When it comes to dental crowns, porcelain is a popular choice. Porcelain is used in dentistry because it is a biocompatible, strong, and aesthetic material. Porcelain-fused-to-metal crowns are strong and durable but still susceptible to chips and cracks. Luckily, there are porcelain repair methods that can fix a chipped crown, but with some limitations. In this blog post, we’ll discuss the common causes of a chipped crown with exposed metal and how it is repaired.
What are Porcelain-Fused-to-Metal Crowns?
Porcelain-fused-to-metal crowns (PFM) are a type of crown used to restore damaged teeth due to extensive tooth decay and after root canal treatment. These dental crowns combine the strength of a metal base with the aesthetic appearance of a porcelain layer, making them ideal for situations where both durability and a beautiful smile are desired. PFM crowns are useful in cases of broken teeth, as they provide the necessary reinforcement to prevent further damage to the natural tooth structure while restoring the tooth’s function and natural appearance, enhancing oral health.
Despite their benefits, chipped or fractured metal-porcelain restorations are a known problem, which may require further dental intervention. Compared to all-ceramic crowns, PFM crowns are less expensive and offer a balance between strength and natural appearance, making them a versatile option in restorative dentistry.
Possible Causes of Chipped Dental Crowns
When a porcelain-fused-to-metal (PFM) dental crown chips, it often results in sharp edges that can irritate the surrounding gum tissue. The visible portion of the tooth crown might reveal the underlying metal base, leading to an aesthetic issue. Symptoms of a chipped dental crown can include discomfort when biting or chewing, sensitivity to hot or cold foods, and an altered natural bite. In severe cases, the fractured edge can cause injury to the tongue or inside of the cheeks. Possible causes of a chipped dental crown with a metal base exposed include:
- Biting on hard objects: Chewing ice, hard candies, or other hard substances can exert excessive force on the crown, leading to fractures.
- Teeth grinding (bruxism): Continuous grinding or clenching of teeth can weaken the crown over time, causing a chipped dental crown.
- Misalignment: An uneven bite can place additional stress on certain areas of the crown, causing fractures.
- Poor bonding: Inadequate adhesion between the crown and the tooth can make the crown more susceptible to chipping. and a loose crown may increase the risk of infection as bacteria can accumulate in the gaps.
- Trauma or injury: Accidents or impacts to the face can cause a chipped dental crown, for example, sports injuries.
- Wear and tear: Over time, normal use can cause wear on the crown, particularly on the porcelain portion.
A chipped crown with the metal base exposed not only poses an aesthetic issue but also compromises the structural integrity of the restoration. The sharp edges of a chipped crown can injure the gum tissue and surrounding oral structures. Additionally, a fractured edge can harbor bacteria, increasing the risk of infection and potential tooth decay of the underlying tooth. Addressing a chipped dental crown promptly is essential to maintaining oral health and ensuring the longevity of the dental restoration.
How to Repair a Chipped Porcelain Crown with Exposed Metal?
If your dental crown is chipped or fractured, schedule an appointment with your dentist. The dentist will examine the chipped crown with its exposed metal base to decide if it can be repaired or if the damage is too severe and requires a replacement.
- Small chipping: Your dentist may be able to repair the chipped crown with exposed metal using a specific porcelain repair kit. This kit contains a repair material, composite material, that can be bonded to the PFM crown. Composite resin is the same material used in tooth filling.
- Large fracture: If damage is too extensive and the crown cannot be repaired, then you may need to get a new dental crown.
The drawback of the dental crown repair procedure is that it typically only works on small fractures and is often considered a temporary measure rather than a permanent solution. Additionally, matching the crown shade perfectly can be challenging, leading to potential aesthetic issues. The use of flowable resin for the repair might not provide the same durability and strength as the original crown material, making the repair less robust over time.
Repair or Replace Chipped Crown with Exposed Metal?
When dealing with a chipped crown that has exposed metal, your dentist will decide between repairing it or replacing it. Key factors to consider include:
- Size of the Fracture: Small fractures can often be repaired, but larger ones typically require a new crown.
- Chipped Area: Chipping on the chewing surface or margins affects the crown’s strength and appearance. If these are compromised, replacement is necessary.
