CROWN-FULL CAST HIGH NOBLE METAL
HCPCS code
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:
- Numbing the Tooth: Local anesthesia is applied to numb the affected tooth and surrounding area.
- Tooth Preparation: The dentist files down the tooth to make room for the crown.
- Impressions: An impression of the prepared tooth and adjacent teeth is taken to create a precise model.
- Temporary Crown Placement: A temporary crown is placed over the prepared tooth to protect it while the permanent crown is being made.
- 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.