Crowns & Bridges

Crowns and Bridges

A dental crown is a type of tooth restoration that fully covers damaged/broken portion of the tooth or is placed over the implant to help in chewing and other functions.

When do you need a crown?

• Damage to the tooth surfaces due to decay
• Large fillings that need additional protection to ensure the integrity of the remaining tooth
• Root canal treated teeth need additional reinforcement with crowns to keep the underlying tooth protected
• To restore a broken or severely worn down tooth
• For aesthetic purposes especially for the front teeth to hide any staining on teeth or damage to the teeth
• To close any minute gaps in between teeth that are desired by the patient for aesthetics
• To cover a dental implant so that it matches your natural teeth and performs all functions like it

What is a Bridge and when do you need it?

• A bridge is used to fill up a gap or one or more missing teeth
• To make a bridge one needs one tooth on either side of the bridge. Support is taken from these teeth to fabricate the bridge. Sometimes if the length of the bridge is more than three teeth, then support may be taken from additional teeth present in the same span of the bridge to be able to bear the stresses from chewing.
• Bridges are the best alternatives if we do not wish to go in for Dental Implants
• It is important to replace missing teeth to avoid drifting of teeth into the open spaces and to thus maintain the health of the gums.
• Replacing the teeth will help to regain any changes to speech and appearance

Types of crowns available for crowns and bridges

Porcelain crowns are made up of porcelain or silica, material similar to vases and clay pots.

Advantages of Porcelain fused to metal crowns

• PFM crowns are the best choice for crowns if aesthetics is not a concern as there is a metal layer beneath the porcelain which differentiates it from the aesthetic metal free crowns.
• Long term prognosis and durability are well established
• Available at an affordable price

Disadvantages of Porcelain fused to metal crowns

• Aesthetics of porcelain free crowns is greater than PFM crowns
• Grey line is visible at the gums due to the presence of metals beneath the porcelain

E-MAX crowns are made from lithium desilicated ceramic, which is known for its translucent colour and durability. As a result, you get a naturally looking crown that is tough and durable and matches with the remaining teeth in your mouth.

Advantages of E-Max crowns

• This is generally a material of choice for Veneers

Zirconia Crowns offer extremely high strength and also are very durable. They are made from zirconium dioxide, which is actually a metal, but is categorised as a type of a ceramic crown.

Advantages of Zirconia crowns

• This is the material of choice for most crowns nowadays due to enhanced aesthetics as the colour and hue matches the natural teeth
• Durable and useful even in the posterior teeth
• Do not cause allergic reaction in most of the patients

CAD CAM Crowns

Click here for more details of CAD CAM crowns

What procedures are involved in making a crown and Bridge?

• An initial assessment is done with the help of a radiograph
• Based on the findings of the radiograph any underlying decay is taken care of with the help of fillings or Root canal treatment as required
• First visit for the crown or Bridge
  • Initial shaping of the crown/crowns is done based on the type of the crown selected
  • Impression is taken with the help of latest materials (Putty) for accurate details that will be helpful during fabrication of the crown/bridge in the lab. The dentist may also take a digital impression
  • Shade selection is done wherever applicable to ensure the colour of the crown matches with the shade of the existing teeth in the mouth
  • The impression is then sent to the Dental lab for fabrication of the crown/bridge and the patient is called for a subsequent visit in 2-3 days. This may vary from case to case
• Second visit for the crown
  • During this visit the dentist will check the fit, size and shape of the crown/bridge
  • He may check the shade as well in this visit if the crown is metal free or may call the patient for another visit
  • If the dentist is satisfied with the fit, size and shape of the crown/bridge and the patient is satisfied with the shade the patient is called for his third visit in 2-3 days
  • The verified crown/bridge is sent back to the lab for final finishing
• Third visit for the crown/bridge
  • During this visit one final check is done to check the fit, size, shape and shade of the crown/bridge
  • The crown/bridge is then finally fixed or cemented onto the tooth or the Dental Implant
  • The patient then checks for fit of the crown/bridge with all his teeth in contact. In case the patient feels uneven in any place, the dentist will correct it with slight adjustments that is possible in the clinic itself
• Follow up visit
  • The patient is advised to come for a recall visit after a week to check for any complaints related to the cemented crown/bridge
• Special notes
  • The above is a standard procedure for fabrication of the crowns/bridge and this may differ according to the crown/bridge
  • There are additional steps during the making of the implant crown which have not been highlighted in this section.
  • A bridge requires shaping of more than one tooth depending on the number of teeth to be replaced.

Post Procedure instructions

• If Local anaesthesia was given to you in any of your visit avoid taking too hot or cold foods and chewing till the effect of the numbness wears off
• It’s normal to experience some hot or cold sensitivity after each appointment.
• Avoid eating anything for an hour after cementation of temporary or final crown & bridges. You may eat after an hour, and use the opposite side for first 24 hrs.
• Avoid chewing gum especially after fixing of temporary crown
• Regular brushing & flossing should be followed. Use mouthwashes if prescribed
• If your bite feels uneven or you feel persistent pain or sensitivity, please book an appointment to consult the dentist.

How to take care of the oral hygiene when one has a crown or a bridge?

• Brushing twice daily with the appropriate technique advised by the dentist
• Use of dental floss to clean the surfaces and food accumulation near the gum line and in between the teeth
• Use of Mouthwash as advised by the dentist on regular intervals
• Visit to the dentist for regular check-ups every six months

Learn more on how to Brush and floss your teeth click here

Digital Impression

• Digital Impressions employs the latest methodology in capturing a replica of the mouth. It uses a wand-like tool with an advanced software which is connected to a computer. A virtual model of the hard and soft tissues of the mouth can be created with this.
• The digital impression is taken by scanning with the wand-like tool and is sent to the lab for fabrication of dentures, crowns, bridges, and retainers. The digital impressions provide a greater accurate replica of the mouth to fabricate the prosthesis. This helps reduce time saved by physical transportation of the impressions of the jaws.
• Digital impressions are less messy and way more pleasant than the traditional impression material. Patients with a severe gag reflex or sensitive teeth can enjoy a more comfortable experience while a dentist takes the digital scan of the teeth.
• Digital impressions have the greatest advantage of higher level of accuracy
• Also, since these are 3D scan which can be zoomed into, it’s easier to replicate and use each and every detail of the scan for the fabrication of a prosthesis or for making an appliance for the patient.