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A crown is needed to preserve the tooth if it is damaged in such a way that its restoration with a filling or an inlay is impossible. It is comparable to a protective cap, which is coated, or jacketed, with ceramic. Technologically, crowns represent a high-quality, long-lasting restoration of heavily damaged teeth, providing them with protection and restoring their full function.
What does a crown look like and how is it made?
A crown is a protective cap that covers the complete visible part of a tooth. The dentist removes the complete tooth enamel in order to provide enough space for the jacket-crown. A high-precision impression is made and the work is sent to a dental laboratory. The dental technician uses state-of the-art techniques to manufacture a customised crown which meets the highest aesthetic requirements and perfectly fits into the patient’s existing teeth alignment. The crown is then bonded to the tooth in a separate session and cannot normally be distinguished from the natural teeth.
What are the advantages of crowns?
- Fixed (as opposed to removable) prosthetic restoration
- Protection for the complete tooth substance
- Optimum aesthetics
- Perfect fit and hygiene thanks to customised preparation
The dentist removes all old and worn-out fillings and decayed areas (caries) and inserts new, crown-supporting fillings. Residue amalgam or untreated caries should never remain under a crown. The consequences can be pain, abscess building, swelling and tooth removal. Root-canal treated teeth are additionally examined by x-ray in order to establish their suitability for a crown. The general status of the tooth-supporting apparatus (periodontium) is also checked for inflammatory processes, which have to be fully cured prior to crown restoration.
In cases where a tooth is largely destroyed by caries, a custom-made post may become necessary. The post is bonded into the root, thus making its further use as crown support possible.
The diagnosis and therapy can be much more elaborate in cases of conditions connected with the jawbone joints (temporomadibular joints), masticating muscles or occlusion. It is important that your dentist addresses these problems, consults further experts and applies appropriate therapy (e.g bite splint).
The quality of a crown depends on the joint efforts of the dentist and the dental technician. Accuracy and painstaking care count more than the choice of material. You as a patient also bear responsibility for the longevity of a crown – strict oral hygiene is vital, and it is very important that the interdental space can be flossed.
On average good work should last for approximately ten years. But a well-executed crown, combined with diligent oral hygiene, can fulfil its function even for fifteen to twenty years. Premature losses are almost always caused by poor oral hygiene.
The crown should merge with the tooth butt smoothly, free of grooves or ridges or visible margin gap. It is difficult for you to check the margin fit yourself. But talk to your dentist if you locate a distinct gap between the crown and the tooth butt with a toothpick or if your floss keeps getting caught in the interdental space. Note: good margin fit of the crown does not release the patient from the need for good personal oral care and dental hygiene treatment.
Porcelain-fused-to-metal crown (PFM)
A cap made of gold or steel alloy is cast to fit the exposed tooth butt perfectly and is then fused with layers of hand-applied porcelain, forming a prefect reconstruction of the natural dental crown. Thus made, the dental crown has a high load capacity and good aesthetic appearance. In rare cases the metal margin of the crown can gleam through the mucosa. Receding of the gum line can result in a visible dark metal crown margin. Since metal is a good heat conductor, vital teeth may become sensitive to changes in temperature.
Porcelain crown (also known as ceramic or metal-free crown)
Modern hi-tech ceramics/porcelain make it possible to manufacture crowns out of solid porcelain, achieving the same stability and durability as porcelain-fused-to-metal crowns. A porcelain crown has a very natural appearance and is metal-fee and thus non-allergic. Heat insulation is improved and there are no unseemly dark edges at the gum line.
When a natural tooth crown has been destroyed by caries so that there is no substance left to which a porcelain crown can be bonded, the remaining root has to be fitted with a custom-made post. The post is first anchored in the root canal; only then can it serve as crown support. A post crown is the last possibility for restoring a tooth before it is completely lost.
- Perfectly white teeth may not match your type or age. Harmonious colouring of all teeth is more pleasing.
- Teeth can be quite sensitive to temperature changes for some time after final fitting of crowns or bridges. Avoid all extremely hot or cold drinks and food for several weeks.
- The durability of crowns and especially of bridges is highly dependent on good oral hygiene. Take extra care when cleaning teeth and restorations, particularly at the gum line.
- Root canal treatment of the relevant tooth (not always)
- Lesions on the root apex (periapical lesion)
- Roots shortened by an apicoectomy (not always)
- Teeth grinding (bruxism)
- Insufficient oral hygiene
All prices quoted are to be understood as indicative and can vary upwards or downwards, depending on the qualifications, facilities and instrumentation, materials used and the fees of the dental surgeon. The prices of dental crowns can also be accompanied by other costs. Dental crowns are not covered by the standard medical insurance in Austria and have to be paid for privately.
Single dental crown - price range
€800 – 2,300
2018 © DDr Robert Viden - Zahnarzt in Wien