For crowns, Dr. Manduzzi generally prefers to use an amazingly strong ceramic material called Zirconia. Easily 3 times stronger than porcelain, our crowns are designed to be both aesthetically pleasing and strong enough to withstand virtually any amount of biting force. All crowns we provide for our patients are made in the USA with the most advanced materials and technology available today.
What Are Dental Crowns?
Dental crowns, sometimes referred to as “caps,” are one of the most common and most important treatment options for restoring a compromised tooth.
Why Do People Need Them?
Teeth can be compromised and in need of a crown restoration for multiple reasons. One of the most common applications for a crown is to restore a broken or fractured tooth. When a significant portion of the tooth is missing, particularly if it is one of the main cusps of the tooth, a crown is generally the restoration of choice. Teeth can fracture or break as a result of a large area of tooth decay which weakens the tooth structure. Teeth can also break if they have been compromised with a large filling because the residual tooth structure becomes weaker and is often like a thin shell around the extensive filling.
Teeth undergo tremendous force during chewing. If you’ve never thought about how much force the teeth and jaws can emit, think about it in these terms: even the strongest bodybuilder in the world cannot break an ice cube with his or her fist. But if you put that ice cube in between your back teeth, you can break it fairly easily. After chewing on a tooth compromised with a large filling in it hundreds of times per day over a period of several years or sometimes even several decades, inevitably the tooth will suffer the effects of wear and tear and can break, thus necessitating being restored with a “full coverage” restoration, like a crown. A crown is sometimes referred to as a “cap” because in putting in a crown, the residual tooth structure is reduced and the crown goes over and “caps” the tooth to protect it from breaking further. It also allows the forces from chewing to be distributed over the entire tooth rather than be directed at a particular, weakened area of the tooth.
What Teeth Do Crowns Treat?
The most common teeth to need a crown are the molar teeth, which are the bigger, “workhorse” chewing teeth found toward the back of the mouth. After the molars, the premolars are the next most common teeth to need a crown. The premolars are also considered “back” or posterior teeth. This makes sense when one compares how the teeth and jaws work to how a device like a nutcracker works. When one wants to break a nutshell in a nutcracker, he or she places the nut as close to the joint of the nutcracker as possible. The area closest to the joint is the most efficient place to crack the nut because this is where the greatest amount of force can be applied. The same principle is true for the teeth and jaws. The joint, in the case of our teeth and jaws, is the temporomandibular joint, or TMJ, and is found close to the ear, behind the teeth. Therefore, the further back the tooth is within the mouth and the closer it is to the TMJ, the more efficient it is to chew because a greater amount of force can be applied. In addition to the location of the tooth within the mouth, the molar teeth by their nature are designed to perform the majority of the chewing work because of their larger, broader chewing surfaces. The same is true of the premolars (found between the canine teeth and the molar teeth), to a lesser degree. The front teeth – the incisors and canines – by contrast, are sharper and thinner, and are designed for shearing a piece of food off of an apple or sandwich, for example, but then that piece of food is moved to the back of the mouth where the bigger, broader premolar and molar teeth grind and mash that piece of food into smaller pieces that are easier to swallow.
Another common scenario when a tooth should be restored with a crown is after a tooth has undergone root canal treatment. This is especially true for the back, or posterior, teeth such as molars and premolars which, as discussed previously, take the majority of the force when chewing, In undergoing a root canal, a tooth is more or less hollowed out to remove the infected nerve tissue which resides internally in the tooth. Removing a significant portion of the tooth during a root canal leaves the tooth weaker and renders it more likely to fracture. Once a root canal-treated tooth is restored with a crown, it is protected and much more likely to last long-term.
Crowns are also sometimes used to restore a tooth that experiences pain when chewing on it. Oftentimes, when one experiences pain upon chewing, it can be a result of a crack within a tooth. This phenomenon is known as “Cracked Tooth Syndrome.” In these cases, restoring the tooth with a crown will generally resolve the symptoms of pain, again because it helps distribute the chewing forces over the entire tooth rather than on the cracked area.
What’s The Difference Between Direct and Indirect Crowns?
Crowns are considered an “indirect” restoration for a tooth. They are different from “direct” restorations such as fillings in that a filling is created and inserted within a tooth in one visit. The term “indirect” implies that a crown is fabricated at an outside dental laboratory and is adhered to the tooth at a second visit. When an indirect restoration such as a crown is done to treat a tooth, the vast majority of the work done to the tooth will be performed in the first visit where the tooth is reduced in size and given a proper shape and contour to house the crown. Further, an impression is taken at the first visit which will be sent to a dental laboratory who will then fabricate the crown. After the impression is taken, a temporary crown will be fabricated in the office at the first visit and cemented onto the tooth with a temporary cement. The temporary crown will be removed at the second visit, which generally occurs about 2 weeks later, when the lab-fabricated crown is inserted and cemented in place.
What Materials Are Dental Crowns Made From?
Crowns can be made from many different materials. In the past, crowns were generally made of gold and other metals. With the advent of cosmetic dentistry, patients began to desire restorations that more closely mimic the color of a real tooth. A hybrid type of material known as PFM, which stands for porcelain-fused-to-metal was a very popular material that was commonly used for decades. PFM crowns have a metal substructure and are covered with porcelain to help the crown look more like a tooth. In the modern era, the most common types of materials used for crowns are ceramic in nature. Dr. Manduzzi generally prefers a ceramic option known as zirconia which offers a combination of tremendous strength and beautiful esthetics.
A bridge is a viable way to replace a missing tooth or a few missing teeth. A bridge is essentially like two crowns on either side of a missing tooth with a fake tooth fused between them that rests on the missing tooth site. The missing tooth is replaced by anchoring it to its two neighboring teeth.