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By Reuben D. Collins, DDS
August 10, 2017
Category: Dental Procedures
Tags: crowns  
4SituationsWhereaCrownCouldImproveanExistingTooth

Porcelain crowns have been used to restore problem teeth since at least the early 20th Century. Crown technology has gradually progressed from the early use of precious metals like gold or silver to more life-like porcelain crowns, often with a metal interior for added strength. Today, most crowns are all-porcelain, made with newer materials that not only look attractive but can endure under the pressures of daily chewing or biting.

While crowns are often part of restorations for missing teeth, they’re also commonly used to cap or fit over a viable tooth with structural or appearance problems. Here are 4 situations where a crown could improve a tooth’s form and function.

Traumatized teeth. A significant blow to the face or mouth could generate enough force to chip away or fracture a significant amount of structure from a tooth. If the root remains healthy and firmly attached within the jaw, however, a crown can replace the missing structure and restore the tooth’s function and appearance.

Root canal treatments. Root canal treatments remove infected or dead tissue within a tooth’s pulp chamber, its inner core, and the root canals. The procedure rescues the tooth but can in the process significantly alter the tooth’s structure and appearance. A crown not only restores the tooth but also provides added protection against further decay or tooth fracture.

Teeth with multiple fillings. We can effectively treat cavities caused by tooth decay by filling them. But with each filling we must remove more of the decayed structure and shape the cavity to accommodate the filling. After a number of times, a tooth may not have enough structure left to support another filling. If the tooth is still viable, a crown could solve this dilemma.

Abnormally developed teeth. Teeth sometimes don’t erupt in the jaw as they should and may be only partly visible. The tooth not only looks out of place but it can’t fully function like a normal tooth. Capping an abnormally developed tooth with a crown will help normalize it and allow it to blend in with surrounding teeth.

If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”

By Reuben D. Collins, DDS
July 25, 2017
Category: Dental Procedures
Tags: crowns  
AreYouintheKnowAboutDentalCrownsTakeourTrueorFalseQuiz

So, you're about to have a tooth capped with a crown. Do you know what you need to know before you undergo this common dental procedure?

Here's a short true or false quiz to test your knowledge of dental crowns.

All crowns are the same. False — while all crowns have the same basic design — a life-like prosthetic tooth fitted over and bonded or cemented to a natural tooth — their compositions can vary greatly. Early metal crowns consisted mainly of gold or silver and are still used today. Porcelain-fused-to-metal (PFM) crowns — a metal interior for strength overlaid by a porcelain exterior for appearance — became popular in the latter 20th Century. Although still widely used, PFMs have been largely surpassed by newer all-ceramic materials that are stronger than past versions.

Crowns can differ in their artistic quality. True — all crowns are designed to replicate a natural tooth's function — in other words, enable the tooth to effectively chew again. But a crown's appearance can be a different story, depending on how much attention to detail and artistry goes into it. The higher the individual craftsmanship, the more lifelike it will appear — and the more expensive it can be.

With digital milling equipment, dental labs are obsolete. False — although technology exists that allows dentists to produce their own crowns, the equipment is not yet in widespread use.  The vast majority of crowns are still produced by a trained technician in a dental laboratory. And just as you base your choice of a dentist on your confidence in and respect for them, dentists look for the same thing in a dental lab — good, reliable and consistent results.

Your insurance may not cover what your dentist recommends. True — dental insurance will typically pay for a basic, functional crown. Aesthetics — how it will look — is a secondary consideration. As a result, your policy may not cover the crown your dentist recommends to function properly and look attractive. A new crown, however, is a long-term investment in both your dental function and your smile. It may be well worth supplementing out of pocket your insurance benefit to get the crown that suits you on both counts.

If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation.

By Reuben D. Collins, DDS
February 11, 2017
Category: Dental Procedures
Tags: crowns  
NewCrownsGiveBothDurabilityandBeautytoProblemTeeth

Repairing a decayed tooth may be as simple as removing the damaged tooth material and filling the void. Many filling materials can now match the color of a tooth, so the dental work is hardly noticeable.

Sometimes, though, the decay is too extensive or we've treated the tooth several times and it won't support another filling. If the tooth is still viable, we may be able to cover it with a custom crown.

Also known as a cap, a crown fits over and is securely affixed to the tooth with bonding material or cement. Crowns have been used for decades to restore teeth, but the materials they're made of have changed with time.

The original crowns were made of metal, usually gold or silver. They were strong and could hold up well to the daily forces produced by chewing or biting. They did, however, visually stand out and came to be regarded as unattractive. There were porcelain materials available that could closely mimic the life-likeness of teeth, but they could be weak and brittle.

