Behind The Scenes: Dental Crown Fabrication
If you have been told you need a dental crown, you may wonder what exactly goes into creating one. Dental crowns are one of the most common restorative procedures in dentistry, and modern technology has made them stronger and more natural-looking than ever before. At Marcos Ortega DDS in San Diego, we offer both traditional lab-fabricated crowns and convenient same-day CEREC crowns to restore your smile. This comprehensive guide walks you through the complete dental crown fabrication process, from initial evaluation to final placement, helping you understand what to expect every step of the way.
What Is a Dental Crown?
A dental crown is a tooth-shaped cap that is placed over a damaged or decayed tooth to restore its shape, size, strength, and appearance. Crowns encase the entire visible portion of the tooth above the gum line, providing complete protection and restoring full function. Dental crowns can be constructed with various materials including ceramic (porcelain), zirconia, metal alloys, or combinations of these materials, each offering different advantages in terms of strength, appearance, and cost.
Think of a dental crown as a protective helmet for your tooth. It covers the tooth completely, sealing it off from bacteria and distributing biting forces evenly across the remaining natural tooth structure. Crowns are custom-designed to match the color, shape, and size of your surrounding teeth, making them virtually indistinguishable from natural teeth when properly fabricated by a skilled dentist or ceramist.
When Do You Need a Dental Crown?
There are several situations where a dental crown may be the recommended treatment option. A tooth with a large filling that does not have enough remaining natural tooth structure to support the filling may need a crown for protection. After a root canal, a crown is typically placed to prevent the weakened tooth from fracturing under normal biting forces. Cracked or fractured teeth can be held together and protected by a crown, preventing the crack from extending and potentially saving the tooth from extraction.
Dental crowns also play an essential role in restorative dentistry. As part of a dental bridge, crowns on adjacent healthy teeth support a replacement tooth in the gap. Dental implants receive crowns as the final visible restoration, completing the tooth replacement process. For cosmetic purposes, crowns can cover severely discolored, misshapen, or worn teeth, providing a uniform, attractive appearance.
Your dentist will evaluate your specific situation and recommend the most appropriate type of crown based on the location of the tooth, your bite patterns, aesthetic considerations, and your budget. Anterior teeth (front teeth) typically require more aesthetic materials like all-porcelain, while posterior teeth (molars) may benefit from stronger materials like zirconia or porcelain-fused-to-metal.
Step-by-Step Dental Crown Fabrication Process
First Visit: Evaluation and Preparation
Your crown journey begins with a comprehensive examination at Marcos Ortega DDS. Dr. Marcos Ortega will evaluate the tooth, take X-rays to assess the extent of any decay or damage, and determine whether a crown is the right treatment option. The examination includes checking the health of the tooth root, the surrounding bone, and the adjacent teeth to ensure optimal treatment planning.
The tooth is then prepared by removing a thin layer of enamel, approximately one to two millimeters, to make room for the crown. If significant tooth structure is missing due to decay or damage, Dr. Ortega may first build up the core of the tooth with filling material to create a solid foundation. The preparation process is performed under local anesthesia to ensure your comfort.
Taking Impressions (Digital or Traditional)
After the tooth is prepared, an impression must be taken to create an exact replica of your tooth and the surrounding teeth. With traditional methods, a dental putty is placed in a tray and pressed over your teeth to create a physical mold. This method is effective but can be uncomfortable for some patients, particularly those with a strong gag reflex.
At Marcos Ortega DDS, we also offer digital impressions using an intraoral scanner. This small wand is passed over your teeth, creating a precise three-dimensional model on a computer screen. Digital impressions are more comfortable for patients, eliminate the mess of traditional impression materials, and offer exceptional accuracy that can improve the fit of your final crown.
Placing a Temporary Crown
While your permanent crown is being fabricated, a temporary crown is placed to protect the prepared tooth. Temporary crowns are made from acrylic or composite material and are cemented with temporary cement that allows easy removal at your next visit. They maintain the appearance and basic function of your tooth while protecting the sensitive prepared surface. Temporary crowns are not as strong as permanent crowns, so you should avoid sticky or hard foods while wearing one and take care when flossing around the crowned area.
Lab Fabrication
For traditional crowns, the impression is sent to a skilled dental laboratory. Modern porcelain crowns are a technological and artistic marvel that makes successful reconstructive and cosmetic dentistry possible. The process begins with scanning the tooth mold into a computer to capture precise dimensions. A computerized milling machine creates plaster models that serve as the foundation for the crown.
The tooth mold is scanned to have the perfect dimensions to send to the factory. A state-of-the-art computerized machine pours plaster into cylindrical molds, making blanks. Once hardened, the machine takes the scanned data from the impression and begins milling out the contours found in the scan. The finished tooth form is initially made 20 to 30 percent larger than necessary to allow for material shrinkage that will occur during the firing process.
