Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

April 21, 2007

Porcelain crowns on lower front teeth.

Filed under: Crowns for front teeth — Tags: , — mesasmiles @ 2:42 pm

Dear Dr. Hall,
I recently had root canal treatment performed on my bottom two front teeth. My dentist indicated that I will need to have crowns put in. But the two bottom front teeth have very short roots, and there may be issues of strengh and stability of these teeth. It order to address these two issues it was suggested by my dentist that I have four porcelain fused to gold crowns put in. Two crowns would be for the two bottom front teeth with short roots , and crowns for each tooth beside these teeth. The stability would come from metal the lab would use to connect all four crowns together. I was also told that you would not see the metal, and that the crowns would appear like four individual teeth.

I asked my dentist if the procedure can be done using all procelain crowns instead of porcelain fused to gold since all procelain crowns have a more natural appearance and there was my concern about the black line appearing on the gumline if the gums recede? She insisted that porcelain fused to gold crowns was the best method for this situation.

My question is: Is it possible to have this procedure done with all procelain crowns? Do I have any other options?

Awaiting your response. Thank you,
– Nancy from Quebec

Dear Nancy,
As we say on our web site, all porcelain crowns look much more natural than porcelain fused to metal crowns. With the metal in them, they tend to get a black line at the gumline.

But you need to be very careful about pushing your dentist to use a material or procedure he or she may not be comfortable with or disagrees with. It’s much better to find a dentist whose philosophy you’re comfortable with and then trust their judgment.

In the case of lower front teeth, where she wants to splint the teeth together, there are several factors that weigh against using all porcelain crowns:
1. The black line at the gumline rarely shows with lower front teeth, on most people.
2. With gold metal on the back of the crown, the dentist will have to grind away less tooth structure on the tongue side of these lower front teeth. Since these lower front teeth are so small, that’s a significant factor.
3. She can join the metal in each crown into a strong metal framework.

So I would tend to agree with your dentist in this situation, just based on what you’re telling me, without doing an exam myself, which admittedly limits me here. If you aren’t happy with that, though, I wouldn’t push your dentist, as I said, but would get a second opinion from our Montreal cosmetic dentist, and see if there is a more esthetic way to do it.
– Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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