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The Dental Crowns Procedure


The steps involved in a dental crowns procedure will depend on whether you are receiving a traditional or implant-supported restoration. The process for a traditional crown involves preparing the tooth, taking impressions, and fabricating the permanent crown. An implant-supported crown requires a more intricate procedure, as dental implants must first be embedded in the jaw.

Placing a Traditional Crown

To place a dental crown, your dentist must first reshape adjacent healthy teeth.

The First Treatment Appointment for a Traditional Crown

A tooth must be prepared for a dental crown to make room for the restoration and ensure the most successful outcome. First, decayed material will be removed. If the tooth is being restored for cosmetic purposes or to correct a large crack, enough enamel will be taken off to make room for the crown. In some cases, the tooth has been excessively worn or broken and the enamel will need to be augmented to give the crown enough material with which to bond.

Molding the Tooth

Once the tooth has been prepared, putty will be used to create a mold. The impression allows the laboratory technicians and the dentist to create a customized crown with a virtually perfect fit.

Some offices utilize advanced mapping technology known as CAD/CAM (computer-aided design, computer-aided manufacturing) to create a virtual impression, eliminating the need for a physical mold.

Fabrication of the Crown

Whether your dentist has an in-office laboratory, a CEREC® machine, or works with an off-site laboratory, your crown will be carefully created to fit your prepared tooth. Proportional to the rest of your smile and color-matched to your tooth, your crown will look natural among the surrounding teeth. In a laboratory, fabricating a crown takes between one and four weeks. With a CEREC machine or other CAD/CAM technology, a porcelain crown can be created in as little as a few minutes.

Placing a Temporary Crown

Most dentists know how important it is to maintain the aesthetics of your smile while you wait for the delivery of your permanent crown. A temporary restoration made of either stainless steel or acrylic can be placed on the prepared tooth. Aside from keeping the appearance of a smile intact, a temporary crown also protects the exposed enamel of the tooth.

Between Appointments

When you leave your appointment with a temporary crown, it is important to follow the doctor’s instructions for proper care in order for it to protect your tooth and stay in place until your next appointment. You should floss on a daily basis but be sure to floss gently. Flossing can easily dislodge a temporary restoration, so direct the floss downward and slide it out, rather than pulling it up. You should also avoid foods that are:

  • Sticky
  • Chewy
  • Hard
  • Crunchy
  • Difficult to chew

In most cases, temporary restorations are worn for a few days or about a week.

The Second Appointment for a Traditional Crown

A week or two after your first treatment appointment, the dental laboratory will deliver your dental crown to the dentist’s office. The doctor will remove your temporary restoration and thoroughly clean the prepared tooth and surrounding gums. Lightly buffing the surface of the tooth will optimize the bonding surface. Using a durable adhesive, your permanent dental crown will be put in place. A final buffing will adjust the fit of the crown. Finally, the crown will be cleaned once more and polished for a finished look.

Implant-Supported Crowns

Dental implants are synthetic tooth roots, typically made of titanium or ceramic, that your dentist, prosthodontist, or periodontist (gum specialist) places under the gums of the missing tooth and into the jawbone. Over time, this post integrates with the jawbone, acting much like a natural tooth root.

At the top of an implant is an attachment onto which a crown, bridge, or even denture can be placed. Implant-supported crowns can replace a single tooth or serve as an anchor for a dental bridge, a larger prosthetic held in place by sturdy teeth on either side of the missing tooth or teeth.

Dental implants are advantageous for restorations because they are very durable and often prevent jawbone deterioration, since the synthetic root exercises the jaw whenever you chew, speak, or smile with your restoration.

The Implant Placement Procedure

The process for placing an implant-supported dental crown is longer than that of placing a traditional crown. First, your dentist will assess your gums and jawbone to determine if they are healthy enough to hold an implant. This usually involves a visual exam, review of your dental history, and x-rays. If you lack sufficient jawbone to hold the titanium or ceramic post, your dentist (or other dental professional) may be able to perform a bone graft or sinus lift to build up the bone.

If no preparatory procedures are needed, your dentist can create a small pilot hole through which an implant can be placed. After closing the incision with sutures, you must wait three to six months for the post to integrate with surrounding tissue before receiving a dental crown.

At-Home Care

When properly cared for, dental crowns can last for over a decade. It is important that you clean your crown as diligently as you would a natural tooth. To care for your crown, you should:

  • Visit the dentist once every six months for a checkup and routine cleaning
  • Brush your teeth twice a day
  • Floss daily

Similar to the flossing technique required with a temporary restoration, slightly modifying the way you floss will help keep your permanent crown securely bonded. It is also advisable to eliminate the sticky, crunchy, and chewy foods from your diet.

Follow-Up Appointment

In addition to routine visits to the dentist, it may be suggested that you make an appointment a few weeks after your crown is placed. This visit allows the dentist to examine your mouth and teeth to ensure they are adapting well to the dental crown. This is also a good time to double check that the crown fits. If you have any questions or concerns after the first few days with a dental crown, this appointment is a good time to address them.

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