John W. Schulz, D.D.S. - San FranciscoDental Crowns
If your smile is in need of a makeover, crowns can provide predictable results. Crowns can give an unattractive tooth back its beautiful shape and color. For smaller or worn down teeth, a crown can restore the natural size of the old tooth. A crown can replace either part of or the tooth's entire structure. For procedures requiring only the areas visible from the outside, a veneer may be an alternative option.
With today's advances in dentistry, there are several options when choosing a type of crown. The most common crown utilized in dentistry is referred to as a PFM or porcelain fused to metal crown. For those that have sensitivities to metals or are worried about aesthetics, there are all porcelain crowns or crowns that are composed of a material called composite. There have been several advances in all porcelain crowns and some labs are now utilizing zirconia which is much stronger than a typical porcelain crown. Also, they still are making all metal crowns, which are typically gold, and are usually used on a molar or a back tooth. Of course all of these different options vary in durability, appearance and cost. Please contact our office for any further questions. We would be more than happy to find the crown that is right for you and your situation.
Stainless steel crowns, also known as 'silver crowns or caps', are a very common procedure used to restore 'baby teeth' (and occasionally permanent teeth) that have large caries or those that had a pulpotomy (baby root canal). Although most teeth can be filled with a white or silver filling material, stainless steel crowns are by far the most predictable and durable option to fix 'baby teeth' with large caries, large defects, or damaged enamel. This is particularly true in very young children that have caries at a young age, since it is preferred that the 'fixed' teeth last as long as possible.
The 'gold' standard. Dental gold is about 60% gold alloy which is meant to match the hardness of the enamel of opposing teeth so both wear about evenly, an important trait. Gold does not tarnish or corrode and has some bacterial-inhibiting quality. Gold crowns are strong and will not break. However, gold crowns obviously are not considered aesthetic; they are gold colored. Usually, gold crowns are used for lower back molars because they aren't as noticeable.
This is most common type of crown and has a proven track record. PFM crowns are fairly aesthetic and they look like real teeth. However, the margins or borders may appear dark because PFM crowns have a metal substructure with layers of porcelain fired over the substructure. Porcelain is very hard, much harder than natural enamel and may cause excessive wear of the enamel of opposing teeth. Porcelain may break with extreme biting forces.
These are very aesthetic, bonded crowns. They are mostly used for front teeth because they are the most natural looking type of crown and are often used in 'cosmetic' dentistry. There are many types, but they all have a common feature - no metal. They can occasionally break, but dental technology has advanced far enough to make them quite strong.
Crowns are used to restore a tooth to its natural size, shape and color after a large filling or crack in the tooth has compromised the tooth. Crowns are almost always placed after a root canal treatment because the tooth becomes weak and is likely to fracture. A crown will strengthen and protect what remains of the tooth and will improve your smile. Crowns are often made of all ceramic material and in some cases can be made in a single visit.
In order for the crown to be placed on the tooth, 1-2mm of the tooth must be taken away and an impression must be made of the tooth. If the office has the ability to make crowns in a day, it will be made and placed on your tooth in the same visit. Otherwise the impression is sent to a lab and your crown is fabricated there. If you have to wait on your crown, a temporary is placed on your tooth and will be replaced with your crown when it arrives. When the crown is placed on your tooth, sometimes it needs to be adjusted a little to make the proper fit. After it is adjusted it is cemented to your tooth and is a permanent solution.