Dental Crowns

Prosthodontics

What are dental crowns?


Dental crowns are covers for your damaged or decayed tooth to restore its functionality and looks. Made with durable materials, dental crowns mimic the shape, size and color of the tooth to provide utmost functionality in addition to a beautiful and natural aesthetic. Dental crowns are considered as "permanent" (long-term) treatments for your teeth, thus once installed, a crown should appear, feel, and operate just like any other tooth. One could need dental crowns if their tooth decay can no longer be treated with dental restoration (fillings). Dental crowns are usually applied to protect the residual tooth structure after procedures like root canal treatment, dental implants or used for stabilizing the framework after the installation of dental bridges. They are also used for reasons other than postoperative treatments, such as tooth decay, tooth injuries like fractures, break or wear downs on the tooth, and natural aging to prevent decay that may happen later on and to restore its aesthetic. Furthermore, in some cases they could be utilized solely for aesthetic purposes, to give your teeth a brand new shape and color, in instances of crookedness, stains etc.



Types of Dental Crowns


Zirconium(Zirconia) Crowns


What are zirconium crowns?


Zirconia is a relatively new material that is being used for different sorts of dental treatments. It has been found as an optimal material for dental crown treatments, due to some of the natural properties that it possesses. It is a special variation of porcelain, namely zirconium oxide, which is subject to less of the wearing down that may be seen with porcelain over the course of its usage, which leads to less sharp edges that form over time. The reason for this is it being more robust in terms of strength, chemically. Due to this, it also happens to cause less stress and mechanical damage to the surrounding teeth when compared to porcelain crowns.

Two different types of zirconium crowns are preferred for dental crowns. Framework zirconia is mostly used for bridges and can be placed on either the front or back side of the mouth whereas full contour zirconia crowns are mostly used for monolithic single tooth operations.



Why choose zirconium crowns


Aesthetic


Zirconia crowns provide top-notch aesthetics for your new set of teeth. By the virtue of the quality of their composed material, zirconia crowns fulfill the aesthetic expectations of the patients to the utmost.



Longevity


A very durable monolithic ceramic material, the least amount of chipping and splitting takes place compared to other materials, excluding emax. Emax and zirconium crowns are very close to each other in terms of longevity, each being very strong materials.



Strength


Stress is placed upon teeth everyday by activities such as chewing and grinding teeth. Zirconium crowns, along with emax are the strongest option for dental crowns. They ensure no amount of daily stress to your teeth will cause fracture or splitting on your teeth.



Compatibility


Dental crowns always have the slight chance of provoking a reaction from the immune system such as inflammation which may result in a number of complications. Zirconium crowns have been found by multiple studies to be the safest option regarding any immunologic responses. This is not to say other options aren't safe, zirconium is just safer!



E-Max Crowns


What are e-max crowns?


E-max is a newer material that has been put into use for the production of dental crowns. Chemically speaking, it is a glass compound of Lithium Disilicate, which qualifies it as a fully ceramic compound. As a result of the materials natural properties, an e-max crown is both the most aesthetically pleasing and strongest option for singular dental crowns. Zirconium crowns surpass emax for dental bridges by a small margin in terms of strength, but in the case of single tooth replacement strengths, emax has the "crown". E-max is usually chosen for its supreme aesthetic qualities, being described as more translucent, therefore better at blending in with the other teeth than other alternatives.



Why choose e-max crowns?


Longevity and Strength


Emax crowns are known for their strength and durability. The material used to craft them are the strongest, along with zirconium crowns, which make it an optimal long term choice. Emax crowns will, under no humane amount of stress, crack or split under pressure and will wear down a very little amount during the course of its usage. This makes them a great choice among dental crown materials.



Aesthetics


Emax crowns, due to their unique chemical properties are described by patients and dentists as translucent and very natural looking, blending in with the rest of teeth very naturally. This makes them a cosmetically pleasing option too, being a very common choice for front teeth, which are the teeth that are the most apparent.



Compatibility


Emax crowns, due to their porcelain nature, are compatible with the dental tissue, meaning they won't cause bodily reactions such as inflammation easily.



