Name of the Procedure:

Crown - Porcelain Fused to High Noble Metal (D2750)

Common name(s): Porcelain-fused-to-metal crown, PFM crown. Technical or medical terms: High noble metal crown with porcelain veneer.

Summary

A porcelain-fused-to-metal (PFM) crown is a type of dental restoration that encases a damaged tooth with a covering made from both metal and porcelain. The metal provides durability, while the porcelain offers a natural tooth-like appearance.

Purpose

PFM crowns are used to restore teeth that are broken, decayed, or weakened. The primary goals are to protect the tooth, restore its function and appearance, and prevent further deterioration.

Indications

• Severe tooth decay or damage
• Cracked or fractured teeth
• After root canal treatment
• Replacement of old, failing crowns or fillings

Preparation

• Initial consultation and examination
• X-rays or digital scans of the affected tooth
• Possibly taking dental impressions
• Instructions on oral hygiene and potential cessation of certain medications

Procedure Description

1. Tooth Preparation: The dentist numbs the area and then reshapes the tooth to make room for the crown.
2. Impressions: An impression of the prepared tooth is taken and sent to a dental lab.
3. Temporary Crown: A temporary crown may be placed to protect the tooth while the permanent crown is being fabricated.
4. Crown Placement: On a subsequent visit, the temporary crown is removed, and the permanent PFM crown is cemented into place after ensuring a proper fit.

Tools, equipment, or technology used: Dental drill, impression materials, dental cement. Anesthesia or sedation details: Local anesthesia to numb the area around the affected tooth.

Duration

Typically spans two dental visits: the first for preparation and impressions (about 1-2 hours) and the second for fitting and cementing the crown (about 30 minutes to 1 hour).

Setting

Performed in a dentist's office or an outpatient dental clinic.

Personnel

• Dentist
• Dental assistant
• Dental lab technician (for fabrication of the crown)

Risks and Complications

Common risks:

• Sensitivity to hot and cold
• Discomfort or soreness in the gum Rare risks:
• Allergic reaction to materials
• Crown loosening or falling off
• Nerve damage

Management: Proper oral hygiene can minimize risks, and any complications should be promptly addressed by the dental professional.

Benefits

• Protection and strengthening of the damaged tooth
• Restoration of normal function and appearance
• Longevity with proper care, potentially lasting 10-15 years or more

Recovery

• Normal activities can usually be resumed immediately
• Avoid sticky or hard foods for a few days
• Follow-up appointments as needed to check the crown and oral health

Alternatives

• All-ceramic or all-porcelain crowns: More aesthetically pleasing but less durable.
• Gold crowns: Very durable but less natural-looking.
• Composite resin fillings: Suitable for smaller repairs but less durable for significant tooth damage.

Patient Experience

During the procedure: The patient will feel numbness but should not feel pain. There may be sensations of pressure and vibrations. After the procedure: Mild discomfort or sensitivity may occur but is typically manageable with over-the-counter pain relief and should subside within a few days. Clear post-care instructions will be provided to ensure proper healing and maintenance of the crown.