What Types Of Dental Crowns Are Available?

Dental crowns, dental overlays or dental veneers can be made to create beautiful natural looking teeth whilst also strengthening the underlying tooth.

So what types of dental crowns are available at Milford Dentists, North Shore, in Auckland?

The types of dental crowns that are available

Emax crowns on front teeth

1) All ceramic dental crowns & dental overlays & dental veneers made from different porcelains – There are many different types of porcelain to make dental restorations from. In my opinion, Emax porcelain is the most incredible & exciting material for making dental restorations & it has been my crown material of choice since 2008.

Because this porcelain mimics actually tooth structure, it makes beautiful natural looking crowns. It is incredibly strong (3-4 times more fracture resistant than a porcelain fused to metal crown). As well as being super fracture resistant it can be bonded to a tooth. This laminate effect makes the restoration even stronger

• This bonding means the crown is highly unlikely to be dislodged
• The bonding technology significantly reduces post placement symptoms
• This bonding also helps hold fractured teeth together preventing cracks from getting bigger

Because the crown overlay is bonded to the tooth it requires less tooth to grip onto which means overlay preparations are very conservative ie more of your tooth is saved.

Porcelain Fused to Metal Bridge

2) Porcelain crowns fused to an inner metal thimble (PFM's). This type of crown was the most frequently placed for decades. There is still a place for this type of crown but it has mostly been superseded by Emax crowns and overlays. PFM’s can be placed

- In cosmetic situations where the teeth surrounding the tooth to be crowned also have PFM’s

- Over a dental implant

As part of a dental bridge where the metal connectors in the centre of the bridge are required for strength. The porcelain is fused on the outside of the metal framework

Gold Crown

3) Metal crowns made of gold or semi-precious alloys. In areas where a tooth is subjected to a lot of chewing forces – for instance on the second permanent molars, these restorations are often a good option

4) Composite resin crowns can be placed as temporary crowns, overlays or dental bridges. They tend to wear out quite quickly which is why they are not used in a permanent situation

Zirconia Crowns

5) Zirconium crowns are even stronger than Emax crowns, however, they do not look as beautiful. An option is to place them on teeth which traditionally would have had a gold or semi-precious crown

Posted by Andrea

Milford Dentists is proud to help the good people of the North Shore with all their dental requirements; especially in our mission to help you strengthen & beautify your teeth - From Devonport and Belmont up through Takapuna, Castor Bay, Mairangi Bay & Browns Bay as well as Albany, Northcote, Hillcrest, the Whangaporoa Peninsula and beyond give us a call - 09 4896575.

8 Reasons Why You Need A Dental Crown

Here are 8 reasons why having a dental crown can improve how your teeth work. A Dental Crown, Dental Overlay or Dental Veneer - 

1. Strengthens a tooth acting like a crash helmet or thimble to hold things together
2. restores the shape of a tooth to help with eating and or decrease food trapping
3. replaces worn tooth
4. improves a tooth’s appearance
5. can be part of a dental bridge to hold a fused false tooth in place
6. Is used in dental implant dentistry to replace a missing tooth
7. Is used to help hold a denture more securely in the mouth with a special attachment.
8. To stop "Cracked Cusp Syndrome" symptoms - see below

Here are common situations where a dental crown may be a good option

If a tooth has a large filling: A large filling equals over 50% of the tooth being replaced by filling material. The remaining tooth structure is in a weakened state & vulnerable to snapping or cracking or secondary tooth decay. 

 SameDay Emax Porcelain Overlay Crown replacing massive failing Mercury dental amalgam 

A Root canal treated tooth: When a tooth is root canal treated it is significantly weakened. To access the root canals an access cavity is made right through the middle of the tooth. Often teeth requiring root fillings are having this treatment because they are already heavily filled and in a weakened state with tooth cracks. Overlaying this weakened tooth structure with a dental crown goes a long way to protecting the tooth from further failure

Root filled tooth that is weakened & highly prone to snapping unless overlayed with a crown or overlay

A tooth with cracked tooth syndrome: Tooth cracks that spread through the enamel into the dentine towards the nerve in the middle of the tooth are painful when chewed on. Often the pain only happens when biting on a certain point whilst eating something like grainy breads or seeds. The little hard piece of food sits right at the wrong place on the tooth and chewing wedges the fractured tooth crack open causing pain. If left untreated the crack propagates & eventually the tooth will break in two. Sometimes pain to hot & cold is also experienced. A dental crown or overlay holds the crack together. This stops the tooth fracture moving & growing & stops the sharp pain on chewing (unless the crack has already reached the nerve)

If a tooth has cracks in it: More often than not structural tooth fractures i.e. cracks that go through the enamel & into the dentine don’t actually hurt. However they are still weakening the tooth & the end result will be cracked cusp syndrome and or the tooth breaking apart. Crowns & now more often overlays strengthen the tooth by these cracks together. Read more on options if you have old Mercury Amalgam Fillings & want to prevent tooth cracking.

