251 Main St
Westport, CT 06880
David Fantarella ,D.D.S. DMD P.C
127 Washington Ave Suite 2
North Haven , CT, 6473
Goldschmidt, Paul R D.D.S.
221 Main St
Southington, CT, 06489-2507
Thomas Kelly, DMD
P.O. Box 523 1 St. John Street
North Haven, CT, 6473
375 Bridgeport Ave # 4
Shelton, CT, 06484-3844
The most common complaint associated with crowns is that they look "opaque," "lifeless," and "fake" compared to natural teeth. Do you need an expensive dental makeover to solve the problem? No!
The appearance of a crown is affected by many factors, but ultimately, the final result is determined by how the crown reacts with light. Natural teeth have a high degree of translucency, which means a certain amount of light passes through the tooth. The result of this is that the tooth appears to have depth and vitality.
Traditionally, crowns are made of two materials:
Generally, it is this type of crown that can appear opaque. The reason for this is that while porcelain is very translucent and lets light travel easily through it, no light can pass through the underlying metal. In order to prevent the metal color from showing through the porcelain, which would make the crown seem dark or gray, the metal has to be "masked out" with an opaquing material. It is this masking or opaquing that can affect the final appearance, giving rise to the opaque or lifeless look.
The answer is no. One thing that can be done to improve the appearance is to remove the metal margin that goes around the crown. By keeping the metal inside the crown and having porcelain at the junction between the crown and the tooth, the "black line" appearance at the gum line can be eliminated, thereby increasing the translucency in this area. It also is necessary to have an adequate thickness of porcelain over the metal substructure. If the metal that has been masked out is too close to the outer surface of the crown, the appearance of depth is lost. What it mostly comes down to, however, is the skill level and artistry of the technician who is making the crown. When done correctly, porcelain crowns with a metal substructure can give you the best of both worlds without the expense of an extreme makeover. They can be made to exactly match your other teeth while still appearing lifelike, and since there is metal in it, they have increased strength.
Today, there are dental crowns available that do not require a metal substructure and are made of only porcelain. Depending on the specific type, they get their strength either from the bond to the remaining tooth structure or from a dense tooth colored substructure. Since there is no metal, these types of dental crowns allow more light to pass through, which enables them to have more depth and vitality, much like natural teeth. So why isn't this type of crown used all the time? The main reason is that they are not as strong as crowns with a metal substructure. So, if a person grinds their teeth, these crowns have a greater risk of fracture. Another reason why an all-ceramic dental crown cannot be used in all situations is if the underlying tooth structure itself is dark. Very dark teeth are difficult to mask with these types of crowns because of their translucency. In these instances, the dark color may show through the crown. So, for situations where a lot of force will be placed on the teeth (such as grinding habits) or if a tooth is really dark, a well-made porcelain crown with a metal substructure may be a better restoration.
By Greggory Kinzer, DDS, MSD
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