Crowns and Bridges
Usually, when our teeth are in unacceptable aesthetic conditions, our first thought, due to the old-fashioned dentistry philosophy, is to remove the damaged teeth. However, it should be the very last option.
Modern technology and materials now allow us to treat more cases without removing natural teeth. The only real reason to extract a tooth is when it is loose, fractured below the gum line or deeply decayed; other than that, your teeth can be restored through dental crowns and/or bridges which are one of the best solutions to avoid teeth extractions (if possible at all).
What is a dental crown?
A dental crown is commonly called as “cap”. It is a dental restoration that fully covers the surface of a tooth in order to restore its size, shape, improve its appearance and/or to add strength.
The crowns over implants will be the outer shell of the titanium screw which will look, feel and act as a natural tooth.
The crown can be manufactured of many different materials such as noble metal, high noble metal, gold, zirconium, ceramic, etc. and then, will be covered (most of the times) with porcelain and/or ceramic to simulate the white color of our tooth.
A dental crown is necessary to:
- Protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth.
- Restore an already broken tooth or a tooth that has been severely worn down.
- Cover and support a tooth with a large filling when there is not a lot of teeth left.
- Hold a dental bridge in place.
- Cover severely discolored teeth.
- Cover a dental implant.
- Make a cosmetic modification (i.e. close a gap).
Process for a dental crown
First appointment:
- Numb the tooth and the gum tissue around the tooth.
- Filed down the tooth in the chewing surface and sides to make room for the new crown. In cases where a large area of the tooth is missing (due to decay or damage), the dentist will use filling material to "build up" the tooth to support the crown.
- Impressions/molds in paste or putty of the reshaped tooth.
- The impressions/molds of the tooth will be sent to the laboratory in order to build the crown (1 to 4 crowns requires 5 business days, +5 crowns need about 7 days or more).
- The color of the porcelain for the top of the crown will be chosen based on your skin, eyes and hair color as well as taking into consideration the color of the adjacent natural teeth.
- During the first visit, you will get a temporary crown in order to protect the prepared tooth while the final crown is being built.
Second appointment: Only if considered necessary, a try-in of the crown substructure (metal or zirconium) will take place before the porcelain is finally added to the crown.
Third appointment: At the third visit, the dentist will remove the temporary crown and check the fit and color of the permanent crown. If everything is acceptable, a local anesthetic will be used to numb the tooth and the new crown is permanently cemented in place.
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What is a Dental Bridge?
Missing teeth left gaps in our mouth. These gaps cause that the immediate teeth move forward and/or backward in order to try to naturally close the space, which results in occlusion problems (bad bite). For this reason, dental bridges are recommended to “bridge” the gap left by one or more missing teeth.
The bridges are made of 2 or more crowns which will be anchored to the teeth that are on either side of the empty space. The anchoring teeth are called “abutment teeth” and the false teeth in between are commonly called “pontics”.
Since the bridges are made with crowns then, the materials are the same as the ones used for dental crowns: metal alloys, gold, zirconium, etc.
A Dental Bridge is necessary to:
- Restore your smile.
- Restore the ability to properly chew and speak.
- Maintain the shape of your face.
- Distribute the forces in your bite properly by replacing missing teeth.
- Prevent remaining teeth from drifting out of position.
Process for a dental bridge
The process for a bridge is the same as the process for a dental crown since, as previously mentioned, bridges are made with crowns.
In the first visit the teeth that will work as “abutment teeth” (or anchors), will be reduced in size and shape. Then, the impressions are taken in order to use them as a model to build the bridge (abutment teeth/implants pontics). During the same appointment, you will leave the clinic with a temporary bridge in order to protect the prepared teeth (or implants) and the gums while the bridge is being made. Then, few days later, you will come back in order to remove the temporary bridge and cement/fit the permanent bridge.
As you can see, our primary concern at New Smile Dental Group in Costa Rica is to provide you with the highest value of dental services and our dentistry philosophy is to keep and restore your natural teeth without removing them, evidently, not sacrificing the quality of the procedure.
Our doctors will extract a tooth just when they have explored all the possible options to save it and there are no more choices.
Types of Dental Bridges
Traditional bridges
These are the most common bridges and require 2 or more teeth/implants (abutments) on either side of the gap where the pontic(s) will be seated.
Cantilever bridges
These bridges are supported by one end only, meaning that there will only be anchoring teeth on one side of the gap left by the missing tooth/teeth.
Maryland bonded bridges
This is not a very common or recommended bridge. It consists of a false tooth (pontic crown) with two metal wings on the sides. These metal wings have a porous surface so that they can receive a bonding agent, and then the wings are bonded to the back sides of the teeth on either side of the missing tooth.