Porcelain Crowns


What are porcelain crowns?


Porcelain crowns are made by first getting an impression of the patients teeth, which will be replicated with the crown afterwards. The crown itself is made by layering porcelain of different colors in order to achieve a very natural looking crown. This is then placed on top of the patients tooth, cemented via different methods so that it will stick along with the rest of the tooth.

The usage of different layers of porcelain each with slightly different colors gives way to very natural looking dental crowns, and porcelain crowns are usually selected among patients for this very reason.



Why choose porcelain crowns?


Aesthetics


The layering of porcelain on top of each other for the formation of the crown makes these seem very natural. Porcelain crowns are usually preferred for natural looking teeth, usually on the front teeth.



Compatibility


Porcelain crowns, compared to metal based crowns are readily compatible with dental tissue, meaning they will not cause bodily reactions such as inflammation easily. Reported cases of such incidents are extremely rare, so patients can feel safe about undergoing porcelain crown treatments.



Same Day and Multi Day Treatments


Our clinic offers both same day and multi day treatments for the patients who wish to visit our clinic for crowns. Same day and multi day treatments suit the needs of the patients whose visits to Turkey allow different timescales for their operations. Our doctors are very experienced in both same day and multi day treatments and will happily assist patients throughout both processes.



Same Day Treatment


Same day treatments drastically reduce the amount of time it takes for the crowns to be produced, allowing the entire process to take place in a single day. The dental impressions are taken with CAD/CAM equipment rather than the traditional process of having the patient bite an impression tray filled with putty-like material. The digitally procured impressions are then sent to our labs for the milling of the crown which typically takes about 30 to 90 minutes. The crown is ready for its placement right after this process. The Periodonta team is highly experienced in this procedure and will handle your treatment with expertise.



Multi Day Treatments


The multiple day treatment, as it should be evident by its name, takes multiple days to be completed and is more suited for patients who will be staying in Istanbul for more than just a couple of days. As opposed to the digital impression of the tooth/teeth and milling that is the case for same day treatments, impressions are taken with impression trays filled with a special matter, which the patient is asked to bite on, then sent to the labs where it will then be crafted. For multi day crown treatments, there will be a couple of try-in appointments where the patient evaluates the functionality, comfort and the looks of the dental crowns. Hence, by means of the try-in appointments, potential risks of discrepancy and incompatibility is exceedingly minimized.



Procedure


Numbing


Tissue around your teeth will be anesthetized in order to proceed with the operation. Local anesthesia is applied around the tissue to not inflict pain to the patient for the duration of the operation.



Impression


In order to prepare the crown, the dentist takes a mold of the tooth which is then sent to a technician for replication. Patients who wish to undergo dental crown treatment due to aesthetical reasons should not be worried about this, as the model of the tooth can be changed for a more aesthetic option which is to be crafted by the technician. The color surrounding teeth is noted in order for the dental crown to better fit in with the surrounding teeth.



Preparation


A dental crown is supposed to mimic the upper portion of the tooth, where it is the most visible and the tooth must undergo some preparation to properly fit the crown that will be placed. For this step, the dentist carefully prepares tooth and filling selected to best fit th patients mouth to then place the dental crown on. Any tooth decay discovered or cavity due to recent root canal are filled with composite core.



Final impression - Temporary crown


In case of a multi day treatment


Final impression of the prepared tooth is taken for the preparation of the crown by having the patient bite down on an impression tray filled with polyvinyl siloxane. The integrity of this impression is critical as even the smallest flaw can affect the success of the operation. The impression is then sent to the lab for the production of a dental crown that best fits the patients prepared tooth. Until the impressions are processed by the technician and the permanent crown is made, the patients prepared tooth is fitted with a temporary crown. This crown is used for about ten days, after which the permanent crown will most likely have been produced.



In case of a same day treatment


For patients who wish to receive a same day dental crown, the impressions are taken with the CAD/CAM equipment that our clinic is equipped with, which are then sent to our machines to mill your custom crown in a time ranging anywhere from 30 to 90 minutes. After the try-in procedure, where the patient evaluates the color, comfort, aesthetics and the compatibility of the dental crowns, the procedure will proceed according to the patients response and feedback. Dental crowns are permanently fitted after the patients approval, thus enabling them to walk out of Periodonta with a brand new smile in the matter of hours.



