Dental crowns

Dental crowns, also known as caps, are restorations that completely cover or encircle a tooth or dental implant. Crowns are used to restore the shape, size, strength, and appearance of teeth. They are typically needed when a large cavity threatens the health of a tooth, or following a root canal treatment, among other reasons.

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Purpose of Dental Crowns:

- Restoration: Repair and restore a damaged or decayed tooth.

- Protection: Protect a weakened tooth from breaking or hold parts of a cracked tooth together.

- Aesthetic Improvement: Improve the appearance of discolored or misshapen teeth.

- Support: Cover and support a tooth with a large filling when there isn't much tooth left.

- Dental Implants: Cover dental implants to restore function and aesthetics.

- Bridges: Hold a dental bridge in place.

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Types of Dental Crowns:

1. Porcelain-Fused-to-Metal (PFM) Crowns:

   - Advantages: Natural tooth color, strong and durable.

   - Disadvantages: Metal can sometimes be visible at the gum line, porcelain can chip or wear.

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2. All-Ceramic or All-Porcelain Crowns:

   - Advantages: Best natural color match, suitable for people with metal allergies, highly aesthetic.

   - Disadvantages: Less durable than metal-based crowns, more wear on opposing teeth.

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3. All-Metal Crowns:

   - Materials: Gold alloy, other alloys (e.g., palladium), or a base-metal alloy (e.g., nickel or chromium).

   - Advantages: Very strong and durable, less tooth removal required, withstands biting and chewing forces.

   - Disadvantages: Metallic color, not suitable for front teeth.

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4. Zirconia Crowns:

   - Advantages: Extremely strong, natural appearance, biocompatible, metal-free.

   - Disadvantages: Can be more expensive.

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5. Resin Crowns:

   - Advantages: Less expensive, can be made to match the color of natural teeth.

   - Disadvantages: Less durable, more prone to fractures and wear.

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Procedure for Dental Crowns:

1. Initial Consultation and Diagnosis:

   - The dentist examines the tooth, takes x-rays, and discusses treatment options.

2. Tooth Preparation:

   - The tooth receiving the crown is filed down along the chewing surface and sides to make room for the crown. If a large area of the tooth is missing due to damage or decay, a filling material may be used to build up the tooth.

3. Impressions:

   - An impression of the prepared tooth and surrounding teeth is made. This can be done using a putty-like material or digitally with a scanner.

   - Temporary Crown: A temporary crown is placed over the prepared tooth to protect it while the permanent crown is being made.

4. Crown Fabrication:

   - The impression is sent to a dental laboratory where the crown is custom-made. This process typically takes 2-3 weeks.

   - In some cases, same-day crowns can be made using CAD/CAM technology (e.g., CEREC).

5. Fitting the Crown:

   - Once the permanent crown is ready, the temporary crown is removed, and the fit and color of the permanent crown are checked.

   - Adjustments are made as necessary, and the crown is cemented in place with a special dental adhesive.

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Post-Procedure Care:

1. Sensitivity:

   - Temporary sensitivity to temperature changes is common. This usually subsides within a few days to a week.

2. Oral Hygiene:

   - Brush twice a day and floss daily to maintain the health of the crowned tooth and surrounding gums. Special flossing tools or techniques may be recommended to clean around the crown effectively.

3. Diet:

   - Avoid chewing hard foods, ice, or other hard objects to prevent damaging the crown. Sticky foods should also be avoided as they can pull off the crown.

4. Regular Dental Visits:

   - Regular check-ups and cleanings are important to monitor the health of the crown and surrounding teeth.

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Longevity and Maintenance:

1. Durability:

   - The lifespan of a dental crown can range from 5 to 15 years or longer, depending on the material used, oral hygiene practices, and habits such as teeth grinding.

2. Replacement and Repair:

   - Crowns may need to be replaced or repaired due to wear, damage, or changes in the underlying tooth structure. Regular dental visits help to identify any issues early.

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Complications and Considerations:

1. Discomfort or Sensitivity:

   - Some patients may experience discomfort or sensitivity, especially if the tooth still has a nerve. Using toothpaste designed for sensitive teeth can help.

2. Chipped Crown:

   - Crowns made of porcelain can sometimes chip. Small chips can be repaired with composite resin, while larger ones may require a replacement crown.

3. Loose Crown:

   - Sometimes the cement that holds the crown in place can wash out, allowing the crown to become loose. This can also allow bacteria to leak in and cause decay. If this happens, see a dentist promptly.

4. Crown Falling Off:

   - If the crown falls off, it’s usually due to an improper fit or lack of cement. The dentist can re-cement the crown or make a new one if necessary.

5. Allergic Reactions:

   - Some people may have an allergic reaction to the metals used in some crowns. This is rare and typically addressed by choosing a different crown material.

6. Gum Irritation:

   - Temporary gum irritation can occur after the placement of a crown. Proper oral hygiene and possibly an antimicrobial mouthwash can help.

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Conclusion:

Dental crowns are a versatile and effective solution for restoring and protecting damaged teeth. By understanding the types of crowns available, the procedure, and post-care recommendations, patients can make informed decisions and ensure the longevity of their dental restorations. Regular dental check-ups and good oral hygiene are essential to maintaining the health of crowns and overall oral health.