Crowns (Caps) and Fixed Bridges

Crowns (Caps)

A crown (or cap) is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.
Although there are several types of crowns, porcelain (tooth colored crown) are the most popular. They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile.
Dental crowns used to be made with metal foundation, but with the new technology we can make them out of pure porcelain, or zirconium.

A porcelain or zirconium

  1. This is the newest type of dental crowns and they have the nicest appearance.
  2. They mimic the natural appearance to the degree that it is difficult to tell that it is not a natural tooth.
  3. They are made of pure ceramic or zirconium base.
  4. It looks like it is one piece with your tooth.
  5. Less tooth structure is taken of for the preparation of this kind of material.
  6. It’s metal free and thus satisfies the needs of patients with metal sensitivity.
  7. The surrounding gum swell less and the crowns last longer due t the different kind of cemenaton.

Porcelain fused to metal

They have a nearly natural appearance because:

  1. They have a metal substructure which makes it impossible to recreate the translucency of the natural tooth.
  2. They can also show a dark line at the edge of the crown next to the gum. Dentists try to hide that lie under the gum but sometimes they are unable to do this and sometimes the line doesn’t show when the crown is first placed but shows later as the gum recedes.
  3. Porcelain fused to metal crowns should be changed earlier than the porcelain ones (somewhere between 6-10 years). This is because in time, the plaque and the bacterial accumulation between the metal line and the gum may caus:
    1. gingivitis
    2. caries of the exposed part of the tooth
    3. and in a long period of time may be the cause of parodontopathy (the ailment of the tissue that is holding the tooth in a bone).
  4. There is a possibility of covering the metal line with porcelain but it is a complicated procedure and rarely used by the practitioners and the technicians.


Reasons for crowns:

  1. Broken or fractured teeth
  2. Cosmetic enhancement
  3. Decayed teeth
  4. Fractured fillings
  5. Large fillings
  6. Tooth has a root canal.


What does getting a crown involve?

A crown procedure usually requires two appointments. Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown. While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown. Once these details are accomplished, your temporary crown will be placed. At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.
You will be given care instructions and encouraged to have regular dental visits every 6 months.

Fixed Bridges

A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth. Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.

Reasons for a fixed bridge:

  1. Fill space of missing teeth.
  2. Maintain facial shape.
  3. Prevent remaining teeth from drifting out of position.
  4. Restore chewing and speaking ability.
  5. Restore your smile.
  6. Upgrade from a removable partial denture to a permanent dental appliance.

What does getting a fixed bridge involve?

Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment. At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time. You will receive care instructions at the conclusion of the procedure. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge. – The advantage for the bridge comparing to the removable appliance is that it is fixed, stable, and feels like your own teeth. In most cases it can be made to look like you never had a tooth missing. – The disadvantage is that you have to treat two teeth besides the one that you extracted. Now if those teeth are already with big fillings and caries than it is a good choice to cover them with a crown to protect them, but if they are healthy teeth with a small filling, there may be a choice (depending on the position of the teeth) which only a dentist can suggest. That would be an inlay bridge where just a little portion of your tooth is prepared keeping the rest of it untouched. This is done to spare the tooth because the person will need it for a long time and who knows when he will need it for a full crown.