- Cause of Fracture: Grinding or clenching teeth at night may necessitate a solid zirconia crown, which is less prone to chipping than a PFM crown.
- Pain or Tooth Decay: The presence of pain or tooth decay under the crown necessitates removing the chipped crown, treating the tooth, and placing a new crown.
- Age of Crown: Older crowns may need replacement rather than repair.
- Durability: New crowns generally last longer than repaired ones.
- Cost: Replacing a crown is more expensive than repairing it.
- Dentist’s Ability: Ensure your dentist is experienced in crown repairs and has access to a specific porcelain repair kit.
To determine the best course of action, schedule a dental appointment with your dentist. They will evaluate the chipped crown with exposed metal to decide whether repair or replacement is more appropriate and discuss the costs involved.
Replacing a Chipped Crown with an Exposed Metal Base
When replacing a chipped crown with an exposed metal base, the procedure involves several detailed steps to ensure the new permanent crown fits perfectly and restores full functionality. The process begins with the dentist using a specialized crown remover to carefully take off the damaged crown without harming the underlying tooth. This step is crucial to maintain sufficient tooth structure for the new dental crown placement.
Once the entire crown is removed, the dentist will thoroughly clean the prepared tooth to ensure it is free from any food debris or tooth decay. Next, a dental impression of the entire tooth and its surrounding area is taken. This impression is sent to lab technicians who will fabricate the new crown. During this period, a temporary crown is placed using temporary cement to protect the prepared tooth and maintain the chewing surface until the permanent crown is ready. If your temporary crown is chipped during daily activities, contact your dentist immediately to address the issue and avoid any potential discomfort or damage.
The shade selection process is a critical step, as the dentist uses a shade guide to match the color of the new crown with the neighboring teeth, ensuring a seamless blend with the patient’s natural smile. Once the permanent crown is ready, the dentist will remove the temporary crown and place the new one, making necessary adjustments to achieve a perfect fit and bite alignment. Finally, the permanent crown is cemented in place, restoring the tooth’s functionality and aesthetic appearance.
Alternatives to Porcelain Crowns with Metal Base
Porcelain crowns with a metal base are popular for their strength and durability, but they are not the only option available in dental practices.
All-ceramic crowns, for example, are a common alternative that offers a more natural appearance and better matches the natural tooth color, eliminating the need for metal surfaces. These crowns are an excellent choice for patients who might have an allergic reaction to metals.
Another alternative is metal crowns, which are extremely durable and often used for molars where the chewing forces are greatest. However, they do not offer the same natural appearance as all-ceramic crowns.
Prefabricated stainless steel crowns are typically used as a temporary measure or for primary teeth in children, providing a cost-effective and durable solution until the permanent tooth comes in.
In some dental practices, advanced techniques allow for the creation of crowns in a single appointment. These crowns, often made from a variety of materials such as ceramic or composite resins, are designed and fabricated using CAD/CAM technology, offering a quick and efficient alternative to traditional crowns.
Caring Tips for Dental Crown & Oral Health
To ensure the longevity of your dental crown, proper care is essential. Here are some key oral hygiene practices to follow:
- Brush your teeth twice daily for two minutes using a soft-bristled brush and fluoride toothpaste to protect your dental crown and gum tissue.
- Floss daily with dental floss to prevent plaque and bacteria buildup around your crown and between teeth.
- Avoid chewing hard foods like candies, which can damage your crown.
- Use a nightguard if you grind or clench your teeth to protect your crown from excessive pressure.
- Stop poor oral habits such as chewing on pens, ice, or other hard objects that can compromise your crown.
- Schedule regular dental checkups and cleanings to maintain overall oral health and ensure your crown remains in good condition.
Chipped Crown with Exposed Metal – Conclusion
Porcelain-fused-to-metal (PFM) crowns are known for their strength and durability, making them a popular choice for dental restorations. However, they can be prone to chipping and fracture over time. If your dental crown is chipped and the metal base is exposed, you have two primary options: repair or replacement. Repair is suitable for small chips that do not compromise the crown’s strength or appearance. If the damage is extensive, replacing the crown may be the better option to ensure the longevity and functionality of your restoration. Maintaining good oral hygiene practices and regularly consulting with your dentist will help you make the best decision for your oral health and preserve your beautiful smile.
