Crown (dentistry) - Advantages and Disadvantages

Advantages and Disadvantages

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The main disadvantages of restoration with a crown are extensive irreversible tooth preparation (grinding away) and higher costs than for direct restorations such as amalgam or dental composite. The benefits, as described above, include long-term durability and evidence-based success as compared to other restorations or no treatment.

The crowning of two fairly large molars to sling a bridge between them for a missing tooth is a costly and sometimes oversold procedure. The increased food and bacteria trapping of the underside of the bridge often offsets the benefits of the bridge element in maintaining the positions of the opposing teeth and the loss of the ease of use and mouth feel of two big natural teeth.

It is usually the damage to a tooth that dictates the need for a crown, and alternative treatments are usually less effective. Risks and benefits can be weighed based on the priorities of the patient.

An example of this occurs when a patient would like to restore an edentulous area between healthy adjacent teeth. Before implants, there were three options:
  • Fixed partial denture (bridge)
  • Removable partial denture
  • No treatment
Those who could afford it were usually told by their dentists that a bridge was their best choice, because it is much sturdier than removable dentures and requires less looking after. When implants became available, however, they were recommended as the best possible treatment, because the virgin teeth adjacent to the edentulous area no longer needed to be cut in order to fit the bridge. The affluent are thus told that a fixed partial denture is no longer desirable, now that implants are available. However, implants are significantly more expensive than a bridge, and the results are generally much less immediate.

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