In this article we talk about our Costa Rica dental crowns procedures, we hope to clarify some doubts you might have about this highly sought  dental procedure.

Dental crowns are one of the most common treatments in dentistry. There are several cases in which they can be done. In order to perform this procedure, the tooth has to fulfill several requirements for the restorations to be successful and highly predictable, since such restorations will cover up the tooth entirely.

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The crowns are used in situations in which the tooth presents a major modification that requires fixing. For example, when a cavity covers more than half the tooth, when there is fracture or trauma of the same size, or for some other cause in which it is necessary to give the tooth its former shape back or to restore it completely.

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Costa Rica dental crowns – Before Dr. Brenes after Dr. Brenes

To make a crown, it is necessary to have 3 very important elements that will support it. The first element is a long enough dental root that will hold to the bone and gums. This root will work as the pillar of the restoration, and if the root is too short, the prognosis of the crown will not be favorable, since it might not have enough to hold on to. Healthy gums are another important element, since they will give cover to the union between the tooth and the crown; when gums are not healthy they tend to recede and show this union, thus making an aesthetic and functional problem. Finally, it is important to have enough tooth to retain the crown on top of it, so that it might recover the functionality it has lost.

In case the root is not long enough for getting one of our Costa Rica dental crowns, an option might be to go for a dental bridge or a dental implant. If there is a problem with the gums, they are to be treated with specialized cleaning procedures in order to return them to their healthy condition and if there is not enough tooth, the possibility of reconstructing it with posts and cores is considered. All this information is determined previously in order to give the patient all the treatment options available.

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When it comes to dental crowns, people have lots of questions, such as:

Can the color of the crown change with whitening or over the years?

The answer is no, since they are covered with porcelain, they maintain its color. That is why it is important to decide if you want to get a whitening prior to your crown’s installation, because once it is done, its color is not going to change.

Can I get cavities on the crown?

Cavities will not appear on the crown. However, the junction between crown and tooth is a very inclined area to develop cavities. In fact, if you don’t perform a professional dental cleaning every six months and take x-rays of the crown once a year, it is impossible to evaluate the state of the tooth.

It has happened many times that a patient has dental treatments done but doesn’t give them the appropriate follow up and doesn´t visit his or her dentist on a regular basis; but thet do come many years after their initial treatment was made with problems in their crowns and with cavities underneath them.

In these cases it is necessary to change the crown and, in many occasions, more procedures are required to compensate the lack of care and maintenance, such as nerve treatments, gum lengthening, or in the worst case scenario, the extraction of the tooth.

How long can a dental crown endure?

It is a tough question to answer. It would be like asking a cardiologist how long will my heart transplant endure. However, in order to give an answer to this question, studies have been performed and they have shown that a crown can endure up to five years, given the proper care.

This care consists of cleanings every six months and a constant x-ray and photographic follow up. Let’s not forget we are trying to give a solution to a problem by introducing a prosthesis to repair something that is no longer there.

Will I be able to feel like I did with my natural teeth?

The nerves that are in the dental complex have only two ways of reacting to stimulation. One is by reacting to pressure and the other one is by feeling pain. You will never feel tickles, or temperature changes in your teeth. If a nerve treatment was not necessary in order to do your crown, it is very likely you will have the same sensations you had with your tooth, perhaps a little diminished. If you had a nerve treatment, you will only experience pressure but no pain.

Are crowns fixed, or can they be removed or fall off?

Crowns are designed to be fixed and to remain over the tooth. There is no need of removing them if they are in good shape. When a crown falls off, it is important to be extra careful for it may be a symptom that there is a problem and the restoration prognosis may be bad.

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Costa Rica dental crowns by Advance Dental (Before & After)

What are crowns made of?

Dental crowns have two parts in their structure. The exterior part in all crowns is made out of porcelain. That is the part that you can see and the one that is in constant contact with the tongue. This part is what we call the coating or the vennering part of the crown. At Advance Dental Costa Rica we use two porcelain brands: Shofu Vintage and VM 9 Vita. Regarding the restoration, the internal part is what changes; there are three types of materials, very different from each other, that are used: Metal, Porcelain and Zirconium.

