Crown placement procedure

Dental crown placement is a restorative dental procedure designed to cover and protect a damaged or weakened tooth. This treatment not only restores the tooth’s function but also enhances its appearance and strength. The crown placement process typically involves multiple steps carried out over two dental visits, though advancements in dental technology have made same-day crowns possible in some clinics.

1. Initial Consultation and Examination

The crown placement journey begins with a thorough examination by the dentist. During this visit, the dentist evaluates the condition of the tooth that requires a crown. This may involve:

• Visual examination

• Digital X-rays to assess the roots and surrounding bone

• Determining the need for additional treatments like root canal therapy if there’s infection or decay reaching the pulp

If the tooth is viable for crowning without further extensive treatment, the dentist will proceed with the preparation.

2. Tooth Preparation

The second step in the crown placement procedure is the preparation of the tooth. The dentist will numb the area using local anesthesia to ensure comfort during the process. Once the area is numb, the dentist reshapes the tooth by removing a portion of the enamel from all sides. This reduction is essential to create space for the crown so that it fits seamlessly with the surrounding teeth.

If the tooth has extensive decay or has lost much of its structure due to fracture, the dentist may use a filling material to build it up and provide a solid foundation for the crown.

3. Impressions and Shade Matching

After the tooth has been properly shaped, the dentist takes an impression or digital scan of the prepared tooth and the surrounding bite. This impression is crucial for creating a crown that fits precisely and maintains proper bite alignment.

At this stage, the dentist also matches the color of the crown with the adjacent natural teeth to ensure aesthetic consistency. Porcelain or ceramic crowns are particularly effective at mimicking natural tooth color, making them a popular choice for front teeth.

4. Temporary Crown Placement

In most traditional crown procedures, a temporary crown is placed over the prepared tooth while the permanent crown is being fabricated in the dental lab. The temporary crown is made from acrylic or composite resin and is cemented with temporary adhesive.

The temporary crown serves several purposes:

• Protecting the tooth from sensitivity

• Preserving the tooth’s function

• Preventing shifting of adjacent teeth

• Maintaining appearance

Patients are typically advised to avoid sticky or hard foods and to take special care when flossing to prevent dislodging the temporary crown.

5. Fabrication of the Permanent Crown

Once the impressions or scans are sent to the dental lab, the crown fabrication process begins. Depending on the material selected—porcelain, ceramic, metal, zirconia, or porcelain-fused-to-metal—the lab crafts a custom crown that replicates the shape, color, and function of a natural tooth. This process can take one to two weeks.

In clinics equipped with CAD/CAM technology, same-day crowns can be created onsite, eliminating the need for a second appointment and temporary crown.

6. Fitting and Cementation of the Crown

When the permanent crown is ready, the patient returns for the final placement. The dentist first removes the temporary crown and cleans the underlying tooth. Then, the permanent crown is tested for fit, shape, color, and bite alignment.

Necessary adjustments are made to ensure comfort and functionality. Once both the patient and dentist are satisfied with the crown, the dentist uses a special dental cement to bond it permanently to the tooth.

7. Final Adjustments and Polishing

After cementation, the dentist ensures that the crown fits well with the opposing teeth and does not interfere with the patient’s bite. Any minor adjustments are made chairside. The crown is then polished to blend with the natural teeth and provide a smooth, aesthetic finish.

Patients may experience mild discomfort or sensitivity after the procedure, especially if the crowned tooth had not previously received a root canal. This typically resolves within a few days.

8. Post-Procedure Care

Proper care is essential to maintain the longevity of the dental crown. Dentists provide patients with guidelines such as:

• Brushing twice daily with a non-abrasive fluoride toothpaste

• Flossing daily to prevent plaque buildup around the crown

• Avoiding hard foods like ice or popcorn kernels that may crack the crown

• Wearing a mouthguard if the patient grinds their teeth at night

• Scheduling regular dental check-ups for monitoring

Common Materials Used for Crowns

The choice of crown material depends on the tooth’s location, patient’s preference, and cost considerations. Common crown materials include:

• Porcelain: Highly aesthetic, ideal for front teeth

• Ceramic: Biocompatible and suitable for patients with metal allergies

• Metal Alloys (Gold or Base-Metal): Extremely durable, typically used for molars

• Porcelain-fused-to-metal (PFM): Offers strength and aesthetics, though the metal base can sometimes show as a dark line near the gum

• Zirconia: Strong, long-lasting, and increasingly popular due to its natural appearance and durability

Risks and Complications

Though dental crowns are generally safe and effective, some patients may experience complications such as:

• Sensitivity or discomfort post-procedure

• Allergic reactions to crown materials

• Crown becoming loose or falling off due to cement failure

• Decay under the crown if oral hygiene is poor

• Gum recession exposing the crown’s margin

Prompt communication with the dentist can help address any concerns early and prevent further complications.

Longevity of Dental Crowns

With proper care, dental crowns can last between 10 to 15 years, and sometimes longer. Factors that affect longevity include:

• Material of the crown

• Patient’s oral hygiene habits

• Diet and lifestyle choices

• The presence of habits like teeth grinding or jaw clenching

Patients are encouraged to follow the dentist’s advice closely and attend regular dental visits to monitor the condition of the crown and surrounding teeth.

Conclusion

Crown placement is a comprehensive dental procedure that restores both the function and appearance of damaged teeth. By following a structured and careful process, dentists ensure the final restoration is durable, comfortable, and aesthetically pleasing. With the right post-care and routine dental checkups, crowns can provide long-lasting benefits and contribute to overall oral health.