The milled form is dipped into liquid ceramic, which hardens and gives the tooth a lustrous, natural finish. The machine then starts a new process of orienting the tooth with others. Ceramic powder is poured into new molds over the form, and the molds are placed on a rod and plunged into a water-filled chamber where increased pressure solidifies each ceramic tooth.
This shell, called a coping, is then exposed to high temperatures for increased strength. It also shrinks to the proper size during this firing process. A plastic replica of the original tooth is created from the computer scan, and the new shell is tested for precise fit over this model. The shell then leaves the factory for the dental laboratory, where a skilled ceramist begins the artistic phase of fabrication.
A master ceramist applies layers of colored porcelain to the shell. Up to 15 layers may be applied to perfectly match the color, translucency, and subtle variations in your surrounding natural teeth. This labor-intensive process accounts for much of the cost of a high-quality crown. The crown is then fired again to condense the porcelain, followed by hand contouring and a final clear ceramic gloss.
All of this work results in a crown that is both functional and beautiful, matching your natural teeth in appearance while providing years of reliable service.
Final Placement and Cementation
At your second visit, typically two to three weeks later, the temporary crown is removed, and the permanent crown is tried in. Dr. Ortega checks the fit, color match, and bite alignment carefully. Adjustments are made as needed to ensure the crown fits perfectly and does not interfere with your natural bite. Once everything is confirmed, the crown is permanently cemented into place. A final check confirms that your bite feels natural and comfortable.
Traditional vs Same-Day CEREC Crowns
One of the most significant advances in dental crown technology is the availability of same-day CEREC crowns. With CEREC technology, Dr. Ortega can design, fabricate, and place a high-quality ceramic crown in a single appointment. The process begins with a digital impression using an intraoral scanner, eliminating the need for messy impression materials. The crown is then designed on a computer screen using specialized software and milled from a solid block of high-strength ceramic in our office.
Same-day crowns offer several advantages: no need for a temporary crown, only one appointment required instead of two, no need for traditional messy impression materials, and precise digital fit. Traditional lab-fabricated crowns remain an excellent option, particularly for complex cases requiring the artistry of a skilled dental ceramist or when specific materials like high-noble metal alloys are indicated.
What Materials Are Used for Dental Crowns?
Several materials are available, each with distinct advantages. Porcelain or all-ceramic crowns provide the most lifelike appearance and are ideal for front teeth where aesthetics are paramount. Zirconia crowns offer exceptional strength and durability while maintaining a natural look, making them excellent for both front and back teeth. Porcelain-fused-to-metal crowns combine the strength of a metal substrate with the aesthetics of a porcelain exterior. Metal crowns including gold alloys offer maximum durability with minimal tooth preparation, making them ideal for molars where aesthetics are less critical.
Sedation Dentistry for Crown Procedures
If dental anxiety has kept you from getting the restorative care you need, Marcos Ortega DDS offers sedation options for crown procedures. Our DOCS-certified sedation expertise means even patients with significant dental anxiety can receive treatment comfortably. We offer a free oral sedation consultation to discuss the best approach for your needs.
Frequently Asked Questions About Dental Crowns
How long do dental crowns last?
With proper care, dental crowns typically last between 10 and 15 years, though many can last 20 years or longer with excellent oral hygiene and regular dental care. Good oral hygiene including regular brushing and flossing around the crown margins, avoiding habits like teeth grinding or chewing ice, and keeping your regular dental checkup schedule can extend the life of your crown significantly.
Does getting a dental crown hurt?
The crown procedure is performed under local anesthesia, so you should not feel pain during the tooth preparation or crown placement. Some patients experience mild sensitivity after the anesthesia wears off, particularly to hot and cold temperatures, but this is usually temporary and resolves within a few days. Over-the-counter pain relievers are typically sufficient for any discomfort.
Are same-day crowns as strong as lab-made crowns?
Yes, modern CEREC crowns are made from high-strength ceramic blocks that are comparable in durability to laboratory-fabricated crowns. The material is rigorously tested to withstand normal biting and chewing forces. Your dentist will recommend the best option based on the location of the tooth and your specific functional and aesthetic needs.
How much do dental crowns cost in San Diego?
The cost of dental crowns varies based on the material used, the complexity of the case, and whether you choose traditional or same-day CEREC crowns. Many dental insurance plans cover a portion of crown treatment as a restorative procedure. At Marcos Ortega DDS, we offer free consultations to discuss treatment options and costs, and we accept CareCredit and other payment plans.
If you have a damaged tooth or are unhappy with an old crown, contact Marcos Ortega DDS in San Diego. Call us at 619-295-4545 to schedule a free consultation and learn how a dental crown can restore both your smile and your peace of mind.