Ok….here’s what we did. Only the front 4 teeth are crowned. Everything else whitened nicely and there was no reason to put crowns on these other teeth. So instead of having crowns on all her upper teeth this happy patient was able to have only 4 and get an absolutely fantastic final result.
As discussed below, option 1 involves moving the teeth to their optimal position leaving the ideal spacing in place so the restorative dentist can bond the spaces that are left, creating teeth that are proportional to the other teeth. But if the orthodontist does not leave the correct amount of space the final result will result in a tooth that is too large or small for the others. In other words, the space has to be filled. If there’s too little you end up with a mini-tooth…..too much and you get a Chicklet! Not good!
Bottom line….the orthodontist has to get the spaces PERFECT for this option to work.
This tooth has been fractured for MANY years. The patient never really did anything about it, but with a bit more of it breaking recently, she wanted me to ’smooth it out’. I thought the better idea was to replace the missing tooth structure.
Broken tooth
Here’s a closer look at these two cavities. You can see that they extend slightly under the gumline:
So here we go again….just starting to clean out the cavity and look how much is hidden inside this tooth!
We cleaned off a good portion of the old filling and then added to the lower corner of both teeth to change the contour and appearance. An easy, quick fix that looks great!
Here’s the tooth with most of the cavity cleaned out. It was REALLY big! And again, no symptoms with hot, cold, or bite. The ONLY way to have found this was with a dental x-ray.
Now that the reasons for the crowns has been explained, let’s check out the results. Both teeth were restored with porcelain crowns. Instead of the ‘regular’ porcelain crown, these were different. Most crowns still have a small metal band around their base. This helps the lab technician when he or she is making the crown or some dentists request this metal band because they feel the crown fits better. The only problem is that when recession of the gums happens slowly over time, the metal band will become more obvious. Here’s a better solution. The margin area (where the crown and tooth meet) can be made with ALL porcelain. This looks better longer and has a fantastic fit. Only problem is it costs a little more, but I sure think it’s worth it. Take a look….what do you think??
So let’s look at this situation a little closer. You can see where the crown meets the tooth because there has been some recession of the gum tissue over the many years this crown has been in service. Also, this same area is starting to ‘leak’, that is, bacteria is migrating under the crown and infecting the tooth underneath. The tooth in front of the crown has a large cavity. In fact it’s big enough that you can see the gray ’shadow’ of the decay if you look closely. It was definitely time to fix these teeth.
Here’s a better view of this same tooth. Again, it was an easy, inexpensive procedure that takes a pretty smile and makes it fantastic!
