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Dentistry/restoration of front lower teeth

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Question
I had 3 metal-free porcelain crowns on my lower front teeth for couple years. Now, after installing bridge on upper implants, two of those lower had cheeped, a third one broke (it is now covered by a plastic crown) because upper crowns lined together with lower teeth rather than advance a little ahead from lower teeth.

Assuming dentist corrects the problem with upper bridge (may be by re-applying new porcelain, bending it a little forward, I really don't know how to advance upper front teeth forward) - how can he fix lower crown?
Should he now put a metal crowns with porcelain and grind even more those teeth (there is very little left from them), or again use a metal free crown and leave them like it is (without grinding for new crowns) if possible? Please explain what choices do I have. Thank you very much!

Answer
Dear Vlad,

Fixing the lower crowns can sometimes be done using composite materials to build the areas of the crowns that have been lost.  Usually, this does not last very long.  I would replace the broken crowns with new ones made of stronger lithium disilicate material (brand name eMax).  This provides double the strength of the older, more commonly used feldspathic porcelains.  If you tend to clench your teeth (you probably do), you will want your dentist to use zirconia (Bruxzir).  Properly made, this material has the characteristics of metal, but has a white color, and can be glazed to the colors of your teeth.

Because we have such a wide variety of materials available to us, that vary widely in strength and beauty without needing to use metal, I have virtually stopped using metal under my crowns.  Since last December, I have made only one crown using metal, and that was at the request of the patient.

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Howard Finnk, D.D.S., P.A., CEO

Expertise

I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.

Experience

Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center (floridaimplantcenter.com). On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (nobhilldentalcenter.com), I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

Organizations
American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

Publications
"How To Save Money At The Dentist" Going to press soon.

Education/Credentials
Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

Awards and Honors
Membership in The Vedder Honors Society

Past/Present Clients
HIPAA rules do not allow me to post this information.

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