materials have improved vastly and make for excellent results.
The old porcelain crowns were very fragile, but purely tooth-colored restorations have progressed a long way. Milling of restorations is a common technique and CAD-CAM crowns are commonly used. The various techniques include different cameras that take video impressions in the mouth or video impressions in the lab of models poured in stone in a laboratory.
There are fine points of validity of each technique and the use of the systems should be understood by all good dentists, we do both here.
Fixed bridge work is an extension of crown therapy to replace missing teeth. Crowns are usually placed at each end of a space and replacement teeth are attached to and between the crowns. This enables a functional and esthetic device that is not removed. On occasion we construct a cantilever bridge which has a replacement tooth affixed to the crowned tooth or teeth and has support only on one side. Special support and stress management must be considered when a cantilever bridge is used.
Fixed bridges are made here to be esthetic, functional, and cleansable. We carefully evaluate the abutment teeth as to their suitability for support for long-term success.
As non-metal bridges become stronger, more may be used. Breakage is still a problem in large non-metal bridges. Therefore, one must be careful in advocating such restorations for all cases.
Bridges and crowns are used routinely on implants. It is advisable to not include natural teeth and implants on the same bridge due to the different root attachments of teeth and implants. However, most rules are not always or never. We try to avoid the mix of the two.
There are quality issues related to the type of the metals and the safety thereof. We, at Berger Dental Group, use the finest materials and abide by ADA (American Dental Association) standards and do not send any dental lab work offshore where standards are sketchy.
Our laboratory companies are highly skilled and we give specific instructions to them. We hold them accountable for the highest performance level and best materials. They are not inexpensive and they do excellent quality of work.
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