A young lady came to our clinic wanted all the gaps between her front teeth to be closed. She stopped her braces treatment about a year ago (due to studying oversea) leaving all her front teeth moving by themselves creating gaps and misalignment..
After examination and assessment of her teeth, we came out with a few treatment plans:
Restart orthodontic treatment /braces again (Require time)
Resin composite veneer or full porcelain veneer on right lateral and central incisor only (Imbalance of the width for the front central incisors)
Crown all the front teeth.
After discussed with her, we finally decided to have her upper four incisors crowned and resin composite on both of her upper canine to reduce the distance between the canines to accommodate the incisors.
Possible problems/risks for crowding the teeth:
The front teeth will look sightly bigger
Possible of devitalizing the teeth during preparation of teeth ending up needed root canal treatment.
Full porcelain crown is a crown frabricated for highly aesthethic demand patient as people today want to see their crown to be as natural as possible and bleanch to the rest of his/her teeth.
This is where full porcelain material comes in!! It is made mostly of Zirconia or E-Max (lithium disilicate) material. The conventional porcelain is made of porcelain layer fused to a metal surface which make is less transucent and greyish.
With zirconia or E-Max material , no metal use, therefore, no greyish appearance and more natural!!
A crown is a replacement of the outside casing of your teeth that is permanently fixed to the tooth below. They are few types of crown depends on the material used:
Full porcelain (highly aesthetic crown)
Porcelain fused to metal (commonly used)
Full metal crown (either precious/non-precious metal crown)
Because full porcelain crown is highly aesthetic, it is used to improve the appearance of the front teeth. For those that are insecure about the appearance of their teeth or their smile, porcelain crowns can be a one-fix-for-all-problems solution.
Full porcelain crown mainly used :
to brighten teeth
to make the tooth slight translucent thus making it more natural
indicated for the front teeth where aesthetic demand is higher
close gap narrowing
fix teeth that stick out
reduce crowding in the mouth
To fit the crowns, a thin layer is shaved off teeth that are to receive treatment, and this prepares them for the crowns. On the patient’s first visit of the treatment a mould is taken of their teeth in order to get the perfect shape for the next session. The crowns are then bonded onto the teeth using a bonding material of some sort. Once the bonding has taken place, which will normally take one session at the dentist, the patient’s can eat as normal.
Cases of Full Porcelain done in our clinic
This young lady presented with a discolour right lateral incisor and her right central slanting inwards. Two full porcelain crowns were fabricated to change the colour of the lateral incisor as well as to change the shape of the right central incisor (below).
A case for prepared tooth (right lateral incisor) for impression taking. A full porcelain crown was fabricated and cemented onto the tooth (below).
This young gentleman presented with poorly restore filling material on his front teeth. The fillings were removed and the front teeth were prepared for porcelain crown.
The full porcelain crowns were constructed on the model and finally cemented into patient’s mouth (below).
Another case of discolour tooth which was treated with full porcelain crown.
This man had a non-vital tooth (left central incisor) which was root treated had showed badly discolouration. The tooth was treated with porcelain crown.
Another case of discolouration which was treated with full porcelain crown
Advantages of full porcelain
Crowns are very popular because they have an excellent history of fixing dental issues, and their track record is proven to work in all countries in the world. Up until quite recently, crowns were bonded to the tooth using a metal-based framework (porcelain fused to metal) so that the crown could withstand the pressures involved with daily chewing of food in the mouth. Today, most of the time the metal framework is not required, since modern technology has advanced up to the point where pure porcelain is strong enough even for use on hard working molar teeth. The metal framework had an issue – after a few years the gum line of a patient would recede with age, revealing an ugly grey line at the top of the crowned tooth. Due to the color of the metal showing through, it was difficult to make crowned teeth look natural for more than a few years.
The advantage of using pure porcelain is that the crowns are near identical in color to the existing colors of the patient’s teeth, making it nigh on impossible for others to discern a crowned tooth from a real one. A dentist will match the color of the crown to the tooth color already in the mouth, and then they will place an order with a lab to create the tooth with the perfect color and shape, taken from the previously mentioned mold, and patients are very happy with the results, and their new smile.
A crown is a replacement of the outside casing of your teeth that is permanently fixed to the tooth below. In other words, the decayed or damaged area of your tooth is removed and replaced by synthetic material, such as porcelain, to create a new ‘tooth’ with permanent results.
Crowns are often used after a root canal treatment, because the removal of a nerve causes a tooth to discolour. However, there are other reasons your dentist might crown one or more of your teeth: to restore a damaged or fracture tooth, to protect a weakened tooth so that it does not fracture under stress or to reinforce a large filling where there is not enough tooth structure left below.
Crowns are also made out of various material: gold or non-precious alloy, porcelain or ceramics, acrylic or composite resin, or even a combination of porcelain on metal. Obviously the material chosen will be in line with what will work best for your particular problem.
Currently, most dentist use porcelain fused to metal crown or full porcelain crown as both crowns produce good aesthetic result
How do we do it?
When crowning a tooth, your dentist starts by filing away away between 1mm and 2mm on every surface of your teeth, and then the entire surface is smoothed. Next, an impression is taken of the prepared tooth by syringing an impression material into the space around the tooth and holding an impression tray in position until the material has set. This gives the laboratory a perfect negative copy of your tooth, which allows them to make up the permanent crown. The dentist also ensures he sends the laboratory details of what the colour porcelain to use, to ensure the crown looks natural.
Your are then fitted with a temporary crown, which is really just a rough space-filler, while you wait for the laboratory manufacture the permanent fixture.
At the following appointment, the dentist will have taken delivery of the permanent crown. The temporary crown is then removed, and the prepared tooth below thoroughly cleaned and dried. Then the new, permanent crown is cemented onto the tooth below. Any excess cement is removed, and the treatment completed.
Picture on cases done in our clinic
Here is a example of a discolour tooth that is replaced with a full porcelain crown (E-Max)
The young gentleman dislike his front discolour right central incisor
His tooth discolouration was due to old filling and the tooth is non-vital
After the tooth is prepared, colour of the porcelain crown is chosen to match his neighbour teeth
The full porcelain crown is cemented onto the tooth
Final Result – natural looking crown!! (Treatment done by Dr. H.W.NG)
You do need to take care of your crown and not overstress it by biting or chewing very hard food. You can also floss normally around a crown. If at a later stage, your crown should break, you need to see your dentist as soon as possible, especially if the tooth inside becomes sensitive. Save the fractured piece if you can, as this can be glued back on temporarily until a new crown is made.