Name of the Procedure:

CROWN - PORCELAIN FUSED TO NOBLE METAL (D2752)

Common name(s): Porcelain-fused-to-metal crown, Dental crown
Technical/medical term: D2752

Summary

A porcelain-fused-to-noble metal crown is a type of dental crown used to restore a damaged or decayed tooth. This crown is made by fusing porcelain to a base of noble metal, combining the strength of metal with the aesthetic appeal of porcelain.

Purpose

Porcelain-fused-to-noble metal crowns are used to:

• Restore the structure, appearance, and function of a damaged or decayed tooth.
• Protect a weakened tooth from further decay.
• Support a tooth with a large filling.
• Hold a dental bridge in place.
• Cover a dental implant.

Indications

• Teeth that are cracked or fractured.
• Teeth with large cavities that cannot be filled with a traditional filling.
• Teeth that have undergone root canal treatment.
• Discolored or misshapen teeth that need cosmetic improvement.
• Teeth requiring enhanced support for bridges or implants.

Preparation

• Dental Examination: Initial dental exam and X-rays to assess the tooth’s condition.
• Impressions: Dental impressions of the teeth to ensure the crown fits perfectly.
• Temporary Crown: A temporary crown may be placed while waiting for the custom crown to be manufactured.

Procedure Description

1. Tooth Preparation: The dentist numbs the area and then shapes the tooth to accommodate the crown.
2. Impressions Taken: Detailed impressions of the tooth are taken to create a perfect fit.
3. Temporary Crown: A temporary crown is placed to protect the tooth until the permanent crown is ready.
4. Creating the Crown: The impressions are sent to a dental lab where the porcelain-fused-to-noble metal crown is custom-made.
5. Fitting the Crown: During the follow-up visit, the dentist removes the temporary crown and fits the permanent crown, making necessary adjustments for a proper bite and fit.
6. Cementing the Crown: The crown is permanently cemented into place once the fit and appearance are satisfactory.

Duration

The initial preparation and fitting of the temporary crown typically take around 1-2 hours. The follow-up visit for fitting and cementing the permanent crown also takes 1-2 hours.

Setting

The procedure is performed in a dental office or clinic.

Personnel

• Dentist
• Dental Assistant

Risks and Complications

• Sensitivity: Temporary sensitivity to hot and cold.
• Discomfort: Initial discomfort, which generally subsides within a few days.
• Chipping: Porcelain may chip off the metal base.
• Crown loosening: Rarely, the crown may become loose or fall off.
• Allergic reaction: Though rare, some patients may have an allergic reaction to the metals used in the crown.

Benefits

• Durability: Combines the strength of metal with the aesthetic appeal of porcelain.
• Aesthetic: Provides a natural tooth color and appearance.
• Functionality: Restores the tooth's function for chewing and speaking.
• Protection: Protects the underlying tooth structure from further damage.

Recovery

• Instructions: Avoid hard or sticky foods for the first few days. Maintain good oral hygiene with regular brushing and flossing.
• Recovery Time: Most patients can resume normal activities immediately. Mild discomfort or sensitivity usually subsides within a few days.
• Follow-up: Routine dental check-ups to ensure the crown is functioning properly.

Alternatives

• Full Porcelain Crowns: Offers better aesthetics but less durability compared to porcelain-fused-to-metal crowns.
• Gold Crowns: Extremely durable but not as aesthetically pleasing.
• Zirconia Crowns: Combines strength and aesthetics but can be more expensive.

Patient Experience

During the procedure, local anesthesia ensures that the patient feels no pain. Some might experience mild discomfort after the anesthesia wears off. Post-procedure, over-the-counter pain medication and avoiding certain foods can manage any discomfort. Regular dental hygiene and follow-up visits ensure the longevity and success of the crown.