D2790 CROWN-FULL CAST HIGH NOBLE METAL

Name of the Procedure:

Common Name(s): Full Cast Crown, High Noble Metal Crown
Technical/Medical Term: HCPCS D2790 - Crown-Full Cast High Noble Metal

Summary

A Full Cast High Noble Metal Crown (D2790) involves placing a fully metal crown made from a high percentage of gold or other high noble metals over a damaged tooth. This durable and long-lasting crown restores the tooth's function and appearance.

Purpose

Medical Conditions/Problems Addressed:

• Severely decayed or damaged teeth
• Restoring fractured teeth
• Teeth weakened by large fillings
• Supporting a tooth with a root canal

Goals/Expected Outcomes:

• To protect and strengthen the damaged tooth
• To restore normal function for chewing and speaking
• To improve the appearance of the tooth

Indications

Specific Symptoms/Conditions:

• Extensive tooth decay
• Broken or fractured teeth
• Large fillings that weaken the tooth structure
• Teeth that have undergone root canal therapy

Patient Criteria/Factors:

• Good oral hygiene
• Sufficient tooth structure remaining to support the crown
• Allergies or sensitivities to metal should be considered

Preparation

Pre-Procedure Instructions:

• Routine dental exam to assess condition
• X-rays to examine tooth roots and surrounding bone
• Possible removal of decayed tooth material
• No specific fasting or medication adjustments usually required

Procedure Description

Step-by-Step Explanation:

1. Numbing the Tooth: Local anesthesia is applied to numb the affected tooth and surrounding area.
2. Tooth Preparation: The dentist files down the tooth to make room for the crown.
3. Impressions: An impression of the prepared tooth and adjacent teeth is taken to create a precise model.
4. Temporary Crown Placement: A temporary crown is placed over the prepared tooth to protect it while the permanent crown is being made.
5. Crown Fitting: During a follow-up visit, the permanent crown is checked for fit and color, then cemented onto the tooth.

Tools/Equipment: Dental drill, impression materials, crown materials

Anesthesia/Sedation: Typically, local anesthesia is used.

Duration

The entire procedure typically takes about 60 to 90 minutes, spread over two appointments – one for preparation and one for fitting the crown.

Setting

Location: Dental office or clinic

Personnel

Healthcare Professionals Involved:

• Dentist
• Dental assistant

Risks and Complications

Common Risks:

• Sensitivity to hot and cold
• Discomfort or soreness after the procedure

Rare Risks:

• Allergic reaction to metals
• Crown loosening or falling off
• Injury to adjacent teeth or gums

Possible Complications:

• Adjustments may be needed for a proper fit
• If complications arise, additional treatments or adjustments may be required

Benefits

Expected Benefits:

• Durability and strength of the tooth
• Restoration of tooth function and aesthetics
• High success rate with long-lasting results

Realization Timeframe: Benefits are usually realized immediately upon fitting the permanent crown.

Recovery

Post-Procedure Care:

• Avoid sticky or hard foods initially
• Maintain good oral hygiene with regular brushing and flossing

Expected Recovery Time: Most patients can resume normal activities immediately, with any minor discomfort resolving within a few days.

Restrictions/Follow-Up:

• Routine dental check-ups and cleanings
• Monitor the crown during regular dental visits

Alternatives

Other Treatment Options:

• Porcelain-fused-to-metal crowns
• All-ceramic or zirconia crowns

Pros and Cons of Alternatives:

• Porcelain-fused-to-metal crowns: Aesthetic and strength advantages but may show metal edges over time.
• All-ceramic or zirconia crowns: Superior aesthetics and biocompatibility, but may not be as durable as metal crowns.

Patient Experience

During the Procedure:

• Minimal discomfort due to local anesthesia
• Pressure and noise during tooth preparation

After the Procedure:

• Mild soreness or sensitivity
• Pain management typically involves over-the-counter analgesics
• Minimal disruption to daily activities

Comfort measures include topical numbing gels and following up with the dentist for any adjustment needs.