Florida Reconstructive Dentistry

Diagnose Fix Repair Replace Bad Dental Crown

Maxillary Mandibular Implant Reconstruction

Mitchell Pohl, D.D.S.
2900 N. Military Trail
Suite 105
Boca Raton FL
South Florida FL 33431
(561) 999-0889

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Reconstructive Cosmetic Dental Crown Dentistry

Replacements and Repair

Failure Dynamics

Dental crown restorations fail for two primary reasons, but the variations of the main reasons are almost infinite.

Although thought to be a normal cause, crowns RARELY fail due to a product failure.

Front Teeth (anterior) Color Failure

Rather, a crown that fails immediately, say, in the form of falling out, becoming loose or sustaining a crack or chip is due usually to the 2 main reasons for a crown treatment going bad:
1. Technical errors (cementation - bonding) in preparation, build-up (if used), post type, post anchoring method, bonding processes and contamination control
2. Technical errors (occlusal related) in crown type (PFM vs ceramic) selection that subjects a crown to biting forces that exceed the properties of the crown used, insufficient porcelain layering due to technical errors in assessment (labs follow instructions of dentist), inaccurate tooth preparation that subject crown to excessive occlusal forces (can cause need for future root canals).

How, when and in what fashion a crown fails is actually a function of how and where the restoration was used in the patient's treatment. Different locations involves different preparation and different bonding procedures. In many instances... even the cementation products can differ.

Crown Reconstruction Failure
Genetic Defect Dentistry

Loose Fitting Crowns

Bite and occlusal issues are can be common causes... as well as generalized trauma to the affected tooth. Bite problems, if they are immediate, may suggest inaccurate treatment. If the bite problems occur over an extended period of time... it may be due to issues involving other tooth structures and the overall occlusal relationship.

Inadequate existing tooth structure or poor preparation of the existing tooth structure may be the culprit. In some instances, with Dr. Briglia's patients, a build up and post may be implemented to create the needed structure for a crown to adhere to.

Defective Color Shading

If certain physical properties aren't monitored closely, even a brand new build up can fail, due to the inadequate relationships of physical forces (biting) and retention qualities of surface areas.

The bonding process and bonding materials can often lead to crowns becoming loose in a very short time. Issues of over-preparation or under-preparation can be the cause. Matching the ideal cement product with the type of bonding surfaces can be critical. Contamination of the bonding surfaces is a frequent cause, arising from air borne bacteria, saliva and even a patient's breath can compromise a bonding procedure.

Older crowns often become loose of decay occuring under the crown. Decay can become manifested either through leakage between the bonding surfaces that allow bacteria ot accumulate. In other instances the preparation process did not remove 100% of the existing decay.

Picture #1 - Before
Crown - Implant Failure

This decay-causing-looseness event occurs frequently in certain types of bridgework applications. Anchor teeth restorations, due to the biting forces operating on the bridge, may cause bonding surfaces to flex and eventually leak.

Discolorations

Many of the older crowns produced during earlier generations of dentistry science become discolored because underlying metal characteristics. Errors in creating and assuring secure margins of the crown can also cause the "dark line effect" on a crown. The use of all porcelain crowns or porcelain fused to gold crowns, as used in our office, overcomes this age old problem.

Picture #2 - After
Reconstructive Crowns Renewed

Sensitivity - Pain

Tooth sensitivity (reactions to hot and cold temperatures) that occurs immediately after placement of a new crown can be caused by indequate bonding procedures. Internal structures of the original tooth structure are indequately sealed due either inaccurate preparation or contamination of bonding compounds.

Pain associated with biting pressure may indicate a crown treatment that may have too much height or poor match of occlusal surfaces of an adjacent tooth. In some severe instances, stories of new crowns being ground down to the point of exposing underlying metal structures are not unheard of. Precision use of Articulators enables dentists to overcome this issue. Unfortunately, articulators are not used as often as they should be.

Doctors who readily accept and/or seek out the development of complex multifaceted treatment plans tend to have the technical know-how of overcoming what should be common error issues in dentistry.

Because of the vast experience acquired in successfully treating chronic dental problems, routine and common place errors in judgement and/or application of treatment rarely occur.

Unique Questions?

Patients with unusual treatment experiences or interests involving dental crowns and replacements are invited to contact Dr. Pohl directly with our on-line Ask The Dentist form. Dr. Pohl will respond directly to questions about material on this page or any unique crown problem directly.

Call our office at (561) 999-0889 to arrange a complimentary consult or use our convenient Consult Request form to arrange a one-on-one consult about crown replacement dentistry with Dr. Pohl.

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Florida Reconstructive Dentist
Mitchell Pohl, D.D.S.
2900 N. Military Trail, Suite 105
Boca Raton South Florida FL 33431
(561) 999-0889
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