Dental Crowns

Dental crowns or crowns for short, are popular toothlike devices worn over the teeth for aesthetic

and medical purposes. These devices offer dual functionality as they protect and treat damaged

teeth/tooth. Crowns are usually held in place by a dental cement often enclosing the entire visible

part of the teeth that lies at or above the gum line. They are sourced from different materials. These

materials are firm and gentle supporting normal matiscatory functions without any complications.

What you need to know

It may interest you to know that dental crowns have been in existence for quite some time now. As

far back as 1903, Dr. Charles Land was credited for creating the first dental crown. Over the years,

dental technologists have succeeded in developing templates for the treatment and correction of

weak and damaged tooth.

Presently, dental crowns are fabricated from four principal materials:

✔ Gold Alloys: Crowns made from gold and other metallic alloys are considered to be more

agreeable with the tooth. This is due to their steadfast nature.

✔ Porcelain fused to metal: They offer a fine blend of aesthetics and strength. Porcelain fused

to metal is better at preventing recurrent dental decays and makes restoration stronger than if

it were only porcelain.

✔ Base Metal Alloys: Common base-metals like silver-palladium, nickel-chromium, and

titanium are excellent materials used for the fabrication of dental crowns. Crowns obtained

from these materials are firm and resist corrosion. However, they are harder to adjust and are

more likely to cause excessive wear on neighbouring combatant tooth.

✔ Ceramic Crowns: Compared to the aforementioned variants, dental ceramics are used

mainly for aesthetic purposes. Hence, they’re are best used for frontal tooth restoration.
 Pros & Cons

When considering any form of therapy, it is always important to have an idea of the benefits and

potential risks of complications that may accompany treatment. Below are the merits and demerits

of dermal crown treatment.

Pros

● Long-term ( usually lasts for 5 to 15 years).

● High success rate:

Scientific evidence proves that treatment with dental crowns have a high success rate when

compared with other dental restoration techniques.

● Very Flexible:

Dental crowns can be used in the treatment of several masticatory disorders. For example,

crowns could be used for supporting a dental bridge or used concurrently with dermal

implants to enhance durability.

● Builds self-confidence ( by fixing broken tooth and improving aesthetic appearance).

Cons

● Crowns made from porcelain are liable to cracking. Total replacement may be necessary

depending on the extent of damage.

● Expensive:
 Dental crowns are quite expensive compared to other methods of tooth restoration. The cost

is dependent on the type of material used for the crown. Treatment with dental ceramics

(porcelain) will cost anywhere between £750 to £1,200.

● Potentially injurious (erosion of dental cement may result in sepsis).

Treatment

Following research and consultation, the following procedures guides treatment:

 Tooth preparation

The design for preparing a tooth that requires dental crown is governed by the following

principles.

✔ Retention and Resistance:

Since there are presently no dental cement that can single-handely hold the crown in place

(through their adhesive abilities), the computative steps in preparation are important for

providing retention and resistance in order to hold the crown in place.

✔ Preservation of tooth structure:

Preparing a tooth for complete crown coverage is potentially dangerous. The procedure may

damage the pulp if not done properly. It is therefore prudent to be as conservative as possible

while attempting a strong retentive restoration.

✔ Structural durability:

Dental crowns must be made with sufficient materials to ensure durability and withstand normal

masticatory function.

✔ Marginal integrity:
The strength and fluidity of dental crown restoration is highly dependent on the marginal line

design regardless of the type of material adopted. Different types of margin line configurations

have been advocated by experts. A chamfer finish provides the best fit for full metal margins

while shoulders are generally required for full ceramic crown margins. Some evidence suggests

adding a slant to margins especially where these are heavy, to decrease the distance between the

crown and the tooth tissue.

✔ Preservation of the periodontium

The placement of the finish line can ease the cementing of the crown and preserve the

periodontium. Best results are achieved when the finish line is above the gum line as this is

completely reversible.

 Procedure

I had to highlight salient points in the process of tooth preparation because, the outcome of

any dental crown treatment is completely dependent on that activity. When it comes to the

execution of dental crown treatment, two approaches may be taken.

✔ One-day procedure:

This procedure is executed in one take ( it is suitable for dental ceramics) . Aided by a wand

(scanning device), the dentist is able to create a ceramic crown from a 3D replica of the

patient’s tooth. This technique is also referred to as computer-aided design. It is time-

effective as the fabrication of dental crowns takes about 20 minutes so the crown can be

placed almost immediately. The entire process of cementing takes anything from 2 to 5

hours.

✔ Extended procedure:

This is a more conventional technique as the one-day procedure may be a little pricey for

most candidates. It usually takes 2 or more visits to completely perform this procedure.
 * During the first visit, a photograph of the tooth and jawbone is taken (some patients may

require root canal therapy before placement of a dental crown). The tooth is shaped and

polished to enhance proper fitting. A temporary crown is usually place over the tooth for

protection pending the fabrication of the final product.

* Following the construction of a fitted crown, the patient is invited for a second visit. The

crown undergoes fit testing before it is firmly cemented.

 Recovery time

Full recovery generally takes up to three months. Recovery may be delayed if proper crown

care is neglected. Ensure you brush gently, floss daily, and avoid chewing on hard foods.

Indications for Crowns

Dental crown treatment is considered appropraite for:

• Restoring the form, function and appearance of badly worn or fractured teeth.
• Improving the aesthetics of unsightly teeth which cannot be managed by simpler restorative
procedures.
• Maintaining the structural stability and reducing the risk of tooth fractures.
• Restoring the visible portion of a single dental implant.

• Replacing existing crowns which have failed.

Final Thoughts

The current technological advances in dental crown therapy is a welcome development considering

the broad range of solutions it provides. As always, the outcome for any procedure is greatly

dependent on the condition of the patient and the skill of the physician. Ensure you always consult

well-trained professional before undertaking procedure at all.