Bridges

Teet on ieiher side of the gap support a bridge which replaces the missing tooth
Teeth on either side of the gap support a bridge which replaces the missing tooth

Bridges

Bridges are used when there are teeth missing.  The teeth on either side of the space are prepared as for crowns and the crowns are linked by the bridge tooth.

Traditionally metal bonded to porcelain was mostly used for bridges but with modern ceramic bridges such as Procera and Lava are now providing a suitable alternative with superior appearance.

Procedure

The teeth supporting the bridge  must first be prepared under local anaesthetic and then impressions of the preparation of the prepared teeth and opposing teeth taken .  Temporary crowns are usually cemented at the end of this visit and the impressions sent to a dental laboratory where the bridge is fabricated.  Usually about 2 weeks later the temporary crowns are removed and the bridge is cemented into place.

Complex crown and bridge cases sometimes require diagnostic study casts and wax ups of the proposed crowns/bridges for the dentist and patient to assess how everything will look at the end of treatment.

Veneers

Porcelain Veneers can be used to change both the colour and shape of teeth.  In order to place a porcelain veneer, the tooth must first be prepared and some enamel removed from its front surface and around the edge of the tooth. Impressions are taken and Porcelain veneers made in a dental laboratory which then are cemented onto the teeth.  Porecelain veneers require less tooth removal than crowns.

Crowns

A crown covers a tooth to improve its appearance or restore its function if it has become broken down, has a very large filling or is

cracked.

Crowns can be made of different materials, the main types being:
  • Gold
  • Metal(inside) bonded to porcelain(outside)
  • All ceramic
  • Composite resin

Gold Crowns are probably the best in terms of function and durability but appearance is obviously an issue and cannot be considered at the front of the mouth.

The 3 other types are tooth coloured with the new ceramic crowns being the best esthetically (particularly their appearance at the gum).

A crown is cemented on to a prepared tooth

A crown is cemented on to a prepared tooth

Procedure

The tooth to be crowned must first be prepared under local anaesthetic and then impressions of the preparation of the prepared tooth and opposing teeth taken .  A temporary crown is usually cemented at the end of this visit and the impressions sent to a dental laboratory where the crown is fabricated.  Usually about 2 weeks later the temporary crown is removed and the new crown is cemented into place.

Complex crown and bridge cases sometimes require diagnostic study casts and wax ups of the proposed crowns/bridges for the dentist and patient to assess how everything will look at the end of treatment.

Example of superior esthetics of Procera (all ceramic) crown on middle tooth.
Example of superior esthetics of Procera (all ceramic) crown on middle tooth.
Before treatment- Patient unhappy with poor appearance of upper front teeth.
Before treatment- Patient unhappy with poor appearance of upper front teeth.
After treatment- 6 composite resin crowns on upper front teeth
After treatment- 6 composite resin crowns on upper front teeth

The images shown illustrate the difference in appearance between the highly esthetic all ceramic crowns, which have a very life-like appearance and are difficult to distinguish from normal teeth, and the composite resin crowns (shown in the bottom picture), which although improving the appearance considerably, are not as life-like.  Please note that these are 2 separate cases.