Tag Archives: problems with dental crowns

CEREC crowns

Open Margins on CEREC Crowns

I had three CEREC crowns made. I don’t feel like they are fitting well and I’m think there are open margins. There are radiolucent images that seem to support this but my dentist is telling me that those are radiographic burnout. Can you verify that?

James

Dear James,

block of porcelain for a cerec crown.

I can verify it with any definitive answer without examining you. CEREC crowns are usually more accurately fit than traditional ones because they are milled by a machine that designs the crown based on sophisticated software. Even so, it is still possible for a dentist to place them with open margins.

I can tell you that radiographic burnout is possible. A cleaner x-ray and running an explorer around the margins should tell you with certainty.

It doesn’t sound like you have much faith in your dentist to tell you the truth. This is a problem. You really do need a dentist that you can trust and feel is ethical. I would get a second opinion from another dentist. Make it a blind second opinion. By that I mean do not tell them who your dentist is or tell them anything about the radiolucent image.

The dental field is a small universe and it is very likely your dentists know each other. He or she may feel torn about saying your dentist messed up if they know who they are. If they ask, just tell them you want an unbiased opinion so just to look at the crowns and ask if there are open margins.

If it turns out that you do have open margins, then I would start looking for an ethical dentist who does quality work. Check out their reviews online. That can often be a way to weed out those whose patients have had bad experiences with them.

This blog is brought to you by a friendly dentist at Libertyville, IL Dr. Matt Roper.
Open Saturdays by appointment.

CEREC crowns

CEREC Crown Disaster

I was told getting a CEREC crown would be a snap and fit better than other crowns. Not only was I in the chair for over three hours, but the crown didn’t fit properly. She said it was because my tooth was in really bad shape so she had to take a general model from the database. It doesn’t fit at all like my normal teeth or even my other crowns. In fact, she had to grind it down because it didn’t fit in properly. Now it hurts. What do I do?

Carol

Dear Carol,

porcelain block for CEREC crowns

Something is wrong here. Let’s start with your dentist’s statement that she had to use a general model from the database. Her reasoning that the tooth was in too bad of shape doesn’t make much sense to me. Of course the tooth was in bad shape. That is the whole point of needing a dental crown! Why would you put a crown on a healthy intact tooth?

CEREC crowns should fit better than other crowns because they are designed and milled using precision software. However, computer software is only as good as the person programming it. Though, this software is pretty user friendly. For instance, let’s say you were missing your lower left molar. Your dentist would program that in and the software would give her a basic shape to use for that type of tooth to start the design. From there, images of your surrounding and opposing teeth give her the remainder of the information she needs to input into the software. Then it designs the crown.

Your crown is uncomfortable and she had to do grinding on the tooth, so clearly this didn’t happen properly. There are so many things that can go wrong with a dental crown. Here are just three:

  • Open margins. If the crown does not fit the tooth perfectly around the complete circumference of the tooth, then you will have a gap where bacteria can get in leading to decay under your crown.
  • Bite Design. When a bite isn’t designed properly, it throws off occlusion and you will end up with painful TMJ Disorder issues.
  • Poor Contouring. If the tooth is not contoured properly, you will have gum inflammation, which will lead to gum disease.

What this boils down to is you need to have this tooth looked at by another dentist. If they can tell you what is wrong with it, you can get either ask her to re-do the crown or ask for a refund and have it redone by another dentist.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
We help patients with dental anxiety.