Treatments

Crowns & Bridgework

A fixed solution to strengthen teeth which are heavily filled or to replace a missing tooth using adjacent teeth as supports.

Is this the right treatment for you?

Crown - your tooth is heavily compromised and needs a protective custom-made tooth that fits over it like a glove, to keep the tooth together.

Bridgework - alternative fixed solution to implants if you have suitable adjacent teeth available, for support.

Good to know

Teeth need to be prepared conservatively to minimise the risk of weakening them or damaging the tooth nerves.

YOUR TEAM
You're in good hands

Using high magnification, the latest drill technology, 3D scanning and the latest techniques, our team will prepare your tooth carefully and conservatively so that it can be covered by a custom-made prosthesis, which is built to last.

John McAleavey

Restorative Dentist

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Kathryn McComisky

Trainee Nurse

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The procedure
  1. Anaesthetic to ensure that you are comfortable during the procedure.
  2. A small  mould of your tooth/ teeth to allow the fabrication of a temporary prosthesis which will protect your tooth whilst the long term prosthesis is custom made.
  3. Careful and conservative preparation of the tooth /teeth to ensure that the most minimal tooth is removed to create space for the new prosthesis.
  4. Whilst following a conservative approach , it is important to prepare the tooth properly . This allows the prosthesis to be strong and make sufficient space for a skilled ceramic technician to create a tooth which actually looks like a tooth.
  5. 3D high definition digital scan is taken of the prepared tooth/teeth.This eliminates the need for messy moulds.
  6. With a detailed design map, discussing the colour gradients and result that we are aiming to create, our dentist will brief the master ceramist on the desired outcome.
  7. Following the custom fabrication of your prosthesis the master ceramist will deliver the completed restoration within 2-3 weeks.
  8. The prosthesis is checked on the 3D printed model by our dentist to ensure that it has been made to the specification requested.
  9. At your fitting appointment, the prosthesis is tried in to ensure a passive fit as well as accurate colour and design by your dentist.
  10. It is then fitted using special resins which connect you tooth to the prosthesis.
  11. The bite is checked to ensure that all the teeth meet as planned and intended

Before and after

Show before & after photos

What our clients say

"110% professional treatment and I raised my hand when I was struggling"
"Had a cracked tooth and after a gap of 5years I went "back" to Manor Place
John and Kat provided 110% professional treatment and I raised my hand when I was struggling. Money well spent on beautifully matching white crown

Kevin Turner

I am very happy with my recent rebuilding of my broken down teeth with thin zirconia crowns; the teeth now look and feel good (and very strong) although the new geometry of my mouth means that I have developed the stupid habit of constantly tapping them together often in time to music I happen to be listening
to ( goes well with quite a bit of J. S. Bach's repertoire !! ) The process; appointments, surgery, pain control and lab work was handled with the consummate professionalism which I associate with your Practice.

Gordon Jefferson

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Your questions answered

How many teeth can be in a bridge?

A bridge can replace anything from one tooth to a whole jaw dependant on sufficient teeth being present in key areas to support the bridge. One tooth can support one missing tooth whilst dependant on the site, two teeth can support six teeth. A six tooth bridge supported by two canines and replacing four missing front teeth has the strongest track record for predictablity. It is sensible to replace missing teeth in small spans as this is much easier to maintain and more economical to resolve in the future.

How long does a dental bridge last?

The longevity of the bridge is dependant on how well the teeth have been prepared by the dentist; how well the bridge has been made and fits; how well you are looking after it and what the conditions in your mouth are. It also depends on if you have sufficient teeth in the back of the mouth to spread the load evenly. If you are grinder/clencher then your dentition, including the bridgework will have a reduced life span. This overloading can be protected and controlled by a sleep clench inhibitor appliance.

Are dental bridges a good idea?

Dental bridges are a great idea to replace missing teeth if you want to avoid implant surgery. This is especially the case when you have insufficent jaw bone and may need multiply surgeries to replace a tooth/teeth. A dental bridge is reliant on teeth and not the jaw bone to support it. Done well, it is very difficult to see where the bridge is.

Are dental bridges better than implants ?

Dental bridges and implants are both "tools" used to achieve an outcome. If you have a tooth missing and the adjacent teeth are crowned then it is perhaps better to bridge that gap as the crowns can be replaced with a bridge. This eliminates the need for surgery and may be a more economical solution. It also provides a faster result. On the other hand, if you want individual teeth which are self supporting then an implant will fullfil this need but dependant on what needs to be addressed this may be a slow result. A dental bridge is dependant on the adjacent teeth being strong. If they are already root treated then have higher chance of fracture due to the extra load that they need to carry.

Are crowns permanent?

