What is a dental crown or cap?

Dental crown is a cap which is permanently cemented or fixed to a tooth. The tooth needs to be prepared to receive a crown. It completely covers the tooth. It is placed to support a broken or chipped tooth, or in which filling alone cannot be done.

They are also used to cover root canal treated tooth to strengthen and support them. It can also be fixed to an implant placed in the jaws.

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What is a dental bridge?

Dental bridge is a fixed system used to replace a missing tooth or  multiple teeth. Presence of adjacent healthy teeth is important as bridge will take support from them. It involves modifying the adjacent teeth so that they can act as pillars to support this bridge.

 

What are the materials used for Dental crowns or Dental bridge?

They can be made from multiple materials, most common of which are

• Complete Metal: Used for posterior tooth.

         Advantage:

           i.   Less tooth cutting is required

           ii.  They are strong and metal doesn’t get chipped.

         Disadvantage:

           i.  It has less esthetics as it is metal (silver) coloured.

• Porcelain fused to metal (PFM) : Base is made up of metal to increase the strength and porcelain (tooth coloured) is layered over it to improve aesthetics.

          Advantage:

            i.   The Aesthetics is better than the metal crown but less than the zirconia crown.

            ii.  Similar to metal in strength.

            iii. Cost effective option.

          Disadvantage:

             i.  Tooth cutting is slightly more as compared to metal crown

             ii. The porcelain can get chipped off leaving the metal surface exposed which acts as nidus for food lodgement and is unpleasant aesthetically. 

             iii. They show an exposed metal line where it meets the tooth if not made properly.

• Zirconia : Its is a strong ceramic material. It is white coloured. It can be used for both anterior and posterior teeth.

            Advantage:

              i. Very good aesthetics as the translucency of the material is good. Higher translucency lets this material transmit more light. Hence, we get a more natural looking tooth.

              ii. They can completely replicate the colour and shade of adjacent tooth.

              iii. It is very strong, similar to metal.

              iv. As there is no metal, chances of allergy are very less.    

           Disadvantage:

              i. It is more expensive than the PFM option

• Emax (Lithium Disilicate crowns) : It is used mostly in front teeth

           Advantage:

              i. Best aesthetics as it can transmit the most amount of light.

              ii. It is most used to cap a single tooth

              iii. It is also used for veneer for correcting fluorosis stains, chipped teeth and to correct minor alignments.

           Disadvantage:

              i. The strength of this is slightly lesser compared to the zirconia.

What is the procedure for Dental Crowns or Dental Bridges?

  Dental Crowns or Dental Bridges procedure involves multiple sittings.

   First visit: 

• The tooth is trimmed and then the impression of the trimmed tooth is taken.

• The shade is recorded according to the adjacent tooth.

• Patients are provided the option of receiving an immediate temporary crown.

The impressions are then sent to the dental laboratory to create the crowns.

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  Second Visit: 

• The crowns will be fitted onto the teeth with dental cement.

• Patient’s bite is checked and the fit of the crown is confirmed.

 

How many appointments are required?

The process of dental crown or bridge will require at least  two appointments.

Most of the time it can be finished within a week.

 

How much do dental crown cost?

The cost of dental crown ranges from ₹ 4500 to ₹ 15000 depending on the material used. When it is a bridge, the cost depends on how many teeth are being restored.

 

Is the procedure painful?

No, the process is not painful. The modification needed for the crown or bridge is done on the superficial surface of tooth. There might be some sensitivity sometimes, which can be alleviated with the help of anaesthetic injection.

 

Are there any inhibitions after crown/ bridge cementation?

You might be asked to eat soft food from that side for 24 hours.After 24 hours there are no inhibitions to food.

 

Are these crowns or bridges permanent?

They are as permanent as your teeth.   

 

Can you do crown and bridge for you front/anterior teeth?

Yes, this treatment is available for the front/anterior teeth.

 

Can you have allergies to materials used in crown and bridges?

The materials used are bioinert and are generally not known to be allergenic. However metal crowns containing nickel may cause an allergy, if you have a history of allergy to metals, but this is very rare.If you are a person who is allergic to metals, there are options like zirconia crowns. These are fabricated from zirconium (titanium dioxide) and various other types of all ceramic crowns.

Which one should you choose PFM or zirconia?

Here are the different parameters on which choice will differ.

• Strength : PFM is Optimum while Zirconia is strongest.

• Aesthetics : PFM is Optimum due to opaque nature of metal inside while Zirconia is Superior, due to better reflection.

• Bio-compatibility : PFM is Optimum due to Not indicated for patients with metal allergywhile Zirconia is Superior.

• Soft tissue (Gums and other tissues) response : PFM is Good while Zirconia is Excellent.

• Is it indicated for bruxers? : PFM is not indicated and it may chip off or wear the opposing tooth while Zirconia is indicated.

• Hypersensitivity : PFM may cause hypersensitivity while Zirconia has reduced hypersensitivity.

• Tooth reduction : PFM has more tooth reduction compared to Zirconia.

• Gum recession related aesthetic problems : PFM has gum recession related aesthetic issues while Zirconia hasnt

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