Periodontal Procedures For Success of a Crown

 

A patient may need a crown because of a root canal which makes the tooth brittle and weaker or because there is too much tooth structure missing for just a filling to restore the tooth.

Periodontal Concerns

What are the considerations for the dentist if the tooth is too compromised to just do a crown? There has to be enough tooth to support the crown. This is usually the problem we encounter. If there is too little, the tooth much be extracted. But sometimes the periodontist can do a procedure known as “crown lengthening” which provides enough tooth above the gum line so that the crown will stay in. This is known as the “ferrule effect” and is an important consideration. (A ferrule is a band that fits around a structure like a barrel to give more support.)

Another consideration is known as the biologic width, which means that you can’t put the margin of the crown too close to the bone. If there is not around 2.5-3 mm of clearance between crown and bone, the gum tissue will be red all the time. In this case the periodontist can remove some of the bone around the tooth to create a correctly acceptable biologic width.

Dental Treatment Planning

So before restoring a tooth with a crown or even having a root canal, the full treatment planning of all that might be necessary should be accomplished before even starting the first procedure. If someone needs a root canal, crown lengthening and then a crown to restore a tooth, all three can add up to a lot of time and a considerable expense. The best solution may be to extract the tooth and have an implant or a bridge to replace the missing tooth. Good communication between patient and dentist is most important at this phase.