Dental Questions: Why does it take two weeks to make a crown?

In today's world of on demand service, it may seem strange that a dental crown takes two weeks to make. Your confusion is probably compounded by news of "same day" crowns available at some dental offices. The reality is that many crowns are created (at least partially) by hand and take time, expertise and effort. Read on to learn how dental labs recreate and help replace lost teeth. 

After your first crown appointment, there is typically a two week wait until the new restoration is ready to be cemented to your tooth. In this time, a lab has to receive the impression, create a stone model and make a wax replica of your tooth. While many offices are using computer aided design and digital scanners to simplify this process, most of it is still done by hand to some degree. Converting the wax replica to metal, zirconia, porcelain, or other ceramics involves delicate processing and layering to maintain the initial structure. Finally, most crowns are colored and glazed (textured) by hand to expertly match them to the adjacent teeth. Currently, there is no computer or machine that can visually blend a tooth color to the rest of the mouth like a skilled lab technician. 

Some dental offices currently offer "same day" or "one visit" dental crowns. Here, a digital impression is taken after your tooth is prepared and the crown is milled out of a ceramic block while you wait. You will leave the office that same day with your permanent crown cemented. While this technology is fantastic in some applications and has a very promising future, our office feels that it needs a little more refining before we offer it to our patients. Studies show that the margins (where the tooth and crown meet) can be less precise with these digitally milled crowns. Additionally, many machines require additional tooth structure to be removed in order to create a shape that is compliant with the milling process. Overall, there is nothing wrong with this style of dental crown, but we feel the benefits of using a lab created restoration outweigh the drawbacks of a waiting period. 

Dental crown placement is one of the most common procedures carried out at dental offices nation wide. At our office, we specialize in creating crowns that are beautiful, functional and feel natural in your mouth. If you would like to know more about crowns, veneers, fillings or other dental procedures, please give our office a call!

Dental Questions: What is the difference between a Crown and a Veneer?

Dental crowns and veneers are two of the most commonly used techniques for restoring teeth in the front of the mouth. They are both typically made from thin layers of zirconia or lithium disilicate and are chemically bonded to the teeth. However, the applications in which they are used can be quite different. In general, crowns have certain structural advantages, while veneers allow us to make cosmetic changes while removing a minimal amount of tooth structure. 

Crowns work by encasing all surfaces of a prepared tooth (hence the nickname "cap"). They can be used on any tooth in the mouth for either esthetic or functional purposes. To place a crown, we need to reduce every side of the tooth to make room for the incoming restoration. The complete coverage allows crowns to repair extensive decay, replace fractures and even add some structural integrity to a compromised tooth. Crowns also have incredible retentive properties, as the cement and mechanical design truly lock it to the tooth. 

In contrast, veneers are typically used in cosmetic applications on the anterior teeth. They are bonded to the front surface of the tooth (as opposed to the complete coverage of a crown), and derive their retention entirely from the bonding cement. Veneers are either placed directly over an unaltered tooth or used after reducing the front surface to accommodate the extra width of material. They can repair smaller chips, close gaps between teeth or correct cosmetic concerns. 

Depending on your personal needs, a crown or veneer may be the most appropriate treatment option. If you have any further questions about crowns, veneers or other dental restorations, please give our office a call!

Case Presentation: Crown Delivery

Take a look at the amazing work we can accomplish with the help of our dental labs! This patient came to us needing a crown repaired in the front of their mouth. As always, our main concern was delivering a restoration that looked completely natural. After preparing the tooth and making impressions, we took a number of diagnostic photographs to capture the nature of the patient's smile. Using just the photos and impressions, our lab created an unbelievable new crown. The color, shaping and opacity are a perfect match to the existing teeth. If you would like to see more of the esthetic work we perform at our office, check out the "cosmetic dentistry" section on our blog index!

Cosmetic Reconstruction With Emax Crowns and Veneers

Today's case is a great example of the importance of color and translucency when designing a crown or veneer in the anterior region. This patient came to our office dissatisfied with their current dental restorations and overall smile esthetics. The crowned teeth appeared unnaturally opaque and presented with a sharp change in color where the teeth met the gum tissue. These crowns were created using porcelain fused to metal (PFM), a classic technique for fabricating tooth colored crowns. While they make very functional restorations, PFMs take away from the natural translucency of teeth due to their solid metal underpinnings. This patient's condition was exacerbated by gingival recession, which revealed contrasting natural tooth structure underneath the crown.

To create a completely natural smile, we utilized Emax lithium disilicate crowns and veneers across the maxillary and mandibular teeth. These crowns are made of a single type of translucent material, and thus transmit light like natural enamel. Similarly, the single piece construction makes these crown very strong, allowing us to replace the PFMs in the posterior region as well. By working closely with our dental lab, we created a set of crowns and veneers that are uniform in shape, color and shade. The final product is a natural and youthful smile designed to stand the test of time! If you would like to know more about crowns, veneers or any other esthetic service offered by our office, please give us a call. 

Broken Teeth

Here you can see a maxillary first premolar fractured between its two cusps. Fractures commonly occur here due to natural stress points in the enamel and dentin. This tooth was fractured down into the root space and needed to be extracted. 

Like any hard object, enamel tends to crack or fracture when subjected to a large amount of force. Hence, broken teeth are a very common source of dental pain. Symptoms can range from mild discomfort to pain when chewing or a constant radiating soreness. They are sometimes preceded by an audible "crack" or "pop" while chewing a hard object. No matter your current state, a cracked tooth needs to be addressed by a dentist before the symptoms will subside.

One of the trickiest parts of treating cracked teeth is that they are difficult to see. Traditional X-Rays frequently miss cracks, as they are trying to represent your three dimensional tooth in a 2-D image. Visual inspection will reveal some cracks, particularly vertical fractures through the crowns. However, smaller crack and cracks in the root area are impossible to spot with the naked eye. The most reliable way to see if a tooth has broken is by imaging with a Cone Beam CT scanner. Here, a specialist (often times an endodontist or oral surgeon) will take a 3D image of your tooth, revealing any cracks or defects throughout its structure. 

Once a tooth is confirmed as cracked, it will typically need to be extracted. Large splits in enamel running into root structure are impossible to repair or remineralize. Still, some shallower cracks in ideal locations can be treated with a crown and/or root canal. Here, the actual cracked portion of the tooth is removed, preventing the possibility of the defect propagating and getting bigger. However, it is important to note that these conditions are rarely met and extraction is the most typical course of treatment for a broken tooth. 

The most important thing to remember is don't wait and suffer in pain! Especially if you have pain while chewing or feel your teeth "flex" or "shift" when you bite down, there is a good chance you cracked your tooth. This discomfort will not resolve on its own; in fact there is a good chance it will worsen with time. If you have any type of dental discomfort, call our office as soon as possible. We can help you alleviate pain, reach a proper diagnosis and plan for the best course of action for getting your mouth back to normal.