Pezzella Dental - General Dentistry

Crowns - Why do we need them?

Dental crowns or caps, are full coverage restorations that protect the tooth from further breakage or fracture. They restore the tooth back to how it formed before all those years of happy chewing. Crowns are indicated when a tooth has a cavity so large that a filling would result in the tooth fracturing, or when a tooth has broken or has deep fractures within it.

Dental crowns can be fabricated on natural teeth or over dental implants

Dental crowns can be made of different materials. Options range from Full Gold, to the older Porcelain Fused to Metal, to the newest Ceramic based crowns.

It is incredibly important that the first preparation of a dental crown be done with care adhering to prosthodontic concepts that yield lasting treatment. Over-reduction of a tooth can and will result in constant loss of crowns or the need for a root canal afterwards! Please see our cases for examples of our work and what not to look for!

Inlay/Onlay

Inlay - is similar to a dental resin filling, however an impression of the inside of the tooth preparation is taken and the lab fabricates a restoration that is cemented inside the tooth. Unfortunately inlays cause a wedging effect as biting pressure is applied to the cusps, which acts to split teeth. We do not use them.

Onlay - is similar to a dental crown , whereas the cusps of the teeth are covered. Onlays are a good option when we are only missing one cusp of a tooth.

Tooth Fillings

Composite or Amalgam - better known as plastic or metal/mercury filling.

Tooth Colored Fillings (Composites) are a synthetic resin that polymerize or harden when cured with a light at 450-470nm. The advantage is aesthetics, strength, and they mimic the color of the tooth. When the resin polymerizes it actually shrinks 5-10%. When bonded to the tooth, this shrinking can actually strengthen the tooth by holding it together. The resin fillings can be made smaller than metal fillings as there is no required depth of material as there is in metal fillings.

Metal Fillings (Amalgam) is a liquid mercury and metal alloy that when mixed hardens. The downsides are the metal fillings are not tooth colored, stain the tooth, expand when heated, aside from containing mercury. The preparation of the tooth has to be larger than resins to lock-in the filling as the metal filling does not bond to tooth structure

Root Canals

Root Canals are performed when cavities have eaten into the pulp chamber of a tooth. The bacteria causes the nerves and blood vessels inside the tooth to die. This can be very painful, which is why root canals have a reputation for being painful. Fortunately, today's rotary endodontic machines and anesthetic agents make these procedures painless!

Dentures

Conventional dentures are a decent option when teeth are missing. The maxillary or top dentures have a great suction effect on the roof of the mouth. They are however made of acrylics and plastics. Dentures are not substitutes for real teeth. The chewing efficiency is vastly lower. Please take care of your teeth! For those who've already lost their teeth, we like to work with the patient to have a few implants placed which greatly increases their quality of life!

Partials

Partials are removable prosthesis which replaces multiple teeth. They are a good option when a bridge or implants can't be placed. In our opinion, we really try to work with our patients to provide fixed options (bridges or implants) over partials. Partials are not natural teeth, and they do not chew like natural teeth.

There are two forms of partials: Tissue supported and Teeth Supported. When patients have lost their posterior molars, the distal extensions have no teeth to latch onto, thus we call it tissue supported. Tissue supported partials have less retention (aka they wiggle some) depending on how many teeth have been lost. Tooth supported partials, are when the teeth that will be replaced by the partial, have teeth on both the front and back of the space. This allows the partial to lock-in, and patients with these types of partials do quite fine.