DENTAL CROWNS AND BRIDGES

Dental Crowns and bridges are reconstructive treatment options, which help prolong the life of compromised teeth, or enable missing teeth to be replaced in a natural looking way.

Teeth restored or replaced by crowns and bridges will look and feel more like natural teeth than those replaced by a denture. Unlike removable dentures, crowns and bridges are permanently fixed in place. They are a good long-term restorative option. To rebuild a deteriorating dentition, a complex treatment plan may involve several crowns or a combination of different types of reconstructive treatments.

Dental Crowns and Bridges may be based on either Natural Teeth (Tooth-Borne) or on Dental Implants (Implant-Supported)

Tooth-Borne Crowns
When teeth are no longer aesthetically pleasing or structurally sound (if weakened by decay, multiple fillings, root canal treatment, trauma, fractures, cracks or heavy wear), such teeth may be rebuilt and supported with a crown. A tooth-borne crown is a porcelain (or porcelain fused to metal) tooth shaped cap, permanently fitted over a prepared natural tooth in order to encase it. A crown is then able to protect remaining tooth structure and restore a tooth's shape, size, strength, and improve its appearance.

Tooth-Borne Bridges
Sometimes teeth may be lost if they are unable to be restored. Unrestored gaps between teeth may be more than just aesthetic concerns. They may also allow adjacent or opposing teeth to tip, drift or move into the spaces, disrupting the alignment of the bite. Such changes may lead to hygiene and functional problems or further tooth loss over the long term.

When a tooth is lost and a gap remains between two teeth, the natural teeth may be used as anchoring supports for artificial teeth in a permanently fixed structure, called a tooth-borne bridge, to fill or "bridge" the gap. There are varying types of bridge design available depending on specific tooth replacement requirements.

A conventional bridge is a single structure consisting of multiple crowns joined together (basically, a crown at either end, cemented onto natural support teeth, called abutments, with tooth replacement crowns, termed pontics, attached between them). Abutment teeth are cut down three dimensionally to allow space for the bridge of crowns to be fitted over them and correspond to the bite. Abutment teeth must be sound and sufficiently strong to support a bridge. The state of available abutment teeth will determine if a bridge is a feasible restorative option.

Alternatively, in certain cases, a bonded bridge, called a maryland bridge may be made. This type of dental bridge is secured to the back of a sound tooth, adjacent to a gap, by a metal arm or wing. It is often recommended for replacing missing lateral incisor teeth where minimal preparation of an abutment tooth is desired and sufficient enamel is available for reliable bonding of the bridge arm.

Dental Implant-Supported Crowns
Modern dentistry has enabled tooth-borne bridges to largely be replaced by dental implant-supported crowns. A single missing tooth may now be restored with a crown attached to a dental implant, akin to a natural tooth. A dental implant-supported crown thus allows a missing tooth to be replaced without the need for sound teeth to be prepared (filed down) to provide the support for an artificial tooth (as is the case for a tooth-borne bridge). A dental implant-supported crown also has the advantage of enabling a fixed tooth replacement option to be provided in circumstances where a tooth-borne bridge is not recommended due to lack of reliable or sound adjacent support teeth.

Dental Implant-Supported Bridges
When no teeth are available to support a dental bridge or many teeth are missing and a denture is not an ideal solution, bridges fixed in place by dental implants may be constructed to reliably restore some, or even all, missing teeth. Bridges supported by dental implants may only be possible if sufficient jawbone is available for dental implants to be placed.

Dental Ceramic Technology

The latest crown and bridge treatment options are available at our practice. At Melbourne Dentistry, we can advise if or when any of these options may be appropriate for you.

We work with Melbourne's top dental ceramic laboratories to provide high quality, durable outcomes for all patients using the latest high strength ceramics (such as Zirconia and E-Max) and resin materials. Through good communication and long term professional relationships with our ceramists, we aim to achieve utmost aesthetic accuracy in treatment results for all porcelain reconstructions.

Most importantly, when restoring our patients' dental implants, we choose to use only genuine brand name components from Straumann or Astra Tech for restoring respective types of implant fixtures - to support treatment success. Recent studies have confirmed the use of non-genuine implant system componentry may adversely affect treatment prognosis of dental implants.

What's Involved in the Construction of a Dental Crown and/or Bridge?

In order for crowns and bridges to restore teeth or dental implants, they need to be custom designed, constructed and then fitted to your mouth. Moulds or impressions of the mouth are required after teeth are prepared, or special impression connectors are secured on to dental implant fittings. Models made from these impressions then allow ceramic dental technicians to custom make your dental reconstructions.

The alignment of your bite and tooth colour choices need to be accurately reproduced for best results. This is a very precise, highly technical and artistic process. At least 2-3 appointments may be required for these types of treatments.

Gum tissue deficiencies or unusual tooth wear and jaw alignments may make the achievement of natural looking aesthetics and treatment stability very challenging. In certain circumstances, referral to a specialist Prosthodontist, may be advised to achieve the best treatment outcomes for complex cases.

 

Porcelain Crowns for Baby Teeth

Porcelain crowns are now also available to protect deciduous teeth. A crown is often advised to restore a baby tooth if the tooth needs to be supported structurally, until scheduled to be lost.

Protecting the exfoliation schedule of primary teeth is important to maintain the space available for developing permanent successors. The early loss of baby teeth may increase the likelihood or severity of dental crowding, affect a child's jaw development and smile confidence.

NuSmile®ZR Paediatric Crowns

At Melbourne Dentistry we have introduced the latest NuSmile® ZR (Zirconia) Paediatric porcelain crowns to enable severely compromised baby teeth to be restored in a natural looking way. Paediatric porcelain crowns look better, are more easily placed and last longer than other restorative options for rebuilding weakened baby teeth. Unsightly stainless steel crowns may now be avoided. Your child may have their teeth restored with NuSmile® ZR Paediatric crowns ideally, only once, to look naturally white and be supported structurally until scheduled to be lost.

NuSmile® ZR Paediatric porcelain crowns are preformed and may be placed in a single appointment. They do not require a two-step indirect technique, using impressions and a ceramic laboratory, as is necessary in adult crown construction.