Porcelain fused to metal crowns can be a good solution in some situations, and they used to be the only solution for a tooth-colored crown. Over time, though, these old crowns can lose their attractive appearance for many reasons.
Metal around the Edges
One of the most common problems with porcelain fused to metal crowns is that they begin to show metal around the edges of the crown. This is normally because your gums are receding around the crown, revealing the metal margins of the crown.
We can investigate whether gum disease is responsible for the recession, and, if so, gum disease treatment might allow your gums to grow back. If not, we can talk about treatments for receding gums such as gum grafting or consider replacing the crown with an all-ceramic crown that will look more attractive.
Broken Crowns and Bite Problems
Other times, your crown may look unattractive because the ceramic has broken away from the metal. When this happens, there may be patches of metal visible on the crown.
This isn’t just unattractive, it can be a sign of bite problems. Sometimes the problem is tooth clenching (bruxism), which can occur during the day or at night and may be related to stress. Other times, your crown is subjected to excessive force because it is poorly placed, causing it to take more than its share of force. Chances are, if we look at the opposite tooth in this situation, we’ll see it’s worn as well. Finally, excess force on your crown might be part of a pattern of malocclusion–when your teeth don’t fit together comfortably.
In any case, a chipped crown might be a sign that you have or are at risk of TMJ, and we’d want to evaluate your bite before deciding how to proceed with treatment.
Restore or Replace a Crown?
If the ceramic broke away from the metal on the crown, but the crown is otherwise in good shape, we can try using dental bonding to restore the crown to its former appearance. This may or may not work. Dental bonding isn’t really designed for clinging to metal, so it might break off. Even when successful, this is a short-term temporary solution.
For the best cosmetic result, it’s often recommended that you replace the damaged crown with an all-ceramic crown, which we can place in one day thanks to our CEREC system.
We may also not have a choice in the matter. If the crown has sustained structural damage, it needs to be replaced to protect your tooth.