Teeth that have broken cusps:

Due to all of the above ie heavily filled teeth & tooth fractures, often cusps will snap off. This often happens when people are eating innocuous things like soft bread. They come to see me with the piece of tooth, bewildered & wanting to know why this happened – “I was only eating soft bread or yoghurt or rice bubbles or some other soft food, why has this happened?” Well the cracks have been propagating painlessly for years & the cucumber sandwich was the last straw.  Cusps frequently break off teeth due to trauma or large existing fillings. The cusps take most of the chewing stresses whilst eating & can be protected and or replaced with a dental crown or overlay.

Teeth that have excessive wear:

People who have shorter teeth because they
1) grind their teeth2) have eroded their teeth with acid caused by gastrointestinal acid reflux (GERD), bulimia, or an acid dietThis wear can sometimes lead to loss of a great deal of enamel in vulnerable areas resulting in small easily worn teeth & a collapsed bite. Restoring these teeth by increasing the height to its original dimensions & covering the softer dentine with a crown is an option

Teeth that have an undesirable appearance: 

The appearance of a tooth can be unacceptable because of the following
1) Colour
2) Shape
3) Spacing

Dental crowns, dental overlays or dental veneers can be made to create beautiful natural looking teeth.

Other occasions when Crowns are placed:

1. Dental implants - Crowns are the final piece placed on a dental implant used to restore spaces where teeth have been lost
2. Dental bridges - A dental crown is one part of a fused structure called a dental bridge. Commonly the two teeth on either side of a gap where a tooth has been lost are crowned & a false tooth is used to the two crowns & cemented in place
3. Dental splinting - If teeth are loose or there is food trapping , dental crowns can be fused together & cemented on multiple teeth thus splinting them together & providing more stability.

If you would like more info on Dental Crowns read our blogs - What is the Cost of a dental Crown? and 8 Reasons Why You Need A Dental Crown

Posted by Andrea

Milford Dentists is proud to help the good people of the North Shore with all their dental requirements; especially in our mission to help you strengthen & beautify your teeth - From Devonport and Belmont up through Takapuna, Castor Bay,Mairangi Bay & Browns Bay as well as Albany, Northcote, Hillcrest, the Whangaporoa Peninsula and beyond give us a call - 09 4896575.

What Is The Difference Between A Filling And A Crown?

If you have a sore tooth and are looking to get it fixed you might wonder what the difference is between a filling and a crown? Dentists can fill a tooth, or crown a tooth, they can create a filling and mould a crown but they are two very different processes even though they sound quite similar and may seem the same to a layperson.

Dental repair work to fix teeth can really be divided into two main types ‘direct’ and ‘indirect’ restoration work. Direct restoration work includes work like fillings and indirect dental work covers crowns and veneers.

The simplest way to differentiate between the two is that a ‘direct’ restoration is when the dentist repairs a tooth ‘directly’ in the patient’s mouth, by moulding material to ‘fill’ a gap or flaws in the tooth. An ‘indirect’ restoration is when the dentist takes a mould of the tooth either with a quick setting impression material or a digital scan of the tooth and then creates the replacement crown or veneer outside of the mouth before fitting it to the patients tooth.

Sometimes dental terminology is confusing for patients so we’ve broken down all the main terms so consumers have a clearer understanding:

Dental restoration 
Dental restoration is the process of repairing a damaged tooth and essentially restoring its function, integrity or appearance.  Most often the tooth will have been damaged by caries (which is the technical term for a cavity) or external trauma. If the tooth is damaged significantly and difficult to repair a dentist may recommend replacing it with a dental implant  a dental Bridge or a partial denture.

A ‘filling’ or ‘direct’ restoration is when a dentist places a soft material into the damaged tooth and shapes it before it sets hard. This is a convenient process to use if patients want the tooth fixed in a single visit.

