Crowns And Bridging

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Crowns And Bridging

Crown refers to the restoration of teeth using materials that are fabricated by indirect methods which are cemented into place. A crown is used to cap or completely cover a tooth.

Traditionally, the teeth to be crowned are prepared by a dentist and records are given to a dental technician to fabricate the crown or bridge, which can then be inserted at another dental appointment. The main advantages of the indirect method of tooth restoration include:

fabrication of the restoration without the need for having the patient in the chair
the utilization of materials that require special fabrication methods, such as casting
the use of materials that require intense heat to be processed into a restoration, such as gold and porcelain.

The restorative materials used in indirect restorations possess superior mechanical properties than do the materials used for direct methods of tooth restoration, and thus produce a restoration of much higher quality.

As new technology and material chemistry has evolved, computers are increasingly becoming a part of crown and bridge fabrication, such as in CAD/CAM technology.

Why restore with a crown?

When decay is first detected in a tooth, the usual action taken by the dentist is to provide the tooth with an intracoronal restoration: a restoration consisting of a dental material that will exist totally within the confines of the remaining tooth structure. The restoration commonly referred to as a "cavity filling", or more colloquially as a "filling", is an intracoronal restoration, and can consist of a number of materials, including silver-colored amalgam, tooth-colored resin or gold. Inlays are also intracoronal restorations.

In a situation where there is not enough remaining solid tooth structure after decay and fragile tooth structure is removed, or the tooth has fractured and is now missing important architectural reinforcements, the tooth might very well require an extracoronal restoration: a restoration consisting of a dental material that will exist around the remaining tooth structure to a varying degree. Restorations that fall into this category include the various types of crowns and onlays, and these can consist of a number of materials as well, including gold, ceramic, or a combination of the two.

The circumstance of the damaged tooth defines the restoration. In other words, based upon factors such as remaining solid tooth structure, aesthetics, the location of the tooth within the dental arch and the consequent forces of function that said tooth will have to deal with once restored, the dentist will then decide on the proper way to treat the tooth.

Things are not always straightforward when it comes to restoring a tooth. An advantage of crowning a tooth over restoring the tooth with an excessively large pin-supported amalgam or composite restoration is that crowns provide much more protection against future fracture or recurrent decay. The indirect techniques of crown fabrication translate into a more adapted tooth-restoration margin, and thus a better seal against the decay-causing bacteria present in saliva.