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Crowns / Bridges

(Artificial) dental crowns and bridges are so-called fixed dentures – in contrast to partial and complete dentures that are removable.

A dental crown is the “covering” of an existing but (severely) damaged tooth, while a dental bridge is when a lost tooth is completely replaced.
Nowadays, however, a missing tooth is usually replaced with a dental implant, as this has the great advantage that no neighboring teeth have to be ground and included in the restoration of the tooth gap (as is the case with a bridge).

Decisive for the decision whether a crown or a bridge, resp. an implant is inserted, is the question whether only the (natural) tooth crown or also the tooth root, resp. the entire tooth is damaged and the corresponding tooth has to be removed.

Crowns / Bridges

(Artificial) dental crowns and bridges are so-called fixed dentures – in contrast to partial and complete dentures that are removable.

A dental crown is the “covering” of an existing but (severely) damaged tooth, while a dental bridge is when a lost tooth is completely replaced.

Nowadays, however, a missing tooth is usually replaced with a dental implant, as this has the great advantage that no neighboring teeth have to be ground and included in the restoration of the tooth gap (as is the case with a bridge).

Decisive for the decision whether a crown or a bridge, resp. an implant is inserted, is the question whether only the (natural) tooth crown or also the tooth root, resp. the entire tooth is damaged and the corresponding tooth has to be removed.

Artificial dental crowns and bridges as tooth replacements

Dental replacements in the form of crowns or bridges are recommended when a natural tooth is so badly damaged as a result of caries, accident etc. that a filling can no longer repair the defect. Consequences of a complete loss of one or more teeth due to diseases of the tooth structure or periodontium can sometimes include:

  • difficulties with chewing and articulation
  • impairment in stability of the dental apparatus
  • potentially associated with incorrect strain on muscles and joints
  • changed appearance

Artificial teeth are primarily used to compensate for major tooth damage and to give the patient back chewing behavior that is as natural as possible. Modern dental crowns are hardly or not at all distinguishable from natural teeth in terms of color. Even darkly discolored teeth after root canal treatment can be effectively treated with a crown. Usually, crowns and bridges are nowadays made from full ceramic, more rarely from a metal-ceramic connection.

What is a dental crown?

The (natural) dental crown is the part of the tooth that protrudes from the gums, while the tooth root anchors the tooth in the jaw and is usually not or only partially visible. If only the natural tooth crown is damaged, but the tooth root is not, the natural tooth crown is ground down and the artificial crown is attached to it. If the natural tooth crown has already been damaged to such an extent that the artificial crown would no longer be able to hold on to it adequately, a so-called pin crown may be able to be used, in which the crown is anchored in the tooth root with a metal pin becomes. However, this requires a root canal treatment of the tooth.

A dental crown may be necessary for a variety of reasons. In addition to completing damaged teeth, it can serve as an anchor for bridges or stabilize root-treated teeth. Depending on what function the crown fulfills and which tooth it is placed on, there are different requirements.

If the crown affects a molar, for example, very high resistance is particularly important. In this case, a crown with a metal core, a so-called composite-metal-ceramic crown (VMK), is ideal.

In contrast, the focus for the visible front teeth is on the aesthetics: an all-ceramic dental crown is therefore recommended here. Even if the gums recede over the years, unlike metal-ceramic crowns, you will not see any exposed metal edge with all-ceramic crowns.

  • All-ceramic crown: made entirely of ceramic, such as zirconium oxide (today’s standard)
  • Composite metal-ceramic crown (VMK): have a core made of a special metal alloy and are veneered with ceramic (2nd choice, e.g. for grinders)
  • Post crowns: are anchored in the tooth with a post made of titanium or special ceramic
  • Telescopic crown: as connecting elements for dental prostheses
  • Full cast crown: metal and gold crowns (practically no longer made today)
  • Venecrated crown: completely or partially coated in tooth color (also outdated)

Usually two appointments are necessary to insert a dental crown. A further check-up a few weeks after placement of the artificial crown is sometimes necessary, depending on the case.

  • Impression/scan and temporary dental crown: Under local anaesthesia, the dentist removes the destroyed part of the natural tooth and frees it from deposits and caries. An impression, resp. scan is then made of the prepared tooth stump, which forms the basis for the individually made crown. The color of your teeth will also be determined at this first appointment. The dental technician then manufactures the crown in the laboratory within 1-2 weeks. During this transition period, the tooth stump is provided with a temporary crown made of plastic.
  • Insertion of the crown: Once the crown has been manufactured, it is inserted onto the patient’s tooth for a trial (i.e. without cement) and it is checked whether it fits correctly from an aesthetic and functional point of view. If this is the case, the artificial dental crown can then be inserted with a special dental cement. Finally, the dentist removes the cement residue and checks the bite again. If necessary, this is “ground in” to ensure an absolutely perfect fit of the crown and to prevent pressure pain when biting.

What is a dental crown?

The (natural) dental crown is the part of the tooth that protrudes from the gums, while the tooth root anchors the tooth in the jaw and is usually not or only partially visible. If only the natural tooth crown is damaged, but the tooth root is not, the natural tooth crown is ground down and the artificial crown is attached to it. If the natural tooth crown has already been damaged to such an extent that the artificial crown would no longer be able to hold on to it adequately, a so-called pin crown may be able to be used, in which the crown is anchored in the tooth root with a metal pin becomes. However, this requires a root canal treatment of the tooth.

A dental crown may be necessary for a variety of reasons. In addition to completing damaged teeth, it can serve as an anchor for bridges or stabilize root-treated teeth. Depending on what function the crown fulfills and which tooth it is placed on, there are different requirements.