‘Filling’ a tooth is also how dentists usually refer to smaller tooth restorations which often just involve repairing a small amount of damage rather than rebuilding a tooth. The more damage there is and the more restoration work needs to be done to restore it, the more likely a crown or veneer will be needed.

When a customer decides they want a damaged tooth strengthened, reshaped or the appearance improved the dentist will very often choose to create a crown or veneer for the tooth or use the ‘indirect’ restoration method. Crowns and veneers are a longer lasting solution for dental repair, replacing more of the tooth and adding more structural integrity. Other terms for ‘indirect’ restorations include inlays, onlays and bridges (which are multiple crowns in a row including a fused false tooth).

Milford Dentists also has a same day cad/cam service that can create crowns, overlays and veneers in a single day if you want a fast permanent high quality solution.

All good dentists should talk you through all your options and the different costs of repairing a damaged tooth. Whether a filling or a crown is most appropriate should be a joint discussion between a patient and the dentist.

But if you want to do a little homework before you go to the dentist check here: 

Cost/benefit	Procedure	Cost	Benefit
White Fillings	Sealant restoration	$85	Simple, fast
Multi-surface white fillings	Single surface White fillings	From $174	Simple & fast, bonding the tooth together
Larger Fillings	White filling on more than one surface	From $196	Simple & fast, bonding the tooth together
Crown	multi-surface rebuild – in front & back teeth (tinting, layering)	From $1279	Look good, strong, more of a long term solution
Veneer	Generally for front teeth (tinting, layering)	From $1579	Look great, can mask discoloured tooth & repair & reshape broken or crooked teeth

Posted by Andrea

Milford Dentists is proud to help the good people of the North Shore with all their dental requirements; especially in our mission to help you strengthen & beautify your teeth - From Devonport and Belmont up through Takapuna, Castor Bay,Mairangi Bay & Browns Bay as well as Albany, Northcote, Hillcrest, the Whangaporoa Peninsula and beyond give us a call - 09 4896575.

Loose lower dentures 5 solutions Case 2 Lower Denture with Special Dental Crowns

Lower dentures are normally the trickiest denture for people to get used to. Here are 3 reasons they are often loose and uncomfortable.

1. Your tongue is the strongest muscle in the body. It can easily flick a lower denture around.
2. A lower denture only has a thin horseshoe shaped area of gum to sit on (unlike an upper denture which can rest on almost the whole surface area of your upper jaw & palate and also has suction). The lips are pushing the lower denture backwards and your tongue is pushing it forwards.
3. An older denture may not fit as snugly as when it was first made. Over time the jaw bone reabsorbs (or shrinks). This resorption happens the most during the first 6 months after a tooth has been removed.

Loose lower dentures – 5 solutions

1. If you have an old denture that used to be comfy and that you are happy with, appearance wise, but has become loose, an option is to realign the fitting surface. This means putting a new layer of acrylic (pink plastic) on the fitting surface of the denture. This fills up any gaps between the denture and the gum
2. Making a basic new denture
3. If there are teeth present making a denture with clasps (or hooks) that clip around the teeth to aid retention
4. If there are teeth present placing dental crowns on teeth adjacent to the denture with special attachments which the denture snugly clips onto. Special attachment crowns which also have milled parallel walls make for a very satisfactory solution – a secure denture and no visible clasps or hooks – see my case below
5. Retaining the denture with dental implants

Case study – Lovely lady from Takapuna who wanted a lower partial denture with Dental Crowns with milled parallel margins and special attachments

This lovely patient had several lower teeth that had failed. After removing them and letting the lower gums heal I placed two dental crowns on her lower eye. These crowns are precion made with special attachments & parallel walls that the denture snugly fits into. I then constructed a lower chrome cobalt acrylic partial denture that clicks into the special attachments & milled margins of the two dental crowns. Run your mouse over the picture below to view before and after.

Here is the view from the front. Note that without denture clasps the cosmetic effect is more pleasing.

Posted by Andrea

Milford Dentists is proud to help the good people of the North Shore with all their dental requirements; especially in our mission to help make comfortable, functional, aesthetically pleasing, natural looking dentures - From Devonport and Belmont up through Takapuna, Castor Bay,Mairangi Bay & Browns Bay as well as Albany, Northcote, Hillcrest & the Whangaporoa Peninsula give us a call - 09 4896575.