CROWNS AND BRIDGES
When do we need a crown or a bridge?
Replacing missing teeth is one of the main fields of dentistry. When teeth are missing, chewing capacity is disrupted, voice formation or speech disturbances may occur, facial harmony is disturbed causing the alteration of facial character and possible problems for the patient. Dental replacements can be basically divided into two categories: fixed and removable replacements.
Fixed replacements are attached by cement to the properly ground teeth and cannot be removed by the patient. We prepare a crown if a tooth is so damaged that the original functions and appearance will not be restored by conservative treatment (fillings, inlay). In case of a bridge, the teeth next to the lack of teeth will serve as support for the denture. Most fixed replacements have a frame, which may be made from precious metals (gold), medical metals, titanium, or zirconium oxide. The frame is covered by porcelain as a shielding material, which comes in various colours, so we can reach a colour harmony between the replacement and the patient's own teeth. Metal ceramic crown is the most often used replacement, mainly due to it being the least costly solution for crowns.
Metal ceramic replacements are durable, but as far as their appearance goes, they are trailing full ceramic and zircon crowns, for even the best colour selection will not provide a fully lifelike imitation of the original teeth. In the frontal teeth it is our goal to reach the most attractive aesthetic result, for which metal-free replacements are a perfect choice. As for their structure, they can be plain porcelain crowns without a frame, or the cutting edge crowns of our times. The frame is made of zirconium or aluminium oxide, matching the colour of porcelain.
The process of creating a crown
After grinding and polishing the teeth, the dentist takes an imprint and sends it to the dental technician laboratory where the replacement frame is made from the requested material, to be fitted by the dentist. The dental technician than layers the porcelain on the frame, followed by another fitting. At this session, the dentist, the technician and the patient are all present and they jointly determine the colour, shape and height of the crown or bridge. This way experts are able to involve the patient and work together for the replacement to satisfy all requirements in it functionality and appearance, and to be easy to clean for the patient. The finished structure is then fixed by cement by the dentist.
CrownWhen a tooth is so damaged that it is unsuitable for a crown but its root is still intact, the missing part of the tooth must be replaced by a stud.
The stud may be made of stainless steel, gold, titanium or a glassfibre material, which the dentist can directly insert into the root canal, but a unique individual stud may also be made by the dental technician as per an imprint to exactly fit the prepared teeth. The latter is a stronger and more durable solution. The stud is placed by the dentist and glued into the root canal, creating a base for the fixing of the crown.
No matter what kind of replacement is necessary, the final structure usually takes a few days to be ready. We always take care to ensure that the patient is not left without a tooth even for a day. In these cases, we prepare a plastic crown, which is not a permanent replacement and does not function as a fully functional structure; it a temporary solution for the days until the permanent replacement is ready. It can be made either by the dentist or the technician. Its main function is to protect the grinded teeth and for you to be able to lead a full life even in these days, and to encourage you to smile, eat and drink.
Bridges and bridge elements
When several teeth next to each other are missing, bridge is the simplest replacement solution. Dental bridges, just like crowns, can be made of several materials, and the way they are fixed in place is also identical, requiring several fitting sessions. In most cases, the bridge is affixed to the teeth bordering the portion lacking in teeth, and provide ample support. It has the disadvantage that the intact teeth next to the empty section need to be ground and root treated to be used as pillars for the denture. A much simpler and more stable solution is reached with a bridge at
tached to the implant, because in this case the neighbouring teeth will not have to be grinded because the implant will provide support.
For bridges, the most popular solution is metal ceramics, for it creates a strong and durable structure. It has the same composition as a crown.
For the many advantages of the metal ceramics bridge, it has the disadvantage of not being suitable for a perfectly lifelike replacement, and that metal allergy may cause problems in some patients.