Prosthodontics

Dental Crowns

A tooth cap or crown covers the tooth to restore its shape, size, funcation and strength. It is recommended to cap a root canal treated tooth to avoid fractures, it is placed on a Dental Implant, used to restore fractured tooth, for a smile makeover to improve appearance.

Crowns can be made out of porcelain (meaning some sort of dental ceramic), metal (a gold or other metal alloy), or a combination of both. Other terms that are used to refer to dental crowns are "dental caps" and " tooth caps."

Since a dental crown that has been cemented into place essentially becomes the new outer surface for the tooth it is easy to imagine how the placement of a crown can restore a tooth to its original shape. Dental crowns are routinely made for teeth that have broken, worn excessively, or else have had large portions destroyed by tooth decay.

It is conceivable that a dental filling, as an alternative, could be used as a means to restore a tooth's shape. Dental crowns however offer your dentist a big advantage over dental fillings by way of the fact that they are fabricated "away from your mouth." By this we simply mean that dental crowns are fabricated in a dental laboratory (by a dental technician using plaster molds your teeth). Dental fillings, in comparison, are created "in your mouth" by way of your dentist placing the filling material directly upon your tooth.

When a dental crown is made the dental laboratory technician can visualize and examine all aspects of your bite and jaw movements, from a variety of angles, and then sculpt your dental crown so it has the perfect anatomy. In comparison, when a dentist places a dental filling they have far less control over the final outcome of the shape of your tooth because it is often difficult for them to visualize, evaluate, and access to the tooth on which they are working.

Since a dental crown serves to cup over and encase the visible portion of a tooth, any dental crown that has a porcelain surface can be used as a means to idealize the cosmetic appearance of a tooth. Possibly you have heard it rumored (especially in past decades) that certain movie stars have had their teeth "capped." This simply means that the person has obtained their "Hollywood smile" by way of having dental crowns placed.

Actually, getting your teeth "capped" just to improve their cosmetic appearance can at times be a very poor choice. Dental crowns are best utilized as a way to improve the cosmetic appearance of a tooth when the crown simultaneously serves other purposes also, such as restoring a tooth to its original shape (repairing a broken tooth) or strengthening a tooth (covering over a tooth that has a very large filling).

In general, a dental crown probably should not be used as a means to improve the appearance of a tooth if there is any other alternative dental treatment that could equally satisfactorily achieve the same cosmetic results. This is because a dentist must grind a significant portion of a tooth away when a dental crown is made. If a more conservative dental procedure could equally well improve the tooth's appearance, such as a porcelain veneer, dental bonding, or even just teeth whitening, then it is usually best to consider that treatment option first.

Dental Bridges

Dental Bridges are used to replace one or more missing teeth by taking the support of the adjacent natural teeth. Putting a dental bridge avoids problems like rotation or shifting of adjacent teeth which results in disturbed bite, gum diseases, decay of adjacent teeth and supra eruption of opposite tooth.

Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.

Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown

How long do Crowns and Bridges Last?

While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.

Dentures

They are a set of artificial teeth used to replace all missing teeth (in case of full denture) and few missing teeth (in case of partial denture)

Types of Dentures

Complete Dentures

When a person has had all of their teeth removed we must make complete dentures for the person to wear. Dentures are an acceptable solution, but no match for our real teeth! Hence we always try to save natural teeth. When the teeth are removed we are left with a ridge of bone on the upper and lower parts of our mouth that we can use to put false teeth on. The lower denture always takes a little more work for most patients to get used to for two reasons: lack of height of bone and prescence of the tongue. The tongue increases in size in an edentulous mouth and it resists any new encumberence to its unchallenged domain. In the upper ridge however there are no such interferences

Advantages

->Long term experience over the years

->Relative low cost

->Predictable results

->Tolerated well by most people

->Restores missing teeth and lost ridge or gums

->Function and appearance is restored

->Aesthetically good where lip and cheek support is inadequate

->Can be fabricated fairly quickly

Disadvantages

->Cause pressure that results in underlying bone resorption and soreness

->Removability- not fixed like natural teeth

->Instability because it is removable and underlying progressive bone resorption

->Looseness as it can only sit atop the gums- especially lowers

->Only low chewing or biting forces can be produced

->Speech problems due to a large appliance in your mouth and it may move

->Taste problems

->Longevity- the need to reline to fit or wearing out

->Covering the roof of the mouth which can result in gagging problems

Removable Partial Dentures

An important step in maintaining a healthy smile is to replace missing teeth. When teeth are missing, the remaining ones can change position, drifting into the surrounding space. Teeth that are out of position can damage tissues in the mouth. In addition, it may be difficult to clean thoroughly between crooked teeth. As a result, you run the risk of tooth decay and periodontal (gum) disease, which can lead to the loss of additional teeth. In situations where only some teeth are missing we can also use a Removable Partial Denture.

A removable partial denture fills in the space created by missing teeth and fills out your smile. It is usually used when the space without teeth is too large for a bridge, or there are no teeth on either side of the gap or for economic reasons. The partial denture locks into place with its metal clasps. A denture helps you to properly chew food, a difficult task when you are missing teeth. In addition, a denture may improve speech and prevent a sagging face by providing support for lips and cheeks. There are two types of these: ones made fully of plastic (acrylic) or ones having a metal framework for rigidity and the teeth are the same kind used in full dentures. The latter ones are called CAST partial dentures and are much better and expensive.

Difference Between implants vs bridges vs crowns