Nothing in dentistry is permanent. How long it lasts depends on how well the tooth has been prepped and the crown made and fitted. Just as important is how well you consistently clean around the tooth/crown joint to minimise bacteria stagnating around this important interface.

Can teeth still rot under crowns?

Provided that the crown has been accurately made and fitted then it there is less likelihood for the tooth underneath rotting away. This is assuming that the joint between the crown and the tooth is being actively cleaned with a tooth brush and floss.

Why do fees for crowns vary for different clinics?

Whilst it may seem that the same crowns are being offered for different fees at different clinics, this is not always the case. To create a perfect crowns is much more than the material. It is based on the skill of the dentist to carefully and conservatively prepare the tooth and then accurately capture the prep data for the lab; clear instructions to the lab which discuss colour gradients (teeth have a number of colours), the appropriate material for that particular client in terms of their bite and their expectations, a skilled experienced master ceramist who devotes sufficient time to recreate a crown is as slender as a natural tooth and looks alive. The ceramist has to ensure that not only does the crown look like a tooth but it fits accurately to minimise ledges for bacteria; hygienic to allow cleaning; good contact points with adjacent teeth to ensure that food/debris and bacteria do not end up rotting the gum and eventually the jawbone. This requires time, experience and skill from both the dentist and the ceramist to achieve consistent out standing results. This is reflected in the fees.

What material choices are available?

Dental crowns can be be custom made with a number of different materials. Gold - this is still an excellent choice for back teeth as it can be thin and very conservative. However it is not very aesthetic. Grey alloy - this an economical solution which is used mainly in the NHS for back teeth. Porcelain crown supported by metal alloy - a tried and tested solution which is easy to fit. However the metal core has to be masked by using opaque porcelains which may result in a flat coloured tooth which does not look as "alive" as a natural tooth. This would be more a problem if it is next to an natural front tooth. A very skilled ceramist can still create a very believable tooth. Pressed ceramic - this is now the first choice for high aesthetics, whether front or back teeth. The advent of 3D scanning technology* has really allowed this to push boundaries. A prepped tooth can be 3D scanned and the data sent to a Digital lab where a new tooth can be designed using CADCAM technology. The tooth crown can then be milled before arriving at the master ceramist who will then use tint artistry to recreate the colours of your natural surrounding teeth from the photographs sent with the work. Using clever polishing techniques the ceramist can also copy how light reflects of your natural teeth. Done well it is very difficult to distinguish the crown from the natural teeth. These crowns are technique sensitive to fit as they need to be bonded to the underlying tooth without moisture contamination. Monolithic Zirconia - milled industrial diamond which can be very thin and stronger than metal. Ideal for back teeth but as colour technology and techniques continue to develop an excellent choice for close to the front of the mouth. These are less techniques sensitive to fit so less complications. Cerec Crown - scan a tooth and mill the crown within an hour. A great technology with the benefit that you don't need to wait 2 weeks for the lab to make the crown. However, still no where near as good as that made by a skilled, experienced ceramist.

Are crowns a good solution for discoloured teeth?

There can be a number of reasons for discoloured/stained teeth. It is essential that the reason for this be determined so that the most conservative solution to address this be undertaken. If the staining is superficial this can be addressed by GBT therapy. If this discolouration is actually through the structure of the tooth then this can be addressed by the appropriate whitening therapy solution. However, if the tooth is stained and heavily restored and there is an increased risk of tooth fracture the an crown would be a great solution to address these issues.

Are crowns the best solution to protect a weak tooth?

Conservative dentistry delivered with care, is the best way to improve the longevity of a tooth. Therefore, if tooth walls are thick enough they should be conserved. In this case, an inlay, overlay or onlay may be the best option as this this requires less preparation of the tooth than a crown. However, leaving weak teeth unsupported may result in fracture of the tooth, leaving it unrestorable.

Do all crowned teeth need root canal treatment?

Whilst not all crowned teeth need to be root treated, teeth that are usually crowned are heavily compromised and have a higher risk of dying. The dental literature quotes an increased risk of 18% of tooth dying following being crowned. However, leaving the tooth unprotected without a crown may risk a catastrophic fracture which may result in tooth loss.

Why do teeth need crowns?

A tooth is at it's strongest when it is whole. When teeth rot or are repaired/restored with filling materials these teeth are still required to withstand the same heavy loads but with less surface area. This increases the risk of the tooth fracturing especially with heavily filled teeth. One of the ways to protect the tooth is to remove a outer layer of the tooth and filling and have a lab custom make a skin which covers the remaining tooth and fits like a glove.

Question not answered here?

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0131 225 9093

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Ready for a new type of dental care?

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0131 225 9093
reception@integrateddentalcare.com

1 Manor Place Edinburgh EH3 7DH