Hi Dr. Joel S. Teig,
May I ask you about crowns for a tooth. After a procedure like a root canal, we are usually advised to get a crown. I have a front tooth that is in need of a crown. I was told about the porcelain crown infused with metal and then there's a more expensive option where it's all porcelain. I heard that the porcelain crown infused with metal gives you a line up the gumline that is not the most eye pleasing. Before I make my choice, I kind of want to know the advantages and disadvantages of each type of crown that I mentioned.
1. Does the porcelain crown infused with metal, does that crown match the colors of all the other teeth?
2. I heard the line on the gumline doesn't show up till a year later as far as the procelain infused with metal crown. If we choose that crown and then switch to the all porcelain one later on (the more expensive option), then will that ugly looking line disappear? That line is from the crown right? I hope that made sense.
3. And finally, my last question is, will changing crowns compromise the tooth in any way? Like you know how when you drill and take out more tooth structure, is it like that with crowns too or are changing crowns completely does not affect the tooth in any way? Thank you! Looking forward to your answers.
Jolene - Your questions are not uncommon. Any crown placement, especially for the front teeth need to be more than structurally sound, they must be cosmetically pleasing and mimic the color and shape of the teeth on either side. Those needs require only certain materials are used. Porcelain can mimic the color better and not change over time. Other materials begin to change over time due to exposure of food, drink and bacteria.
Either the porcelain or the porcelain fused to metal can match the color of the teeth on either side.
The gumline of the crown does not have to show up a year later. Any dentist must tell and show the patient how to maintain the maximum cleanliness of the area. If the area is not kept completely clean, via brushing, flossing and the use of antibacterial rinses, recession of the gums can occur to display the edge of the crown now at or below the gum line. Once exposed, the only way to recover the tooth with the gum is via periodontal surgery or redo the crown after recutting the underlying tooth.
If you choose porcelain fused to metal or the porcelain, if changed to the other in the future, the tooth will need to be reshaped under the crown and the crown will be longer to go under the gum. That begins to wear away the periodontal ligaments that hold the tooth to the bone. For that reason, the selection of the correct one initially is important to reduce problems in the future when changing the crowns.
Changing the crown will not compromise the tooth, but it will structurally change the tooth to bone relationship, which can potentially make the tooth less stable.
If you have additional questions, feel free to contact me again.