Crown / bridge

Our dentists carry out dental restorations of teeth that are so damaged that they need to be replaced.

What is a bridge?

A bridge is a dental restoration that can be used to replace one or more teeth.

Presentation of a bridge:

If a tooth is missing, it can be replaced with a bridge (I). The dentist grinds and shapes the neighboring teeth, which will act as an attachment for the bridge (II). An impression is then taken before the ground teeth are covered with temporary crowns. After 1-3 weeks, the permanent bridge is ready and can be cemented onto the teeth (III and IV). The color and shape of the bridge is matched to the other teeth and the result is therefore very attractive.

The process of creating a bridge is time-consuming and technically difficult for both the dentist and the dental technician.

What is the bridge made of?

There are several different types of bridges and these have different properties in terms of strength and aesthetics. The two most common types are all-ceramic bridges (porcelain) and bridges with an inner core of gold with porcelain fired on top. All-ceramic bridges have recently become more and more common. These bridges have superior aesthetics and are primarily used where the demand for a beautiful result is high. Very strong porcelains are now available, so this type of bridge can also be used on teeth with greater chewing pressure.

How long does a bridge last?

A bridge is meant to last for many years. However, there are a number of factors that can shorten the life of a bridge:

  • Breakage of porcelain:
    When a bridge is chewed, it is subjected to great forces. Over time, accidental stresses can cause pieces of the porcelain to break off. This normally has no practical significance and can in some cases be repaired with a filling. If the function or aesthetics deteriorate significantly, it may be necessary to create a new bridge.
  • Caries:
    There can be no cavities in the bridge itself. However, there may be a hole in the tooth below the end of the bridge. Usually such holes can be repaired with a filling, but if the hole is large, the bridge may loosen or the attachment teeth may break. It may then be necessary to make a new bridge.
  • Dental pain/ root canal:
    Some teeth with deep cavities and large fillings can eventually have reduced blood circulation in the nerve. They are therefore more prone to inflammation and infections that can lead to dental pain. This also applies to teeth that have been ground down and fitted with a bridge. In order to root-fill an abutment tooth in a bridge, an opening must be drilled through the bridge and into the nerve. Even if the opening is sealed with a filling after the tooth has been fully rooted, the bridge is no longer intact and therefore weakened.

To take the best possible care of the bridge, you should:

1. Use the toothbrush carefully but gently on the gum line so that the gums are not damaged and recede. A worn toothbrush is not very effective. Therefore, change the brush every 3 months or when the bristles crack.

2. Keep the spaces between the teeth thoroughly clean. Use toothpicks or interdental brushes between the teeth in the bridge. Interdental brushes come in different sizes and are used in the same way as toothpicks. Your dentist or dental hygienist can help you find the correct size.

3. Avoid snacking between meals and reduce the amount of sugary food to avoid caries in the bridge attachment teeth. Also, rinse regularly with a fluoride rinse. Fluoride strengthens tooth enamel and is therefore important for the prevention of caries.

What is a crown?

A crown is a dental restoration used if the tooth is so damaged that it cannot be repaired with a regular filling (I).

Presentation of a crown:

To make a crown, what’s left of the tooth must be ground and shaped (II). An impression is then taken before the ground tooth is covered with a temporary crown. After approx. 1-2 weeks, the permanent crown is ready and can be cemented in place (III and IV). The color and shape of the crown is matched to the other teeth and the result is therefore very attractive.

The whole process is time-consuming and technically difficult for both the dentist and the dental technician. That’s why the price of a crown is higher than for a regular filling.


What is the crown made of?

There are several different types of crowns and these have different properties in terms of strength and aesthetics. The two most common types are 1) all-ceramic crowns and 2) crowns with an inner core of gold with porcelain fired on the outside. All-ceramic crowns (porcelain) have recently become more and more common. These crowns have superior aesthetics and are primarily used where the demand for a beautiful result is high. Very strong porcelains are now available, so this type of crown can also be used on teeth with greater chewing pressure.


How long does a penny last?

A crown is meant to last for many years. However, there are a number of factors that can shorten the life of a crown:

  • Breakage of porcelain:
    When chewing, a crown is exposed to great forces. Over time, unfortunate stresses can cause pieces of the porcelain to break off. This normally has no practical significance and can in many cases be repaired with a filling. If the function or aesthetics of the crown deteriorate significantly, it may be necessary to make a new crown.
  • Caries in the crown edge:
    There can be no cavities in the crown itself. However, there may be a hole in the tooth below the end of the crown. These holes can usually be repaired with a filling. If the hole is large, it may be necessary to make a new crown.
  • Tooth pain/ root canal:
    Some teeth with deep holes and large fillings can eventually have reduced blood flow to the nerve. They are therefore more prone to inflammation and infections that can lead to dental pain. This also applies to teeth that have been grinded and crowned. To root-fill a tooth with a crown, an opening must be drilled through the crown and into the nerve. Even if the opening is sealed with a filling after the tooth has been completed, the crown is no longer intact and will therefore be weakened.

To take the best possible care of the crown, you should:

1. Use your toothbrush carefully but gently at the gum line so that the gums are not damaged and recede. A worn toothbrush is not very effective. Therefore, replace the brush every 3 months or when the bristles crack.

2. Clean between your teeth at least once a day. If the teeth are close together, dental floss will be an effective aid. For larger gaps between teeth, interdental brushes are best. These come in different sizes and are used in a similar way to toothpicks.

3. Rinse regularly with fluoride to avoid caries at the crown edge. Fluoride strengthens tooth enamel and is therefore important for the prevention of caries.

Sometimes a tooth breaks at the level of the gums. If the tooth is root-filled, it is still possible to rebuild it. Since there is little tooth substance left (fig. I), a pin must first be installed in the root-filled tooth. The function of the pin is to anchor the structure.

Manufacture of pin and crown

Before the pin can be installed, the tooth’s root filling must be checked. If the root filling is no longer up to standard, it should be redone before the pin is put in place. If the root canal filling is assessed and found to be tight and of good quality, part of the root canal filling is removed to make room for the pin (fig. II). The staple can then be fixed with a suitable cement (fig. III). A mass (cone) is then built up around the pin, which is sanded and shaped (fig. IV). Now you can take an impression of the sharpened tooth, send this to a dental technician and get the finished crown back ready for cementation (fig. V and VI). The whole process usually takes 1 to 2 weeks.

Restoring a tooth using a post and crown is a time-consuming and expensive treatment. You can therefore ask for a cost estimate before starting the treatment.

Preparation of pins and fillings (alternative treatment)

Figure VII

A cheaper alternative is to build up the tooth with a composite (plastic) filling (fig VII). The filling is shaped and built up around the post. This is normally considered a weaker solution, with poorer aesthetics compared to a crown. The dentist will be able to inform you about which alternatives are possible in each individual case.

Possible complications:

Treatment with a post and crown (or filling) is in most cases good and safe treatment. However, be aware of the following:

  • The shape of the root canal can lead to root perforation when drilling to make room for the pin. In such cases, it is often necessary to remove the tooth.
  • A root-filled tooth with a post and crown will never be as strong as a healthy tooth. Chewing can put a great deal of strain on the post and the post/tooth can break.
  • A root-filled tooth with a post will always be more prone to the development of cracks in the root. In the worst case, this can lead to the tooth having to be extracted.
  • Even if the root canal filling appears to be of good quality when the post is installed, bacteria may still have gotten down along the old root canal filling. This can become apparent at a later stage when the tooth becomes tender to the touch due to an infection in the jaw around the root tip. The weak point is the transition between the tooth and the crown edge. It is therefore important to pay close attention to cleaning this area.

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