Good oral hygiene helps keep teeth healthy and gives a person a beautiful smile. Unfortunately, many people do not take good enough care of their teeth and get cavities. In some cases, the cavities can lead to root canals and missing teeth. How does a person get a set of happy and healthy teeth again? Two of the most popular solutions are dental crowns and dental implants.
Dental crowns and dental implants are two separate procedures that are used depending on the condition of the patient.
A dental crown is a prosthetic restoration that is placed on the natural tooth structure or an implant. It is the tooth restoration that people actually see as opposed to a medical function. The procedure for putting a crown on a natural tooth involves numbing a patient. The dentist prepares the tooth to set up a porcelain crown and there are different materials that can be used. There are all-metal crowns, which is a metal with porcelain on the top of the crown. There are different types of all-porcelain crowns, and there is also a zirconia crown. The choices range from a full metal crown to a full tooth colored natural looking crown. If a patient is having the procedure only for aesthetic reasons then porcelain gives the best result. Depending on a patient’s bite, as well as the location of the crown, there may be another material suggested for use.
An implant almost looks like a screw. It is placed inside the bone underneath the tissue so nobody can really see the implant. The implant is there to act as the root of a tooth. On top of the implant, there can be a single crown. Patients can also have two implants to fill a larger space with crowns on top of those. They can also have an implant for every single tooth or every other tooth, and have a complete prosthesis that is screwed on those implants. The implant itself can range from replacing one tooth to multiples used to replace a complete arch or mouth of teeth. The implant itself is completely under the tissue.
There is also a third piece called an abutment. This is the junction between the implant and a crown that acts as the tooth to put the crown on. With more aesthetic situations, a patient is probably looking at having an implant placed and then having the implant restored with the abutment, and a crown on top of the abutment.
Tooth crowns are most commonly used to replace tooth structure lost by traumatic occlusion, cavities or after a root canal. Following a root canal, the tooth becomes very brittle because it has lost its blood supply. Putting crowns on top of teeth that just had a root canal gives them added strength.
Denture implants takes the place of a completely lost tooth where there is no root and no part of the tooth left. Whereas a crown takes the space of either tooth structure loss or is used on an implant to restore that space, an implant is used as the root of a natural tooth.
A patient does not need to have an implant. A patient could have a traditional denture that is not attached to anything and just sits on the gum tissue. Patients do not do very well with dentures because they are a piece of plastic they are biting on. A normal standard of care is putting dentures with implants where the denture kind of locks onto the implant.
A dental crown can be anywhere from $1,000 to $2,500 in the United States. The cost depends on the type of porcelain that is used and how aesthetic the case is. If a patient has a lot of dark stains on their front teeth, the laboratory and the dentist are going to have to do a lot more work to make sure the patient is happy with the end result.
There are a lot of places that offer crowns for $500. When you see a price like that, a patient needs to ask where the crown is being made. If the crown is made in the United States, it is going to cost more. One can be made in China pretty cheaply. Also, what material is that crown made of? That can really change the price range.
The cost of implants is around $2,500 to $3,000. That is just to place the implant. That is no crown with no abutment on top of it. That is one implant. There is a lot that goes into specifically pricing something like that. The price of implants is difficult because the dentist has to make sure that the bone and the gum tissue are ready to support that implant. For example, implants can be used in coordination with orthodontics as anchors. There are tiny implants called Temporary Anchorage Devices (TAD). A patient can use them or they can use an implant that is meant to be restored with the tooth at a later date. The Temporary Anchorage Devices are used as anchorages. The implant itself will not move.
A crown will come off if there is a failure in the bonding system. If a person ends up with a cavity underneath their crown, the bonding can fail. If there has been some kind of trauma in the front teeth, the bonding can fail. If an implant comes out of the bone, it has failed but that is a rare occasion. It is not going to just fall out. A patient needs to have it cleaned and that should be monitored. But it will not just fall out.
There are crowns that can be made within a couple of hours in an office. It is called CAD scan technology and the crown is made in the office. It really depends on the material being used. A really aesthetic case might take the laboratory 3 or 4 weeks. The patient would be in a provisional for that time.
Some implants can be placed the same day a tooth is removed. Other implants need to wait a few months before they are able to be placed, so it can be anywhere from one day to six months before the implant is placed. The implant is definitely more time consuming because of the nature of the procedure.
Any restrictions on what foods can be enjoyed by the patient depend on the material of the crown. Do not chew ice or have a jawbreaker. The porcelain can break at the back.
Different crowns require different cement. A porcelain crown can use a cement that utilizes a light and it hardens right there. A metal crown can get light through it so it has different cement that may take up to 24-hours to fully set. If a crown is placed within a seating, a patient cannot leave the office until it is secure.
Porcelain crowns and teeth implants should not change color unless the patient is a heavy smoker.
Once the implant is integrated, it should last forever. The lifetime of a crown depends on how well the patient takes care of it. If the patient does not brush well, they will probably get a cavity under it and lose it.
Before deciding on having a crown or an implant, a patient should consult with an experienced dentist. The overall condition of the tooth will determine whether a crown or an implant is the best option for the patient. A skilled dentist will also show a patient the best way to take care of their teeth once the procedure is performed. If a patient has any questions before or after having a crown or implant, it is in their best interest to consult with the dentist who performed the procedure.
Written by Cosmetic Town Editorial Team - MA
Based off an exclusive interview with Dr. Julie Storm in Oklahoma City, OK