A fixed denture is a dental prostheses that is permanently attached to your teeth. The teeth absorb the loads transferred by the replacement. Fixed dentures also include crowns and bridges. They have the ability to restore normal mastication and speech function.

What is a Crown?

A crown is essentially a cap that tightly encircles the top part (the visible part) of a tooth.
Its purpose is to restore the missing tooth substance in form and function, and to prevent the reemergence of caries. Crowns are not made with edges beneath the gum line, since they are known to cause gum disease.
In order to achieve a perfect fit, the natural tooth will be given a certian shape. An accurate impression using a high quality impress material is performed, in order to custom tailor a crown to the exact proportions of your tooth (dental laboratory).

What is a Bridge?

A single tooth extracted and not replaced may lead to tilting or rotation of the adjacent teeth, and possible migration of the same towards the opening.
Dentures in the form of a bridge can be compared to an actual road bridge: at least two supporting columns are necessary for stability. In our case, crowned teeth serve as pillars (bridge anchors), supporting the entire construction. The missing tooth is replaced by an intermediate member. In our case it is a three-part bridge: 2 pillars and an intermediate member.
When viewed from the outside, no aesthetic differences are noticeable. The area of the missing tooth (underneath) is barely noticeable.

What kind of crowns or bridges are used?

We fabricate different types of crowns and bridges. There are full cast crowns (full cast bridges), metal-ceramic crowns (bridges), zirconia crowns (zirconia bridges), and full-ceramic crowns (ceramic bridges).
We will be glad to discuss the characteristics and differences of the aforementioned choices in order to assist in choosing the right material for you.

What is a full cast crown or bridge?

The full cast crown is a non-veneered metal crown made out of precious or non-precious metal alloys.

Advantage: the light preparation of the tooth in comparison to other types of crowns.
Disadvantage: the crown is not aesthetically pleasing, as it is shiny and of gold or silver color.

Made of gold, the full cast crown has excellent tolerability and the longest lifetime. Due to its distinctive color, we recommend this option only for non-visible teeth, where function, and not aesthetics, are important.

What is a metal-ceramic crown or bridge?

In this particular combination of materials, the cap is made out of a precious or non-precious metal alloy. Porcelain is then applied to the cap. Differences to your natural teeth will be barely noticeable, if a high-quality ceramic is used.
Cheap crowns are made of inferior porcelain and metal alloys. They are more prone to premature failure, and are aesthetically visible. Breaks in the porcelain require the crown to be remade.
Advantages:
Metal-ceramic crowns and bridges provide good aesthetic results.
They are very tissue-friendly whenever the base is made out of an gold alloy.
Cons:
In visible areas shimmers of gray may protrude, as metal-ceramic crowns do not have the refraction properties (translucency, transparency) of natural teeth.
Over years, and in combination with gum recession, a dark edge may appear in the area of the transition between a metal-ceramic crown and the tooth. Many patients consider this to be disturbing.

All-ceramic crowns do not have any of these disadvantages!

What is an all-ceramic crown or bridge? What is a zirconia crown or bridge?

Only ceramic compounds are used for the fabrication of all-ceramic crowns or all ceramic-bridges.
Several all-ceramic systems exist. A state of the art system is the zirconium oxide crown or bridge.

Zirconium-dioxide, (a non-metallic and inorganic material) is not only extremely robust and very resilient (used as the space shuttle heat shield), but also absolutely biocompatible and free of allergens.
Zirconium-oxide ceramics do not rely on metal frames (important for aesthetics). Zirconia crowns and bridges are translucent and have the refractive properties of natural teeth (translucency, transparency). The quality of the overall impression is so high, that one would have a hard time findind a difference between a zirconia-ceramic crown / bridge and your natural teeth.
Zirconium crowns and bridges remain a top-choice among all full-ceramic systems, because of their combination of high strength and beautiful aesthetics.

How long will the treatment take? Is it painful?

Usually two to three sessions are required: the first one is the most comprehensive one. The teeth are ground, dental impressions are made, a color is chosen, and a provisional denture is fabricated and attached. The second session is needed for a trial, and a third for the permanent attachment of the finished crown or bridge. A period 1-2 weeks will pass between the first and last session.
The treatment is completely painless, since it is performed under local anesthesia.

How long will a crown or a bridge last?

With proper care and regular checkups, crowns and bridges should last for many years. The average life expectancy of a crown or bridge is about 15 years (according to studies).
The following measures are necessary to maximize their life span:

  • appropriate personal oral hygiene at home (toothbrush, toothpaste, especially dental floss - like Super Floss, or interdental brushes).
  • semi-annual follow-up checkups (to maintain the warranty of your crown or bridge)
  • semi-annual dental cleaning by professional dental hygienists.

How is a bridge cleaned?

Your bridge, as your natural teeth, requires cleaning every day. In addition to your regular oral hygiene ritual, areas, like the one underneath the pontic, need to be cared for with special dental floss (Oral B Super Floss, Meridol Special Floss), or interdental brushes. This prevents problems, such as gum disease and bad breath. For important information in regards to the retention period of a bridge, please click here.

Are there alternatives to bridges?

Implants are the only “non-removable” alternative to a bridge. This is important when the teeth to be crowned are caries-free, or are not to be touched, in order to preserve their substance.
A “removable” alternative to the bridge would be the detachable denture. We can provide additional information about the available treatment options in our office.