General

Crowns

Crowns are used to restore heavily damaged teeth. A crown fits onto and around a core of tooth, to provide a realistic replacement.

Tooth Preparation for a Crown

Where appearance is vital, we try to use zirconia or porcelain only crowns, which provide a very lifelike appearance.

Further back in the mouth porcelain bonded to metal crowns are sometimes used. These have greater strength which is required in this region, but still look like a natural tooth.

It is often necessary to provide a crown for a root treated tooth to prevent a fracture from occurring. In this case a post is usually placed within the root canal to help provide support.

Preparation is a relatively simple procedure, carried out under local analgesia. The crown is fitted at a second appointment after it has been manufactured by a technician.

Bridges

A bridge is provided to replace one or more missing teeth, using the ones next to the gap to provide support.

Traditionally one or more teeth on either side of the gap are prepared as for a crown, and an impression taken to send to the technician.

The technician makes a crown for each of the supporting teeth, and fills the gap with the required replacements, welding all the components together. This is returned to the dentist to cement in position.

This technique is still suitable if the supporting teeth are heavily filled, or already have crowns, but other methods are n Lattice Bridge ow used to minimise the loss of sound tooth tissue.

If there are fillings in the teeth either side, these can sometimes be removed and an artificial tooth made to fill the gap, supported by strengthened porcelain inlays in the holes where the fillings were. This is called a lattice bridge. The x-ray shows a lattice bridge replacing an upper molar that has been in position for 15 years.

Other types of adhesive bridge can be cantilevered from a wing support stuck to just one adjacent tooth, with little or no preparation (a Maryland bridge).

As with crowns, bridges can now be made using all porcelain or zirconia construction in areas where aesthetics are vital.

Where the surrounding teeth are in perfect condition, and an adhesive bridge is not suitable it is a better option to leave these teeth untouched and provide an implant supported crown or bridge.

Roots Fillings (Endodontics)

Prior to root treatment A root filling is provided when the nerve in the tooth is irreversibly damaged, or dead.

A tooth has a nerve and blood supply in health, this enters the tip(s) of the root(s), runs up its length in narrow canals, to form a central pulp chamber in the middle.

This can be damaged by decay (caries), or by trauma such as being hit in the mouth
by a ball.

If the tooth loses this live tissue, then a space is left in the pulp chamber and canals, where bacteria can thrive.

The tooth often darkens in colour at this time, and may well develop an abscess, with
pressure building around the root tips causing acute pain.

When we root treat a tooth, we access Post root treatment the pulp chamber through the top of the tooth,
and widen the root canals down the length of the roots. This allows us to clean the canals with specialised rotary instruments and small files.

We use chemicals to reduce the bacterial population in the canals, and ultimately fill the canal system (usually with a form of rubber), and then seal over the top to prevent re-infection.

It is often necessary to provide a crown shortly after this procedure to prevent fracturing the tooth.