Placement of the Dental Crown


The dentist will place the permanent crown and check for contact between adjacent teeth, compatibility with the other teeth, its color and the ease/comfort of biting and chewing. A fit too tight may render it difficult for the patient to floss their teeth and one too loose may cause food to become lodged, leading to tooth decay in the long run. The doctor performing the operation may reduce some body from the adjacent tooth in order to get the crown to fit properly or send it back to the lab to have a tighter fit. The permanent crown is filled with bonding material and then placed over the prepared tooth in order to create a contact and have it bond with the underlying tooth. Some excess cement is produced around the dental crown which is then cleaned by the dentist, after which the operation will be complete. The job of the dentist is now done and the patient needs to give the cementing material some time to solidify.



Recovery and Care


Recovery:


Patients should expect some amount of inflammation, irritation and high sensitivity around the crown for the few days following the operation. Gum swelling, which is also typically experienced can be subsided by rinsing the area with warm salt water a couple of times during the recovery phase. Patients also experience a mild pain, but for most of the cases over the counter painkillers can be more than enough to overcome the pain. If the patient still experiences soreness or discomfort after the recovery period, it is highly recommended that they visit a dentist as this is not expected after the recovery period and may point to issues with the crown.



Care:


Temporary crown:


Most patients prefer the multi day treatment and thus are given a temporary crown to work with between the two dental appointments that they have. The temporary crown, since it is a quick fix, is more vulnerable to fractures and dislodgement than a permanent crown, and patients have to be more careful with it in order to avoid any problems that may arise due to it. Luckily, the guidelines that we provide for its usage are not very restrictive and patients who stick to them will probably have no problems until their next appointment. The guidelines are as follows:

• Sticky foods should be avoided, since they may result in the dislodgement of the temporary crown
• Very hard foods, such as nuts should not be consumed to avoid the risk of temporary crowns breaking
• Patients should try not to chew on food close to their temporary crowns.
• Brushing teeth can be continued as usual, but it should be noted that too much pressure should not be applied over the temporary crown, as it can lead to dislodgement



Permanent crown:


Short term(Cementation):


The permanent crown is much less susceptible to dislodgement and fracturing compared to the temporary crown, but the first 24 hours following its cementation is critical. Not giving the tooth proper care during this timespan can result in the cementation failing, or even worse, the crown being cemented in an incorrect position.The guidelines for its care are not restrictive and patients following them closely should not face any of the mentioned problems. The guidelines are as follows:

• Sticky foods should not be consumed, as it may result in the crown tilting or dislodging

• Hard foods should not be consumed to avoid applying too much pressure on the crown

• Chewing with or near the permanent crowns should be avoided

•A good care for oral health is a must for the well being of the crown following the week of its cementation since crowns are susceptible to delay especially near the gum lining. Patients must brush their teeth but should not apply too much pressure on the crown. Dental flossing may continue but patients should try to apply as little pressure as they can on the crown. Flossing vertically should be preferred over flossing horizontally for this reason.



Long term:


Permanent crowns are usually quite unproblematic after the initial symptoms described in the recovery period have passed, but there are important points that should be kept in mind for the proper treatment of dental crowns even after the symptoms have passed and cementation has been completed to prevent any problems relating to the crowns.

Proper oral hygiene is a must. It is well known that patients who do not give proper care to their oral hygiene experience crown decay and related degradation after some time. Brushing your teeth regularly and taking good care of your oral hygiene is heavily recommended to increase the lifespan of your crown.
Patients should be careful not to exert extreme pressures on the crown. Permanent crowns may be very strong but a regular exposure to high pressures may cause fracturing and splitting. Teeth grinding is also known to cause the mentioned pressure related problems and thus should be avoided as much as possible. In cases where the patient feels they won't be able to stop their habitual teeth grinding, the doctors should be informed beforehand so they can take the precautions necessary for the long term well being of their crowns.