Crown & Bridge Dentistry

WHAT IS A CROWN?

The crown of a tooth is the visible part above your gums.

If your dentist tells you "Your tooth needs a crown," he means that your natural tooth needs a laboratory-made, prosthetic crown. Prosthetic crowns are made of metal, porcelain fused to metal substrates, or new all-white restorative materials. A prosthetic crown covers all or part of a tooth and holds a tooth together. Crowns are the treatment of choice whenever decay, a crack,a fracture,previously placed large filling ,or a root-canal filling have compromised the strength of a tooth.

Crown restorations require a minimum of two appointments to complete. The tooth is numbed and prepared for the crown by removing any decay or weakened areas. The remaining tooth structure is then reshaped to meet proper crown preparation design. If necessary, a restorative material, usually a composite resin, is added to the remaining tooth structure to ensure that the prosthetic crown will have a good foundation. This procedure is called a "build-up." After the tooth is prepared, we take an impression of it. This is sent to the dental lab, where the crown is fabricated to our specifications.

During the second appointment,the new crown is placed on the tooth. Adjustments may be required to exact the perfect fit, so that the crown will feel comfortable in the mouth and will conform to the bite. When the crown fits seamlessly and contacts the neighboring teeth correctly, the crown is cemented on the tooth.

The finished crown will protect the tooth, function harmoniously in the mouth, and enhance the appearance. However, as with all dental restorations, proper oral hygiene is essential to protect the crown. Crowns, veneers, and composite resin restorations must all be kept clean with daily brushing and flossing. Regularly scheduled examinations and hygiene appointments must be adhered to, or the same bacterial assault which causes decay and makes dental care necessary may cause the restorations to fail. We can design a personal hygiene schedule to help you stay ahead of dental decay and maintain your healthy smile.

 Before Crown

After Crown

Gaps Before Crowns

Closed with Crowns

A BRIDGE

You might have heard of a "bridge" that someone might have done at the dentist. We like to call it a fixed partial denture.A bridge to replace a missing tooth or teeth. It allows us to fill in the space. To use it, however, we must "file" down the teeth on each side to let it the dummy tooth/teeth hold on to something. The extra tooth/teeth connect/s to both of the filed down teeth. We use a cement (or luting agent) to hold it in place and create a good seal. The bridge can be made of either vitallium(non-precious white metal), porcelain fused to metal,the new ceramo composites(Targis/Vectris) or precious metal.The porcelain obviously looks much more natural and is the strongest.

A bridge prior to placement

The "bridge" in the mouth

A Typical bridge

A Ceramic bridge

BRIDGES - FREQUENTLY ASKED QUESTIONS

What is a bridge?

A bridge is a dental appliance that replaces one or more natural missing teeth,thereby "bridging" the space between two teeth.Bridges are cemented into place on the "abutment" teeth--the surrounding teeth on either side of the space or span. Unlike removable partial dentures,bridges cannot be taken out of the mouth by the patient.

A bridge is a device that typically consists of three units-a pontic (a false tooth) fused between two crowns that are cemented onto the abutment teeth.

Who should get a bridge?

A person with missing teeth and committed to maintaining good oral hygiene practices,is a good candidate for a bridge. A bridge is the most natural choice to fill the space in the mouth left by missing teeth. If left unfilled, this space can cause the surrounding teeth to drift out of position and can cause teeth and gums to become more susceptible to tooth decay and gum disease that can cause further tooth loss. Bridges not only correct an altered bite, improve the chewing ability and speech, but they also safeguard the appearance by preventing the collapse of facial features that can cause premature wrinkles and age lines.

What type of bridges are there?

Besides traditional bridges, another popular design is the resin bonded or "Maryland" bridge, primarily used for the front teeth. This is usually the most economical choice when the abutment teeth are healthy and don't contain large fillings. The pontic is fused to metal bands that can be bonded to the abutment teeth with a resin cement and hidden from view, reducing the amount of preparation on the adjacent teeth.

A cantilever bridge may be used if there are teeth on only one side of the span. This involves anchoring the pontic to one side over one or more natural, adjacent teeth. If there are no adjacent teeth to act as anchors,an implant is recommended--a metal post that is surgically embedded into the bone and capped with a crown as an abutment. In some cases where the span is large, a removable partial denture is recommended or even an implant-supported prosthesis.

What is the procedure of its fabrication?

For a traditional fixed bridge, the first appointment consists of the dentist reducing the adjacent abutment teeth that will act as anchors. Impressions are made, from which a metal framework, including the pontic, is created. By the second appointment, the final bridge is fitted over the teeth. The total treatment time is usually around one week, depending on the type of bridge. However, because it is often difficult to match the natural shade of your teeth, the treatment time may be longer.

How do I care for a bridge?

With a bridge, it is more important than ever to brush, floss and see the dentist regularly. If buildup of food debris and plaque -the sticky film of bacteria formed from food acids-is not controlled, the teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge.We recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums. If optimal oral hygiene care is maintained,a bridge can last for many years.