Dentists came up with a hybrid crown that could supply strength as well as an attractive appearance. These were composed of two parts: an inner metal frame for strength overlaid with porcelain for appearance. These fused crowns were the most popular until the mid-2000s.

About that time, newer forms of porcelain came on the market that were not only attractive, but also durable. Although caution should still be taken when biting something hard, they've proven to stand up well to biting forces. Fused porcelain to metal is still in use, but usually for back teeth where biting forces are higher and the crown won't be as noticeable as on front teeth.

Crowns can also address cosmetic issues with chipped, fractured or excessively worn teeth. But with any crown you should be aware that much of the original tooth material must be removed to accommodate the fit. The altered tooth will require a crown or other restoration from then on. Crowns must also be custom-made by a dental technician in a process that can take weeks.

Still, the process can be well worth it. With proper care and maintenance, a crown could serve you and your smile well for many years to come.

If you would like more information on crowns and other restoration options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”

By Reuben D. Collins, DDS
December 08, 2016
Category: Dental Procedures
Tags: dental implants   crowns  
ChoosingaScreworCementtoAttachanImplantCrown

If you've lost a tooth, you have a number of options for replacing it. Perhaps the best choice in terms of lifelikeness and durability is a dental implant.

All implants have the same basic architecture: a titanium metal post imbedded in the jawbone to replace the root; and an abutment, a metal collar that links the post with a lifelike porcelain crown. But implants can vary in how the crown attaches to the abutment and post — either cemented to the abutment or screwed through the abutment to the post.

Either method will permanently secure the crown to the implant. But there are advantages and disadvantages for each.

A screw-retained crown may better facilitate any future repair that might be needed. For a skilled dentist it's a simple matter of removing the screw and then the crown from the abutment. There's less risk of damage to the implant during repairs or crown replacement. Many dentists also prefer screws for crowns placed at the same time they're installing the implant post (a procedure called immediate loading).

The screw access hole, however, could pose a cosmetic problem. Although we can cover it over with tooth-colored filling, it may still be noticeable and unattractive especially for a tooth visible when you smile (in the smile zone). There's also the possibility the porcelain around the access hole could chip.

By contrast, cemented crowns have a smooth, unbroken surface and are aesthetically ideal for smile zone teeth. But the cement could interact poorly with gum and bone tissue in some patients, causing inflammation and possible bone loss.

And unlike screw-retained crowns, cemented crowns are difficult to remove for implant repair. We may have to drill through the crown to access the screw between the abutment and the post, and then repair it cosmetically if we use the same crown. Again, the final result may not be quite as visually appealing.

In the end, it will depend on the implant's location, how your body reacts to the cement or your dentist's preference. In either case, though, you'll have a tooth replacement that's functional, life-like and able to endure for many years to come.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Crowns Attach to Implants.”

By Reuben D. Collins, DDS
October 04, 2016
Category: Dental Procedures
Tags: crowns  
NotAllCrownsareAlikeKnowtheDifferencestoGettheLookyouWant

If you're in need of a crown to cover a damaged tooth, you have a lot of options. But before you choose, you need to know what you want. Would you be happy with an affordable, well-fitting crown that holds up well and allows you to chew comfortably? Or are you interested in a more expensive one that also provides the most attractive result?

Crowns have been a mainstay in dentistry for generations. The first were made of metals like gold or silver — durable and effective but not very attractive.

In time, a ceramic material known as dental porcelain began to make its appearance in crowns. Dental porcelain could be fashioned to resemble the color and texture of natural teeth, but it had a significant drawback: it could be brittle and subject to shattering under chewing pressure.

This problem was somewhat addressed with the innovation of a crown with a metal substructure fused with an outer layer of porcelain. These porcelain-fused-to-metal (PFM) crowns combined the best advantages of both materials: strength and life-likeness. Up until around the mid-2000s, PFM made up over 80% of crowns.

But later porcelains continued to improve in strength, beginning in 1993 with the introduction of a Lucite-reinforced material. Newer formulations like lithium disilicate or zirconium oxide (now considered the strongest porcelain) have made all-porcelain crowns a viable option. Today, an estimated 60% of new crowns are all-porcelain.

From an appearance standpoint, all-porcelain crowns achieve the best results. The most realistic crown can be costly — not because of the material but the level of artistry required. A skilled dental technician will spend several hours, including brushing on as many as fifteen coats of liquid porcelain to the crown, to achieve the most life-like outcome. Your insurance plan, if you have one, will most likely not pay as high a percentage for that type of crown.

In the end, it's your decision as to what type of crown you wish to have. We'll help you weigh your options and decide what's best for you and your budget.

If you would like more information on crown options, please contact us or schedule an appointment for a consultation.