Dental Crown-types, experience, replacement procedure and reasons

You probably would have already experienced root canal and may expect dental crown replacement to be equally traumatic. Or you might be suffering from dental phobia. Fear not! You have your dentist to your rescue!

You will be sedated, therefore you will experience a pain free treatment. If you are very scared you’ll be given intravenous sedation. With sedation, you will be so relaxed,  you will not even remember the procedure.

Types of Dental Crowns

Temporary crowns are used for appearance and to fill the holes in a smile while the final permanent work is still being completed. Rather than being made with metals or durable porcelain, they are often made using resin composites or acrylic. They look great and help to protect the site being prepared for final restoration.

Temporary crowns are not meant to withstand more than a few months at most. Specific bonding agents, for example softer cements, are used for easy removal in the near-term future.

Permanent also known as “definitive” crowns are bonded to the tooth or implant using dental cement. These crowns are made with porcelain or metal alloys that are designed to last long-term. The process of removing a permanent crown is a more challenging and involved procedure than removing a temporary crown.

Replacement Experience

A crown replacement appointment is similar to your previous appointment when your original crown was fitted.  Following the numbing procedure, and sedation if required, treatment can begin.  The old crown is removed and the underlying tooth assessed.

If it is decayed and needs a filling, we will advise you of this. If it is a healthy tooth, it may need shaping to fit a new crown.  At this stage, the dentist will make a physical mould of your mouth ready to send to the laboratory where your new crown will be made,   allowing for a perfect shape, fit and colour.

Alternatively, a computerised scan will be made avoiding having a mould tray put into your mouth.  A temporary crown will be fitted and you will be asked to return when your new replacement crown is ready.

From your mould, or scan, the highly skilled technicians at our laboratory will handcraft your new crown from appropriate materials such as ceramic or resin to combine the right degree of strength and aesthetics.

Depending on the position of the crown, it might be a molar or an incisor, it will need to be strong enough to take the pressure when you repeatedly bite down.  The crowns are shaped and colour matched to the best specifications.  Once the work is completed, you will return for a final appointment and have your crown fitted.

Dental Crown replacement procedure

This is a very straightforward process. There are specific devices designed to remove the crowns and bridges from their underlying teeth. Soft temporary adhesives are used to make it a simple process. The crown is gently moved until the adhesive seal is broken. The weak cement releases as the crown is dried and removed from the tooth.

Permanently casted and cemented crowns however are quite challenging to remove. There are several techniques available to remove and replace a failed crown. The state of the current crown determines the type of treatment that is required. Roughly, the different opportunities fall into three categories:

• Destructive – A damaged crown cannot be reused. In this method, the crown is cut and sectioned with a high speed rotary instrument. This enables it to be pried and levered from the tooth.
• Conservative – Whenever it is available, the crown can be removed and it will remain intact. However, this can be achieved by methods that apply certain types of force which can break the cement seal hence enabling the crown to be removed.

• Semi-conservative – The crown goes through minimal damage during the removal process and it could potentially be reused. Techniques may involve cutting a whole in the crown and using the exposed hole to break the cement seal to lift the crown from the tooth.

Reasons for Dental Crown Replacement

• Tooth Decay
  One of the most common reasons patients replace old dental crowns is tooth decay. When your tooth starts to decay under the dental crown, your gums could recede. That is when your tooth root surface gets exposed and you could develop a cavity.

Regular teeth cleanings and exams will help your dentist see any decay early and potentially save you from needing a root canal. So make sure you take regular appointments!

• Chips and Breaks
  Quite often than not dental crowns these are made from strong ceramic and porcelain. Even these could get fractured. If you notice a chip or break in your dental crown after enduring a sports related injury or even biting down on something that is too hard, it is important to see your dentist.
• Complications with Old Dental Crowns
  Sometimes older dental crowns, especially those that were made from an older type of porcelain on front teeth may need replacing as you age. Gum recession tends to happen to everyone as we get older.

Old porcelain dental crowns that are placed over metal crowns can show up as shadows along the gum line. A professional and experienced dentist can replace your old crown with a new and better quality ceramic crown to ensure your smile looks great.