Specialisations

Crown and bridge work

Crown

A crown is an enclosing cap around your own tooth or molar to strengthen and/or enhance it. They are usually recommended after root canal treatment (in combination with a large filling) or for teeth and molars with large fillings.

  • In the first place, these elements are often weakened by the large fillings, which can cause fractures and loss of the tooth.
  • Secondly, often the old anatomical shape is no longer maintained. This can cause reduced chewing efficiency and increased stress and wear on teeth or molars elsewhere in the mouth. If the anatomical shape is no longer present and cannot be properly restored in the mouth with a filling, a dental technician can often still do this outside the mouth by making a crown.

Bridge

If you are missing a tooth somewhere, masking it with a bridge may be a good option. The teeth either side of the gap must then be fitted with a crown, which have a ‘dummy’ attached to them to conceal the gap. So, a bridge consists of at least three parts: two crowns and a dummy in between. In many cases, implantology is also a good option (see heading ‘implantology’).

Crowns and bridges today are usually made of zirconia, possibly supplemented with porcelain. Another option is lithium disilicate, feldspar porcelain or gold.

What does the treatment involve?

  • Making a crown takes about 60 minutes (1st appointment; grinding, impressions, making temporary crown), followed by 30 minutes 2 to 3 weeks later (2nd appointment; placing crown).
  • Making a bridge takes about 60-120 minutes (1st appointment; grinding, impressions, making temporary crown) followed by 30-60 minutes 2 to 3 weeks later (2nd appointment; placing bridge).
  • An impression of the current tooth shape is taken so that we can make a temporary crown at the end of the treatment.
  • The tooth is prepared by removing a layer of its outer surface, with 1 mm of tissue being removed all around and about 1.5 mm on top.
  • Impressions of the maxilla and mandible and a bite impression are made.
  • A temporary crown is made for the next 2-3 weeks.
  • The impressions taken are sent to the dental lab.
  • You may be asked to go to the lab for the colour determination if you wish, so thatthe dental technician can determine the colour.
  • After 2-3 weeks, the final crown is fitted and, if approved, cemented.

The treatment may cause the nerve of the tooth to become irreparably inflamed and require root canal treatment. If this occurs before the placement of the final crown, the root canal treatment can be performed before we permanently cement the crown. If it happens later, we will have to drill through the crown to reach the root canal. This may prove necessary weeks, months or even years later.

We will, of course, do everything we can to prevent this from happening. We lacquer all vital teeth (immediate dentin seal or IDS), resealing the open porous dentin using a thin composite layer. By doing so, we greatly reduce the chances of the nerve flaring up.