Category: Cosmetic Dentistry

Crowns, why they break

Ever look at that new crown put in less than 5 years ago and see that half of it is missing? This is especially true in the back of the mouth (posterior) where the forces that you bite with can sometimes overcome the strength of the materials used. This is often true of the “full ceramic” crowns, and the new “Zirconia” crowns. In a study presented at the recent American Association of Dental Research it was reported that after just 2 years almost 40% of this type of crown failed usually splitting in half and necessitating complete replacement. It’s generally due to surface cracks that grow (that’s called crack propagation), connect and then the crown fails. The cracks are from the manufacturing of the crown by the lab or when we have to make adjustments before seating the crown in your mouth. In our practice we use a metal re-enforced crown called a PFM (porcelain fused to metal) which helps avoid these cracks and fractures. Any porcelain can crack and fail, but generally PFMs last longer in the back potions of the mouth. We tend to want to use the conservative method, the PFM, in our practice but always want to give options and respect the wishes of our...

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Why did this new filling break?

Why did this new “white filling” break is a question I hear more and more in my practice. A new patient comes in for an exam and has a “new” filling that has been done within the last 2 years, sometimes within the last year, and it has already failed. Normally I tell the patient that it most likely was the filling material the dentist used or the bonding agent that was used. Both are critical in achieving a restoration that does not fail too early. Research is telling of controlled clinical studies that show the new “nano” fills are failing within the first 2 years at rates we have not seen since the late 1980’s. In my practice, based on my knowledge of materials, my research I have done and continue to do at the UTHSCSA Dental School, and the published research, we use a composite first manufactured in the mid 1990’s and a bonding agent first used in 1990. Why? Because they work, have long term clinical trials that say they work and in our practice normally last more than the American Dental Association’s average of 3-5 years. We want them to last more than 10 years and that’s the reason we are conservative in what we use to restore teeth to their vibrant form and...

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So, How did I get this Broken Tooth?

We get patients from time to time who say, “I was eating breakfast this morning, oatmeal, and suddenly there was something crunchy and half my tooth is missing.  How did that happen?”  Well it is pretty simple.  Teeth are brittle and a property of brittle materials is that they are subject to fracture.  It’s like the windshield of your car.  You get a small nick or crack from a rock, and the crack grows until, if you don’t replace the windshield first, the windshield will break.  This is called crack propagation, or simply the crack grows.  In the mouth we sometimes chew things that crunch and when they do crunch can place a great deal of force on the teeth.  Things like chewing on ice, the un-popped popcorn kernels in the bottom of the bowl, or the last little pea size bit of candy left over when you suck on a jaw breaker or atomic fireball.  When we chew, we compress our food between our teeth and stress builds up and if what we are compressing is exceptionally hard, all the stress built up will release all at once and the teeth will actually slam together.  This will produce sometimes a flaw or crack in the enamel of the tooth, the outside hard material called the crown.  As we chew and force is applied daily, the cusp of the...

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