When teeth are lost due to accident, decay, or bone loss (periodontal disease), it is important to replace the missing teeth. Failure to replace missing teeth results in shifting of the tooth alignment. This shifting makes it more difficult to keep your teeth clean and will have long-term effects on your bite.
There are many options to replace missing teeth. Some of the options are removable. An example of a removable appliance is a removable partial denture, or RPD. An RPD is an appliance with the missing teeth embedded in acrylic. There are clasps that connect to the remaining teeth to hold the RPD in place. The RPD must be removed when you brush your teeth and when you go to sleep at night.
There are several fixed, or non removable options, to replace missing teeth. Fixed appliances are cemented in place and are not removed. Examples of fixed appliances are bridges and implants. When a bridge is made, the teeth adjacent to the missing tooth are prepared for crowns. The replacement tooth is attached to the crowns as one unit, and it is cemented in place permanently.
Dental implants have become increasingly popular because they only address the missing space, and, unlike a bridge, nothing needs to be done to the teeth next to the missing tooth. The implant is threaded in the space into the bone that supports the teeth. The crown is screwed into the implant. A dental implant is as close as you can come to your natural teeth.
There are many options to fill teeth, but sometimes there isn’t enough tooth structure remaining to fill. In this case a crown (some patients call this a cap) is necessary. To make a crown, the tooth is reduced about 1.5 mm on top and all the way around. An impression is taken and sent to the dental lab where the permanent crown will be fabricated. While the crown is being made, a temporary crown is made and cemented to the tooth until the permanent crown is finished.
There are many factors involved in deciding what kind of crown to use in a given situation. Fortunately there are many types of crowns possible. Some examples are:
Porcelain-to-Metal Crowns – This crown has a metal substructure with porcelain bonded on top of the metal. A porcelain to metal crown is very durable and has a nice aesthetic appearance.
Full Cast Gold Crowns – This crown is gold colored and has no porcelain. It is not very aesthetic but in areas in the back of the mouth, this can be an excellent choice. Gold is very kind to the opposing teeth and the gum tissue responds better to gold than to any other material we use.
All-Porcelain Crowns – All-porcelain crowns are the most aesthetic crowns available. They are ideal for use on the front teeth. All porcelain crowns refract light similar to enamel, allowing for more depth of shade.
The type of crown used depends on many factors. Dr. DeFazio will discuss your crown options with you in great detail, explaining your options to you in an easy to understand manner.