Fixed Prosthodontics.

“Fixed prosthodontics” is the umbrella term that encapsulates all types of indirect restorations of teeth. “Indirect” means that the restoration is fabricated specifically for your tooth in a laboratory. This type of restoration is more complex than a simple filling which is done directly. There are several reasons why an indirect restoration might be more suitable than a direct filling. These include but are not limited to:

  • Strength
  • Function
  • Aesthetics
  • Replacement of missing teeth
 
 

What's involved?

We do not offer in office bleaching treatments. If you decide after your consult that you may benefit from generalised bleaching of your teeth, we will take some impressions to be able to fabricate your custom made close fitting bleach trays. The method we prefer to use employs the use of trays overnight while you sleep with a small amount of bleach adapted to the outer surface of your teeth. Results can usually start to be seen after a few weeks.

  • Each case is individual, however the following is an outline of what you might expect:
  • Radiograph/s to assess the roots of the teeth and surrounding bone
  • Anaesthesia
  • Impressions
  • Tooth preparation (much like a filling)

  • More impressions!

  • Tooth shade selection in consult with you
  • Photos -> before and after for your wall
  • Temporisation -> Temporary crowns or bridges are made to be easily removed so don’t worry if they come off, let us know and we will either re-cement it or make you a new one.
  • Try in and cementation

The whole process usually takes 2-3 visits over the course of a few weeks. We will give you a printed outline of all costs and appointments involved. Please ask us if you have any concerns.

 

Crowns:

A crown is an artificial covering for a tooth processed in a dental laboratory. Usually a crown will cover the entire visible surface of the tooth. The materials used in crown fabrication are constantly evolving and always improving, the most commonly used materials are:

Full Porcelain – Full porcelain crowns produce restorations of high aesthetic quality. They are often used anteriorly where aesthetics is the primary concern. Full porcelain crowns are more susceptible to fracture than porcelain bonded to metal (PBM) so are less frequently used in areas of high stress. Several different types of full porcelain crowns have been developed with differences in properties. 

Porcelain bonded to metal (PBM) – As mentioned above, the porcelain is layered or pressed on top of an interior metal coping. The metal provides the crown with increased strength with only a slight drop in the aesthetic quality of the restoration. PBM’s are used frequently in areas of aesthetic importance under some stress.

Full Gold Crowns (FGC) – As the name suggests the appearance of the crown is lustrous gold. FGC’s are used less frequently these days as the improvement in the strength and wearing properties of the more aesthetic indirect restorations make those options preferable. In instances where the only concern is strength (ie posteriorly) and resistance to compressive forces an FGC might be considered. 

 

Bridges:

A bridge is used to replace missing teeth. A bridge is much like the physical bridges we encounter in everyday life. A dental bridge will most often use two existing teeth as “abutments” to fill in the gap left by a missing tooth or teeth. The abutment teeth will be prepared in the same way a single crown is prepared and a bridge fabricated in the dental laboratory that will then be cemented in place over the prepared teeth. There are variations of bridges that we offer and be happy to discuss with you.

 

Implants:

*We do not currently offer the provision of implants. However, if this is deemed to be an appropriate treatment option for your individual clinical scenario we will inform you of all possible treatment options and provide you with the necessary referral/s.

Implants are similar to crowns as they are an indirectly prepared restoration, usually full porcelain or PBM. The difference is that an implant will replace a missing tooth (or teeth) rather than restoring an existing one. A surgical stage is needed to place the implant prior to restoring over the top of it with following osseointegration (fusion of the implant to the bone that contains it) and appropriate healing. We are happy to discuss the need for implant placement with you and the process it entails.

 

Possible problems during fixed prosthodontic:

During any medical or dental or health treatments it is possible that unplanned complications can occur.

 
 

Breakage of the tooth:

While every effort is made to evaluate teeth before the crown preparation is undertaken, sometimes it is simply not possible to detect microscopic cracks/fractures visually or with radiographs. In rare circumstances, a tooth may fracture during crown preparation or it may fracture later. If a fracture occurs during crown preparation you will be notified and the treatment of the tooth may be modified. 

 

Pain, sensitivity and/or discomfor:

After the preparation of a tooth for a crown it is not unusual for the tooth to feel tender or sensitive. This will most often only be noticed after the anaesthetic wears off. Usually this is a temporary reaction from the tooth having had treatment. If this discomfort persists for more than 48 hours please let us know. Most often we will be able to diagnose the issue and offer advice or simply treat the cause of the problem. In some cases this pain/sensitivity is evident following cementation of the fixed crown or bridge. Most often it decreases over the period of a few days, if you are concerned please let us know. 

 

Necrosis of the tooth or “nerve death”:

Most often teeth that are crowned have had large and/or deep restorations previously. These teeth are more likely to require root canal treatment (endodontics). If pain persists for weeks after preparation for a crown or after a crown is placed, please let us know. Your dentist will use diagnostic tests and advise you whether or not the tooth in question is likely to require endodontics. The cost of root canal treatment is separate to the cost of the crown. Please ask us if you have any questions or concerns.

 

Loose crown:

Temporary Crown

If your temporary crown feels loose or debonds/falls out, please let us know. This is not a big problem so don’t stress! Temporary crowns are made to come out easily! We will fabricate a new temporary crown and cement it in place for you.

Crown or Bridge

If you start to notice your fixed crown or bridge is loose it is more of a concern. In this instance extensive decay of the remaining underlying tooth structure can occur quite quickly. We may be able to cement it back in place following cleaning, if not we will explain the options available to you. 

 

Allergic response:

Being allergic to gold or porcelain is very rare. Usually the metal used inside a metal/porcelain crown is a mixture of semi-precious and precious metals including gold. Sometimes non-precious metals are used in crowns. If you are allergic to any jewellery, please tell us before we plan a crown so we can determine and fabricate using the materials of least risk. Allergic response to crowns may take some time to be seen or may develop after a crown has been put in place. It may be seen with increased inflammation or the discoloration of the gingival tissue around the crowns only.