Morristown, Morris County - Reconstructive Dentistry - From Crowns to Implant Dentistry

• Dental Crowns
• Dental Bridges
• Implant Dentistry
• Patient Information

Dental Crowns

When a tooth is cracked, decayed, or damaged, a dental crown may need to be fitted onto the tooth. A dental crown is a permanent covering that fits over the original tooth. Crowns can be made of porcelain, gold and other metals, acrylic resin, or an amalgam (a mix) of these materials. Porcelain crowns typically have the most realistic appearance, although they tend to be less durable than other materials. Dental crowns can whiten, reshape, and realign existing teeth, adding to a healthy and vibrant smile.

Preparing the Tooth and Crown

During your first visit, the dentist will numb the tooth to be crowned and remove the decay in or around it. The tooth is then rescultped to provide an easy fit for the dental crown. This is a painless process that is performed in the dentist's chair. An impression of your teeth is then taken and sent to the dental lab where permanent, custom-made crowns are created (this usually takes one to two weeks). Often, using the CEREC 3, we can create a crown during your appointment, so that no wait time is necessary, and your crown procedure can be completed in only one visit.

Applying the Dental Crown

To apply the crown, your dentist simply fits the permanent crown onto the teeth. He or she makes sure the dental crown has the proper look and fit and then cements the crown into place using a long-lasting resin that will harden in just minutes.

Maintaining your New Crown

The proper dental hygiene for normal teeth should be applied to your new dental crown. Daily brushing and flossing will help to keep the teeth, gums, and new crown free from the bacteria that can cause gum disease. Avoid chewing on hard foods such as ice or pistachios, which, over time, can cause crowns to crack or break. Given proper care, dental crowns can last several decades, and may last a lifetime. Contact Doctor Romano, Vaccaro and Aesthetic Smiles of NJ if you are interested in dental crowns.

Dental Bridges

A dental bridge is a device used to fill the space where a tooth has fallen out or been removed. A typical dental bridge consists of a pontic (a filler tooth) that is attached to two surrounding crowns (abutments). Once complete, this bridge structure is bonded into the mouth. Without the use of a bridge, spaces in the mouth from missing teeth can cause multiple teeth to shift, lead to occlusion (biting) and/or jaw problems, and may spur periodontal disease. Dental bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile.

The Process

Dental bridges usually require two trips to the dentist's office. During the initial visit, the surrounding teeth are numbed with a local anesthetic. The dentist prepares the surrounding teeth by cleaning any plaque or decay that remains and reducing them so that the crowns can be fitted. The dentist makes a mold of the teeth and sends it off to a dental lab where the customized impression is prepared. The customized mold takes one to two weeks to return to the office. In the interim, patients are fitted with a temporary dental bridge constructed of acrylic resin. When the patient returns to the dental office, the dentist removes the temporary bridge and replaces it with the permanent one. The dentist then adjusts the dental bridge for the proper bite and fit, and the bridge is permanently bonded into the mouth

Types of Dental Bridges

Fixed bridge: A fixed bridge consists of a filler tooth (referred to as a pontic) that is attached to two dental crowns. The crowns fit over the existing teeth to hold the bridge in place. The fixed bridge is the most popular bridge.

Composite bond, or "Maryland" bridge: This type of bridge is commonly used to replace the front teeth. The pontic is attached to metal bands that are bonded to the abutment teeth, and the metal bands are hidden with a white-colored composite resin.

Cantilever bridge: This type is often used when there are teeth on only one side of the span. A typical three unit cantilever bridge consists of two abutment crowns that are positioned side by side on the same side of the missing tooth space. The pontic is then connected to the two crowns, which extend into the missing tooth space.

If the missing tooth space has no surrounding teeth, the dentist may decide an implant is the most appropriate choice. Please see Dental Implants below for more information. When a series of teeth are missing, the dentist may suggest a partial denture as the most effective way to maintain the structure of the jawbone and teeth.

