Crowns and Bridges Treatment
Crowns
A crown is a tooth-shaped porcelain covering that is bonded over a tooth that is badly decayed, root canal treated, or structurally damaged so as to improve its appearance and to restore its shape, size and strength. Crowns are generally used when the damage or decay is so extensive that filling materials cannot make the tooth strong enough. In addition, crowns can be used to retain a bridge and cover discoloured or misshapen teeth.
Bridges
A bridge is a fixed prosthesis that replaces one or more missing teeth (i.e. the part above the gum) and is made up of two or more crowns. A conventional bridge will be one that consists of two crowns, one on either side of missing teeth or space, carrying a replacement tooth. Most bridges have the supporting crowns and replacement teeth joined rigidly together in one piece.
Importance of replacement of missing tooth and/or teeth. What happens if I do not
- Drifting of adjacent teeth and over-eruption of opposing teeth -> possible decay
- Difficulty with eating -> indigestion a common contributing factor
- Loss of youthful look
- Loss of Lip support
- Difficulty with speaking
- Bone loss in areas where teeth used to be -> loss of facial contours which will affect the appearance.
Options to Replace
- Dentures
- Fixed Bridges
- Implant supported crowns or bridges. (Medisave claimable)
Success rate
The lifespan of a bridge varies tremendously, depending upon numerous factors present in different people. Research has shown that the success rate for crowns is about 85% to 90% over ten years.
Advantages of Crown and Bridges
- Advanced treatment that almost mimics the look, feel, and function of natural teeth.
- No or only slight movement during function ( depending on the health of the supporting tooth/ teeth)
- If extraction is not involved, treatment period is shorter, within 1 month
- Treatment cost is affordable
- Preserve facial contours and appearance.
- Protection of weakened tooth (e.g. large restorations done or root canal treated tooth)
What is the process of Crowns and Bridges treatment?
- Pre-treatment evaluation and Treatment Planning.
- a. Examination & Diagnosis
- b. X-ray ( OPG or CT for more complex cases) and U/L Study models
- Temporary Crowns and Bridges Placement 2 weeks later
- a. local anaesthesia only
- b. Preparation of the supporting tooth/teeth 45 to 60 min per supporting tooth.
- c. Cementation of the Temporary Crown and Bridges with Temporary cement.
- Crown Placement 2 weeks later
- a. Removal of temporary crown.
- b. Trial fit for the final crown. Proper bite, contact, aesthetics, and margin are checked.
- c. Cementation of the final crown with permanent cement.
- Crowns and Bridges maintenance every 6 months.
For full mouth rehabilitation ( Full months Crowns and Bridges). A mouthguard is strongly recommended.
Suitability for Crown and Bridges.
- Medical Health.eg. Diabetes, reduced body resistance
- Dental Health. e.g. Periodontal health, Bruxism
- Social Health e.g. Smoking ( Note : Success Rate <10 %)
How long to wait after extraction?
Depends on the degree of difficulty of the extraction, presence of infection, bone quality and quantity.
- Immediately restored with Temporary Replacement Prostheses.
- 1 to 3 months after extraction. Temporary Replacement Prostheses may be requested while the wound site is healing.
Ensure that no patients leave the clinic with MISSING TEETH at all times.
How long will I have to wait until I get my teeth?
Temporary Crowns and Bridges will be cemented on the prepared tooth/ teeth and the final Permanent Crowns and Bridges will be ready within 2 weeks from when extraction is not involved.
Is it Painful?
Only local anaesthesia is required. Some patients do feel slight sensitivity but the discomfort will diminish with time.
Pre-Crown and Bridges Precaution?
Not necessary unless due to medical considerations. Thorough Scaling and polishing is always advised if patients’ teeth are covered in thick plaque or calculus (calcified plaque) or they have gum disease.
Post-Crowns and Bridges Care
- Proper oral hygiene habits
- Soft diet
- Mouthguard if the patient is a bruxer( grinding of teeth) or a full mouth rehabilitation case.
How soon can I eat and function after my crowns and/ or bridge is fit?
Immediately. After 1 to 2 hours it is advised to ensure proper setting of the permanent cement.
How to take care of my crowns and bridges?
- Keep clean and plague-free by brushing using a small soft-bristled toothbrush twice a day
- Floss once daily
- Cleaning or rinsing after a meal.
- Mouthwash
- Inter-dental brush
- Visit a Dentist 2x a year.
Complications
- Crowns and Bridges become loose
- a. Failure of the cement
- b. Heavy bite
- c. Supporting tooth / teeth failing
- Chipped tooth/ porcelain
- Gum inflammation/ Infection
Patient Cost For Crowns and bridges replacements
Affordable and comfortable.
Aesthetically acceptable as porcelain is closest to tooth enamel in terms of strength, translucency, and colour.