Dental Crown Restoration: A crown or a dental cap is a type of dental restoration that completely caps or encircles a tooth or dental implant. A crown may be needed when a large dental cavity threatens the health of a tooth. A crown is typically bonded to the tooth by dental cement. They can be made from various materials, which are usually fabricated using indirect methods. Crowns are used to improve the strength or appearance of teeth and to halt deterioration. While beneficial to dental health, the procedure and materials can be costly.
The most common method of crowning a tooth involves taking a dental impression of a tooth prepared by a dentist, then fabricating the crown outside of the mouth. The crown can then be inserted at a subsequent dental appointment. This indirect method of tooth restoration allows use of strong restorative material requiring time-consuming fabrication under intense heat, such as casting metal or firing porcelain, that would not be possible inside the mouth.
Indications for dental crowns:
Replace existing crowns which have failed.Restore the form, function and appearance of badly broken down, worn or fractured teeth, where other simpler forms of restorations are unsuitable or have been found to fail clinically.
Improve the aesthetics of unsightly teeth which cannot be managed by simpler cosmetic and restorative procedures.
Maintain the structural stability and reduce the risk of fractures of extensively restored teeth including those which have been treated endodontically.
Restore the visible portion of a single dental implant.
Clinical stages of dental crown provision :
AssessmentChoice of restoration
Tooth preparation
Tooth preparation impressions
Construction and fit of temporary restoration
Fit of definitive restoration
Short-term follow up
Long-term follow up
Assessment :
In order to ensure optimum condition and longevity for the proposed crowns, several factors need to be explored by conducting a thorough and targeted patient history and clinical dental examination. These factors inc
Patient factors :
Patient expectations
Patient motivation to adhere to the treatment plan and maintain results
Financial and time costs to the patient
Biological factors :
Periodontal health status and periodontal disease risk
Pulpal health and endodontic disease risk.
Caries and caries risk Occlusion and occlusal problems risk
Mechanical factors :
Amount of remaining tooth structureHeight and width of tooth to be prepared
Attachment levels of the tooth to be prepared
Root shape and length of the tooth to be prepared
Aesthetic factors :
Choice of restoration
The dimensions and percentage coverage of the natural crown
Full crowns
3/4 and 7/8 crowns
Material to be used :
Metal crowns
Metal-ceramic crowns
Full ceramic crowns
Impression and shade taking :
For the first step, your dentist will take alginate impressions of your upper and lower arches. This is the model that both the temporary and permanent crowns will be based on. Your dentist will then place a temporary crown to protect your tooth while the permanent crown is created in a dental lab.
Preparation :
To place the crown over the problem tooth, your dentist will need to remove some of the tooth’s enamel to make room for the hollow part of the crown to fit over the tooth. This is to make sure the tooth will not look bulky or unnatural once the crown has been placed. Of all the processes involved in this procedure, this is the most time-consuming part. Your dentist will use a local anesthetic to ensure you are comfortable during the enamel-removing process.
Taking of final impression :
To ensure that the crown created fits perfectly and looks natural, your dentist will need to take final impressions of your teeth once they have been prepared for the crown. They must take extra care during this step, as it can affect the results of the permanent prosthesis created by an off-site lab.
Creating a temporary crown :
This step serves more than just a cosmetic purpose. Temporary crowns are necessary to form a barrier to protect the exposed part of the tooth where the enamel has been removed. A temporary crown will also keep the prepared tooth from shifting out of place.
Application of the permanent crown :
The creation of the permanent crown is usually completed in about two weeks. Once the permanent crown is ready, and the dentist has gotten it from the lab, you can schedule an appointment to have it placed. But, before the crown is placed, your dentist will need to clean the tooth, which may require local anesthesia thoroughly. Your dentist will also check the proper placement of the crown and the adjacent teeth to avoid future issues.
Short-term Follow up visit :
A dental crown follow-up visit involves checking the fit, bite alignment, and overall comfort of your new permanent restoration.
Bite Check: Your dentist uses special paper to test how your teeth come together and makes minor adjustments if the bite feels high or uneven.
Fit Evaluation: They inspect the margin where the crown meets the gumline to ensure a tight, seamless seal.
Tissue Assessment: Your dentist looks at the surrounding gum tissue to make sure it is responding well to the crown.
Long-term follow up visit :
signs of Complications: If you experience any of the following symptoms, please contact our office:
Pain or discomfort around the crown.
Loosening or movement of the crown.
Sensitivity that doesn’t subside after a few days.
Signs of infection, such as swelling, fever, or drainage