What is the difference between Metal, Porcelain and Zirconium crowns?

There are 2 different types of Metal crowns: the first ones are done with base metal, and they don’t have any noble metals in them; and there are the ones with high levels of noble metals on them.

The greatest difference between them is that some people have noticed base metals cause allergies, particularly because of their high levels of nickel. Additionally, if the dental technician is not skilled enough when handling these restorations, they could present imperfections that might become problems at some point.

We use crowns with a high content of noble metals, which guarantee a better adjustment, and we can also avoid problems with allergies to the restorations. The metal crowns have been studied for more than 75 years and have proved to be an excellent option for when patients have very strong bites.

They are widely used for restoring the back teeth, because they are highly resistant but also have great flexibility that prevents the crowns from breaking.

Porcelain and Zirconium crowns are, in a manner of speaking, sisters restorations.

Porcelain crowns have a substrate that is resistant but not so flexible, and are ideal for when restoring the front teeth in people with not so strong bites, since they feature a better aesthetic result when compared to metal ones.

They are not recommended when replacing the back teeth, because they can break. These have been available for around 20 years and there are studies that prove they work in the situations mentioned above.

Zirconium crowns are porcelain structures reinforced with Zirconium oxide, which makes them more resistant. They are recommended for the front teeth and, in very specific cases, for the back teeth. These were introduced to the market 5 years ago and studies say they can’t endure for longer than 10 years.

What is the required procedure to make a dental crown?

Once it is determined a dental crown is required, the tooth is prepared. That means making the necessary reductions to locate the crown on top of it, position from which the name “crown” is derived, since the restoration goes on top of the tooth.

Also, if a post is necessary, it is done at this point and the tooth is rebuilt. Once the piece is prepared, an impression is made and then a provisional crown is cemented. This information is sent to a dental laboratory where the crown is made and in another appointment the crown is cemented and the treatment is finished.

When there is more than one crown to be placed, or a crown in a highly visible place, there is an appointment prior to the cementation to evaluate with the patient the appearance of the crown and the adjustment to the bite.

This crown will be 90% complete, and if the patient is satisfied with the results, the final cementation will be done in the following 24 hours, in order for the lab to make the final adjustments.

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(Image: Before and after our Costa Rica dental crowns procedure)

What are CAD-CAM crowns?

CAD-CAM are crowns made with the help of a computer, and receive the name for the acronym of the English Computer Assisted Designed and Computer Assisted Manufactured. In this process, the crowns are made with a mill which is controlled by a computer. The information is entered through software that guides the construction of the crown in the desired material (Metal, Porcelain of Zirconium). At Advance Dental Costa Rica our Zirconium and Porcelain crowns are CAD-CAM made in the Amann Girrbach system.

What are CEREC crowns?

CEREC is the commercial trademark of a CAD-CAM system used in several countries. At Advance Dental Costa Rica our Zirconium and Porcelain crowns are CAD-CAM of the Amann Girrbach system.

What are metal free crowns?

This is mostly a marketing term that refers to crowns that do not have metal as interior substrate. Most of the times it refers to porcelain or Zirconium crowns, however, if you want to be truly specific, this term is tricky, since Zirconium has a metallic element in its contexture and it is closely related to aluminum.

Dental Crowns Cost in Costa Rica

One of the most common procedures done at our office, is also one of the procedures that’s going to cost about 50% less to get done in Costa Rica than it would in the United States. International patients ask commonly for Costa Rica dental crowns since their return over investment is much higher when done at Advance Dental. Variations apply depending on the material of the crown, however, the result is always more affordable, high quality crowns and at the end, more smiling all around.

Dr. Eugenio J. Brenes, DDS, has a specialty in crowns and bridges called Prosthodontics from Loma Linda in California, U.S.A. During the four years of his residency he made several studies and treated many cases, in order to be able to offer you the best possible results.

Please, contact us , and we’ll gladly respond to any inquiries you may have regarding our Costa Rica dental crowns.