Gap between my crown and my bridge


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I have a space between my 2 front teeth, however one of my front teeth is a crown and the other front tooth is part of a bridge. Can the gap between my front teeth be closed with Lumineers or any other procedure or would I have to get a new bridge and crown, possibly all in one structure to close the gap?
– Laura from Nevada

Laura,
Your question prompts me to ask a question of my own: Why did the dentist who made the crown and/or the bridge leave a gap between your front teeth? The easy way to fix this would have been to make them correctly in the first place.

At this point, yes, you pretty much need to have probably both of them re-made—depending on how big the gap is. Both front teeth need to be the same size—you don’t want to close the gap from just one side by making one side larger.

this microetcher has a long nozzle with a button on it, and at one end a small clear plastic bottle as a reservoir

A Micro-Etcher

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But there is a procedure you might want to try before doing that. There are ways to bond composite to porcelain, and you could start with trying that—treating this as a dental bonding case. If the dentist has what is called a micro-etcher, which is a small sand-blasting handpiece, he or she could micro-etch the porcelain surfaces next to the gap. This would be followed by etching with a hydrofluoric acid gel and then priming the surface with a silane coupling agent. A bonding resin would then be applied followed by composite bonding material to match the shade of the crown and the bridge. The composite would be shaped and polished. In theory, this should work. However, my experience with bonding to porcelain was that after a few months, we would see staining along the margin between the composite and the porcelain. But it could be worth a try to try to avoid the expense of a complete re-do of your front teeth.
I would think it goes without saying that you need an expert cosmetic dentist to do this, such as we recommend on this website.

The company that makes Lumineers, a few years ago, tried to promote the idea of bonding Lumineers over the top of porcelain crowns, but I strongly discourage that. You would get the same risk of staining at the margins, and would spend the same amount of money as you would spend just re-doing the case completely. Click the link to read more about the problems with that approach.

– 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.

How to repair an Encore bridge

Dr. Hall,

I had an Encore bridge done in 2012 and the tooth has now come off the bridge, but the back of the bridge is still attached to the gum and the other two teeth. Can the tooth be re-attached to the bridge and where can I go in CA ,or a nearby state, to have it done and at what cost since my insurance has been used already this year? It is a top tooth next to the front teeth.
– Dori from California

Dori,

The Encore bridge is tricky to do in the first place, and repairing it is even trickier. You can’t just do the bonding over again. The dentist has to thoroughly clean off all the old bonding material. Then the surface of the porcelain tooth has to be re-etched so that it will bond to the luting composite. This requires either having hydrofluoric acid, or what is called a micro-etcher, which is a mini sand blaster to treat the surface of the porcelain, or both. Cleaning off the surface of the resin framework is not as critical and that could just be scraped clean. If the porcelain is properly prepared, it should adhere to the framework. Though I wouldn’t expect it to last as long as the original. You got three years out of the first installation–I would expect less than that this time. So I’d start saving up to have a dental implant placed as a long-term solution.

(I then recommended an expert cosmetic dentist in her area. I’m not going to mention the dentist here, as it would make Dori personally identifiable. But I’m confident that the dentists I list here would have the expertise needed to do this repair.)

Dr. Hall

Note – I wrote a post about 3 1/2 years ago about the lifespan of a Maryland bridge where I included some comments about the lifespan of an Encore bridge.

Click here to ask Dr. Hall a question of your own.

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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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