The anatomy of a tooth can be divided into two basic parts—the root and the crown. In a person with a healthy gum and bone level, the root of the tooth is covered by the gums and bone. The rest of the tooth that is visible in the mouth, above the gum line on lower teeth and below the gum line on upper teeth, is called the clinical crown. A cemented restoration that partially or completely covers the outside of the clinical crown is referred to as a dental crown, or cap.
Crowns can be made out of a gold alloy, some other metal alloy, stainless steel, all-porcelain/all-ceramic, composite resin, zirconia, or porcelain on the outside fused to metal or zirconia on the inside. In many cases, Dr. Horne can create ceramic crowns with CAD/CAM technology by milling the crowns out of blocks of porcelain in the dental office, without the need for temporaries or a dental laboratory. There are advantages and disadvantages to all of the types of dental crowns. Gold dental crowns have traditionally been the most durable and require less of the tooth to be removed or shaved down. The primary advantage of porcelain crowns is their esthetics, and newer types of ceramic crowns have become increasingly more durable.
Dr. Horne will ask you if you would like to use nitrous oxide to help achieve a more relaxed state. Then he will apply anesthetic gel around your tooth before numbing the tooth with local anesthesia. If the tooth has been fractured or had a root canal treatment, it will first need to have a buildup—a filling that restores enough of the tooth for the crown to hold onto. Then the tooth is shaved down to make room for the crown and an impression is made of the prepared tooth with a putty-like substance or a digital scanner. Dr. Horne will then determine the shade of your teeth using a shade guide or take pictures of your teeth to help the lab technician make crowns that will match the rest of your teeth. If Dr. Horne determines your crown can be made the same day, he will design the crown, mill it, apply custom glaze and tinting, and fire it. Then it will be cemented—all in about 2 ½ hours.
If the crown needs to be sent to the laboratory, a temporary crown will be made from a resin or acrylic material using a molding or stent of the original tooth. This temporary crown is cemented with temporary cement so that it can come off easily once the permanent crown is ready.
Usually after a few weeks, you will return for a second visit. During this visit, the tooth may or may not need to be numbed again and the temporary crown is removed. The permanent crown is placed on the tooth and inspected for acceptable fit, bite, and smooth margins. After any necessary adjustments have been performed, the crown is cemented with a permanent cement or glue.
Call our Encinitas, CA office today to schedule a consultation with Dr. Horne. Together, you will develop a conservative treatment plan that will help you with all your dental needs.