If the crown affects a molar, for example, very high resistance is particularly important. In this case, a crown with a metal core, a so-called composite-metal-ceramic crown (VMK), is ideal.

In contrast, the focus for the visible front teeth is on the aesthetics: an all-ceramic dental crown is therefore recommended here. Even if the gums recede over the years, unlike metal-ceramic crowns, you will not see any exposed metal edge with all-ceramic crowns.

  • All-ceramic crown: made entirely of ceramic, such as zirconium oxide (today’s standard)
  • Composite metal-ceramic crown (VMK): have a core made of a special metal alloy and are veneered with ceramic (2nd choice, e.g. for grinders)
  • Post crowns: are anchored in the tooth with a post made of titanium or special ceramic
  • Telescopic crown: as connecting elements for dental prostheses
  • Full cast crown: metal and gold crowns (practically no longer made today)
  • Venecrated crown: completely or partially coated in tooth color (also outdated)

Usually two appointments are necessary to insert a dental crown. A further check-up a few weeks after placement of the artificial crown is sometimes necessary, depending on the case.

  • Impression/scan and temporary dental crown: Under local anaesthesia, the dentist removes the destroyed part of the natural tooth and frees it from deposits and caries. An impression, resp. scan is then made of the prepared tooth stump, which forms the basis for the individually made crown. The color of your teeth will also be determined at this first appointment. The dental technician then manufactures the crown in the laboratory within 1-2 weeks. During this transition period, the tooth stump is provided with a temporary crown made of plastic.
  • Insertion of the crown: Once the crown has been manufactured, it is inserted onto the patient’s tooth for a trial (i.e. without cement) and it is checked whether it fits correctly from an aesthetic and functional point of view. If this is the case, the artificial dental crown can then be inserted with a special dental cement. Finally, the dentist removes the cement residue and checks the bite again. If necessary, this is “ground in” to ensure an absolutely perfect fit of the crown and to prevent pressure pain when biting.

What is a dental bridge?

If not only the crown of the tooth is damaged, but also the tooth root and the entire tooth has to be removed, the resulting gap can be closed with a dental bridge. For this purpose, artificial crowns are applied to the teeth adjacent to the tooth gap (the so-called pillar teeth), to which the dental replacement for the missing tooth is attached as a so-called intermediate link, so that a closed row of teeth is created again.

Alternatively, instead of a bridge, a dental implant can be used, i.e. an artificial replacement of the lost tooth root. A dental crown is then attached to the implant. The advantage is that no pillar teeth are required with this type of tooth replacement.

While the dentist attaches a conventional bridge to the neighboring teeth (so-called pillar teeth) with dental cement using crowns, the adhesive bridge (also known as Maryland bridge) is bonded to the inside of the neighboring teeth using an adhesive. However, the stability of this variant is significantly lower than that of a conventional bridge and is therefore now mostly only used as a temporary solution.

The following indications speak against the use of a dental bridge:

  • Stability and sufficient support of the pillar teeth are not guaranteed
  • Static unfavorable position for a dental bridge
  • Restrictions on the part of the patient that make it impossible to adequately care for the dental bridge

Since each dental bridge is manufactured individually, it must be carefully planned. If necessary, an x-ray of the jaw will be taken as part of a preliminary examination to check the abutment teeth. Depending on the complexity of the bridge and the location where it is used, several sessions are necessary; usually there are two to three. The treatment process is basically the same as for the dental crown (see details there).

What is a dental bridge?

If not only the crown of the tooth is damaged, but also the tooth root and the entire tooth has to be removed, the resulting gap can be closed with a dental bridge. For this purpose, artificial crowns are applied to the teeth adjacent to the tooth gap (the so-called pillar teeth), to which the dental replacement for the missing tooth is attached as a so-called intermediate link, so that a closed row of teeth is created again.

Alternatively, instead of a bridge, a dental implant can be used, i.e. an artificial replacement of the lost tooth root. A dental crown is then attached to the implant. The advantage is that no pillar teeth are required with this type of tooth replacement.

While the dentist attaches a conventional bridge to the neighboring teeth (so-called pillar teeth) with dental cement using crowns, the adhesive bridge (also known as Maryland bridge) is bonded to the inside of the neighboring teeth using an adhesive. However, the stability of this variant is significantly lower than that of a conventional bridge and is therefore now mostly only used as a temporary solution.

The following indications speak against the use of a dental bridge:

  • Stability and sufficient support of the pillar teeth are not guaranteed
  • Static unfavorable position for a dental bridge
  • Restrictions on the part of the patient that make it impossible to adequately care for the dental bridge

Since each dental bridge is manufactured individually, it must be carefully planned. If necessary, an x-ray of the jaw will be taken as part of a preliminary examination to check the abutment teeth. Depending on the complexity of the bridge and the location where it is used, several sessions are necessary; usually there are two to three. The treatment process is basically the same as for the dental crown (see details there).

Proper care of dental bridges and crowns

Patients can do a lot to help keep dentures long-lasting: conscientious dental care and thorough oral hygiene are the be-all and end-all – this doesn’t just apply to natural teeth. What’s more, greater care is required when it comes to dentures. You can minimize the risk of deposits collecting at the junction between your own tooth and the artificial tooth (part) and causing tooth decay or inflammation of the gums by cleaning the affected areas properly. In addition to daily use of dental floss, we also recommend cleaning with special interdental brushes. Get advice from your dental practice in Zug on how you can optimally care for your dental bridge.

Are you having problems with an old crown? Or are you looking for a experienced dentist to replace a bridge with a dental implant? We would be happy to advise you!

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