This type of restoration can be used for front and back teeth and reproduces the anatomy and colour such that it is difficult to tell the difference between a crowned tooth and a natural tooth.
While crowns can be used purely for cosmetic reasons (link to smile makeovers), it is usual for a crowned tooth to be heavily restored with filling material prior to preparation. A crown improves the appearance of a tooth but also protects tooth substance which is at risk from fracture. It is usual to recommend that a root treated tooth (link to this) is protected and a crown is very often the treatment of choice.
Crowns can be made from porcelain (or ceramic), porcelain fused to precious metal or entirely from gold. Great advances have been made in recent times allowing the manufacture of an all porcelain (or all ceramic) crown that is just as strong as porcelain fused to metal and without the grey lines that are sometimes a problem with porcelain fused to metal crowns (link to Procera, Nobelbiocare?). Making a crown is a highly skilled job completed by a dental technician. Each individual crown is hand crafted and designed for the individual patient's needs. With an all-ceramic crown, the foundation is sometimes made in Sweden and then shipped back to the United Kingdom and finished to our exacting standards. At SCED, we have our own in-house technicians and we also use some of the best technicians in the United Kingdom. It is amazing that this procedure only takes two to three weeks to complete!
At the first appointment, any old or defective material is removed and replaced and the tooth prepared. A crown preparation is best described as a reduction of tooth structure – imagine a tooth and then imagine this same tooth shrunk by a precise amount. At the preparation visit any tooth structure is replaced with a provisional or temporary crown which restores the appearance while the crown is being made but allows the patient to get on with their life.
At the second visit, the temporary crown is removed, the final crown placed with try in paste and assessed by the patient and then cemented into place. When multiple crowns are being planned it can be useful to complete a final visualisation of the predicted final outcome on a model of the teeth.
A well planned and well executed crown looks and feels excellent and should last in excess of ten years.