Dental crowns are one of the best ways to protect badly damaged teeth. In most cases, crowns are needed on back teeth that may have needed a root canal treatment. For front teeth, the most common reason for the need of a crown is due to trauma . This could be from a childhood playground accident or a sports injury for example. Ouch!

If a front tooth crown was placed many years ago, over time there will have been changes in the mouth including the level of the gums and the shape and colour of the teeth. This often why there is a 'black' line around old crowns where the gum has receded and the underlying root becomes visible. Older crowns will have been made with a metal base, called a metal ceramic crown and the metal can also show as the tissues change.
 

Our case of the month for October 2018 is one which involves a fully customised crown. What is this, you may ask. Well, we mainly advise a fully customised crown for single front teeth where the aesthetics are incredibly important. Essentially, this technique is the very best we can offer in terms of aesthetic dentistry. The process involves:


1. Full planning and diagnostic wax up if required.

2. Initial shade testing at the laboratory to ensure the base shades are all correct

3. Preparation of the front tooth and records. We now use intra oral scanning which eliminates the need for messy dental impressions.

4. Placing a temporary crown made from a mixture of acrylic and a resin.

5. Trying in the crown prior to any final customisation to ensure that the fit, margins, emergence profile, embrasure spaces, contact points and bite is all fine.

6. Placing the temporary with a soft cement and then a journey to the laboratory straight after the try in.

7. Full customisation of the crown until you are 100% happy with the overall aesthetics.

8. Straight back to the practice for fitting.


Although this may seem a long winded approach for one single tooth, we can assure you it well worth the effort. After all, it is your front tooth! Here are some photos of a recent case: