Bridges, crowns, dentures

Root canal treated tooth tends to dry out and can break, since the blood flow to the tooth has been stopped. To strengthen the tooth, crown is recommended.  In addition to protection, the crown ensures pleasing appearance and comfort.  

Bridges can fill gaps. To fit a bridge, adjacent teeth need to be grinded away. 

There is a wide variety of materials to choose from. Bridges, crowns can be made of metallic alloys, metal-ceramic combination, ceramic only, plastics, pressed ceramics, metal free materials. Full scale allergy test is recommended prior to all new prosthetic procedure.

Crowns

Crowns are replacing the missing parts of the clinical crown and covering the appropriately prepared surfaces of the clinical crown; they don’t replace missing teeth.

Bridges

Removable dentures and fixed bridges are made to replace missing teeth of partially toothless patients

Removable complete dentures

Removable complete dentures (full dental plates) are still the most common restoration used today for completely toothless patients. 
Crowns

Crowns are replacing the missing parts of the clinical crown and covering the appropriately prepared surfaces of the clinical crown; they don’t replace missing teeth.

Major indications:
  • misshapen tooth crown (mainly aesthetical indication
  • serious decay of tooth crown (restorations)
  • misalignment of the crown
  • Improvement of parodontium’s conditions, load distribution, (splinting)
  • To hold permanent replacement
  • To hold removable, partial replacements
  • Temporary crown for prepared post, or broken tooth
  • Bite rising
Main types of crowns:
  • All-metal crowns
  • aesthetic crowns, acrylic, porcelain, partial crowns, metal free crowns
  • post and core
  • post + metallic crown + aesthetic crown

Eligible materials:
  • nickel-chrome alloys (possibility of allergy)
  • Gold alloys with 5-10% platinum
  • Gold alloys
  • Silver-palladium alloys
  • Porcelain (porcelain only or fused to metal)
  • Acrylic –temporary crown or aesthetic crown, fused to metal
  • Metal free replacements, zirconium

Steps of crown making:
  1. Preparation of the post
  2. Impression taking
  3. Fitting, adjustment of the crown
  4. Seating the crown
Bridges

Removable dentures and fixed bridges are made to replace missing teeth of partially toothless patients. Bridges are replacing missing teeth permanently anchored to remaining teeth, root, or implant...

Indication:
Bridges can replace missing teeth if the remaining teeth can support the increased loading.

Contraindications:
  • Patient’s overall health conditions 
  • Patient doesn’t consent to the procedure
  • Dentist cannot carry out the expected dental work for any reason
  • Size and axial position of the remaining teeth doesn’t allow to make, or to anchor the bridge
Selection of abutment teeth
  • anchors
  • pontics
When planning the pontics, it is to be considered that:
  • pontics replacing missing teeth must ensure their original functions
  • pontics mustn’t be distorted by the occlusal force
  • pontics mustn’t damage neither the oral structures nor the  oral hygiene 
Steps of bridge making:

Clinical phases of bridge making are generally same, as those of crown making.