17250 N. 43rd Ave #3
Glendale, AZ 85308
Hymovitch, Steven D.D.S.
310 N Wilmot Rd # 102
Tucson, AZ, 85711-2626
Gutman, Jonathan M D.D.S.
3085 W Ina Rd # 101
Tucson, AZ, 85741-2382
Gilbert, Shawn D D.D.S.
702 E Bell Rd # 120
Phoenix, AZ, 85022-6639
Miller, Neil T D.D.S.
2150 S Dobson Rd # 3
Mesa, AZ, 85202-6487
We have all seen smiles that you know have dental crowns in the front. You look at them and say to yourself that something is not natural. Many times, it is the dark rim of gum tissue that gives it away. The dark rim of gum tissue does not occur around natural teeth, only around teeth that have been covered with dental crowns.
The dark line is associated with an old porcelain dental crown. This style of dental crown is referred to as porcelain fused-to-metal dental crowns because it uses tooth-colored porcelain on the outside and it uses metal under the porcelain for strength. The dark line originates from the edge of the dental crowns where the porcelain and the metal meet at a knife-edge at the gum line. At the knife-edge, a very thin amount of the metal always shows. One of the illusionary techniques cosmetic dentists have used was to hide the thin dark line under the gum line. Over time, the gum tissue would recede and expose the dark line. In some patients the dark line would show through the gum and make it appear dark as well.
The only way to eliminate the esthetic problem is to replace the dental crowns. When replacing just one single dental crown in the front, you should expect that it might take more than one try-in of the new dental crown before it is permanently cemented into place. Because your central incisors are the most prominent teeth in the mouth, matching them is the most difficult esthetic challenge. Only the best dental technicians are able to mimic one central incisor tooth next to another.
Some of the clever ways dentists and dental technicians have been able to mimic natural teeth is through the new advancements in dental materials. New all-tooth-colored ceramic dental crowns are the latest technological advancement cosmetic dentists have to recreate natural teeth. In comparison to porcelain fused-to-metal dental crowns, all-ceramic dental crowns do not contain any metal, thus no dark line can appear.
Some advantages and disadvantages of all-ceramic dental crowns are as follows:
Dental crowns often need to be replaced after several years of service for esthetic or functional reasons. With the growing esthetic awareness of patients and the available ceramic technology, this type of re-treatment is becoming more common in the dental office.
By Benjamin O. Watkins, III, DDS
A general dentist attends four years of dental school after college and receives training in all areas of dentistry, including fillings, crowns, cleaning teeth, root canals, extracting teeth and much more. At the completion of this training period, a dentist can either go out and open a dental practice or continue on with their education and specialize in any of the above-mentioned areas. For example, an orthodontist is a specialist in braces.
A prosthodontist is a specialist in the restoration and replacement of broken and missing teeth. Their additional training lasts three years. During that time, they are taught in greater detail about both removable and fixed prosthodontics.
Removable Prosthodontics includes replacing missing teeth with appliances that the patients themselves can take in and out of their mouth, such as dentures and partial dentures.
Fixed prosthodontics includes replacing missing and/or broken teeth with restorations that the patient cannot take in and out, such as veneers, dental crowns, bridges and implants.
The most important part of the training is how to restore teeth in a variety of different situations so that the end result is the most esthetic and predictable outcome possible. The types of cases seen in cosmetic dentistry are often more comprehensive and complex in nature. They often involve the combination of crowns and implants or can even be as involved as placing crowns on every tooth in a person's mouth.
To do this, prosthodontists are trained to evaluate all the different aspects of your teeth and mouth. They observe and treat your mouth with regards to:
By evaluating these different areas, the prosthodontist can treat one area of your mouth, but also will determine how other areas will impact the treatment. In essence, a prosthodontist looks at your mouth as a whole, even though there may be only one tooth requiring treatment.
Often times, especially in cases involving multiple and/or missing teeth, the involvement of other specialists and cosmetic dentistry will be needed to help with treatment. These specialists include orthodontists (to straighten or move teeth using braces), periodontists (for gum surgeries and placement of implants), endodontists (root canals) and oral surgeons (for the extraction of teeth and placement of implants). In essence, the prosthodontist acts as the coordinator to help sequence the proper treatment before the final restorations are placed. Often times, treatment can take longer to complete, especially if other specialists are involved. In taking a complete approach, you can be assured that you will end up with the most esthetic and reliable treatment, whether it involves one or all of your teeth.
By Greggory Kinzer, DDS, MSD