Proper Maintenance

Special care must be given to ensure that the gumline and area surrounding the new structure is kept clean. This is especially true because the pontic and crowns are constructed as a single piece. Special floss is often necessary to clean underneath the teeth and maintain strong, healthy gums. With proper dental care, dental bridges can last up to 10 years. Contact Doctor Romano, Vaccaro and Aesthetic Smiles of NJ if you are interested in dental bridges.

Dental Implants

For individuals who wish to replace missing teeth, dental implants may be an effective long-term solution. Implants provide greater structural support and last longer than either bridges or dentures. Implants serve as the artificial root to which new teeth are bonded. They are typically constructed of titanium, a strong and safe material that effectively attaches to bone. The procedure to insert dental implants typically involves three steps: the implant insertion stage, osseointegration (the period of healing for the jawbone), and the attachment of the restoration or new tooth.

Types of Dental Implants

The most popular form of dental implant is the Root Implant. This type of implant is very effective and mirrors the size and the shape of a patient's natural tooth. Many times, this dental implant will be as strong structurally as the original tooth's root. Once the dentist applies the local anesthesia, he or she makes an incision in the gum in order to gain access to the jawbone. The bone is then prepared and the dental implant inserted into the jawbone with care and precision. Finally, the dentist stitches the gums and, if necessary, prescribes the appropriate medication. During the osseointegration step, which lasts anywhere from three to eight months, the jawbone firmly attaches itself to the dental implant. Once osseointegration is completed, the patient returns to the dental office where the implant is fitted with the new tooth.

Another form of dental implant is the Plate Form Implant. This implant is ideal in situations where the jaw bone is not wide enough to properly support a Root Implant. The Plate form implant is long and thin, unlike the Root Implant, and anchors into thin jawbones. Once the dentist applies the local anesthesia, he or she makes an incision in the gumline in order to gain access to the jawbone. The bone is then prepared, and the implant is inserted into the jawbone with care and precision. The dentist then sutures the gums and prescribes the appropriate medication. In certain cases, Plate Implants are immediately fitted with the restoration without waiting for the osseointegration period.

The last type of dental implant is the Subperiosteal Implant. These implants are utilized when the jawbone has receded to the point where it no longer supports a permanent implant. These dental implants are placed on top of the bone and embedded in the gums, but not in the jawbone as with the other types of dental implants. The dentist applies a local anesthesia and makes a mold of the mouth and jawbone. From this impression, a dental lab constructs implants to custom fit the patient's jaw. On the second visit to the dentist, the dentist exposes the jawbone and inserts the dental implant on top of it. Over the next month the gums grow up and around the dental implant. This same type of implant can sometimes be performed in a single procedure with the use of an initial CAT scan of the gumline and jawbone.

Health Concerns

As with any cosmetic dental procedure, complications are rare, but can include infection, slight damage to nerves, and mild discomfort. Although very unlikely, infection of the gums or jawbone is a possibility and is treated through medication and/or antibiotics. Surgery to the upper or lower jawbone can result in mild nerve damage. Nerve damage typically subsides in several weeks, but it can persist for longer periods of time. As the jawbone heals, patients may experience some discomfort, which can be tempered through medication. Discomfort subsides within seven to 10 days.

Proper Maintenance

Although patients should always practice proper dental hygiene, this is especially true once a dental implant has been put into place. When teeth and gums are not properly cleaned, bacteria can attack sensitive areas, causing the gums to swell and the jawbone to gradually recede. Enough recession of the jawbone can weaken dental implants and eventually necessitate their removal. Patients should visit their dentist's office at least twice a year in order to ensure the health of your teeth and your implant. Following a dental implant operation, smoking should be avoided, as it impairs the gum and jawbone's ability to heal. Given the proper care, dental implants should last 25 years or longer. Contact Doctor Romano, Vaccaro and Aesthetic Smiles of NJ if you are interested in implant dentistry in the Morris County area.

Patient Information

Still not enough information? Read more about dental implants and other restorative dentistry procedures listed above.