The typical crown needs to be strong to last through years of heavy repetitive biting, chewing and grinding. High strength crowns derive their resistance and durability from the sub-layer of the crown which is made of metal (i.e.  a PFM or Porcelain Fused to Metal crown). The structure of a PFM is like the bathtub where there is a high strength metal core with a weaker but prettier ceramic material. The best metals are high-noble compositions having over 88% gold and additionally alloyed with platinum and a few other trace metals which are necessary for processing and fabrication . Core alternatives to metal are available today as emerging technologies.  These high strength ceramics are composed of either aluminum oxide or zirconium oxide. Well fabricated crowns can easily last 10 to 20 years or longer.

All Ceramic Crown restoring a damaged tooth:

For other pictures of actual treatment crowns, see Treatment Examples in the header at the top of this page.

Fixed bridges, when done well, can easily last 10 to 15 years or longer. A more conservative variation of the complete coverage bridge is a surface-bonded bridge that requires only a minimum of trimming of the enamel of the abutment teeth. The surface-bonded bridge does not have porcelain covering the abutment so a small amount of metal may be visible. In the right circumstances this type of bridge works exceedingly well and has less morbidity and less cost associated with it.

High strength ceramic core layered with enameling porcelain:

For actual treatment pictures of Fixed Bridges see the Treatment Examples heading at the top of the pages bar.

The image below is of a 51 year old male who grinds his teeth. At this stage there is already more than 70% wear of his upper front teeth.

Complete Oral Rehabilitation is a treatment process that requires considerable know-how and experience since so many things can go wrong. One of the most critical factors is to develop the occlusion or bite functionality to work properly.  If a malocclusion is erroneously created or perpetuated, patients may suffer terribly from jaw dysfunction with TMJ pain and often will need a complete re-restoration, and this sometimes after requiring a prolonged realignment therapy.

Complete Oral Rehabilitation many times will also involve other treatment modalities such as dental implants, orthodontics, periodontics, endodontics as well as cosmetic considerations. Most importantly, the undertaking of a Complete Oral Rehabilitation requires the know-how of how to plan and execute a comprehensive diagnosis and treatment plan.

Without a doubt, a Complete Oral Rehabilitation is the most challenging restorative treatment in Dentistry.  Only the most proficiently trained Dentists or Prosthodontists supported by meticulous and knowledgable Dental Technicians should undertake COR.

For pictures of a Complete Oral Rehabilitation, see the Treatment Examples heading in the menu bar at the top of this page.

Veneers restorations are utilized to improve the appearance of teeth that are chipped, worn, discolored, misaligned or blemished. If the tooth core is very dark then a veneer may not be able to mask out enough of an underlying blemish and the dark stump may show through. In these instances crowns may be more suitable.

When Dental Veneers are made by skilled Dentists and skilled Dental Technicians, they can become the most beautiful of all restorations, sometimes looking better than natural enamel itself. Veneers are more fragile than crowns so that extra care needs to be exercised so as not to crack or chip them (do not open cellophane bags or cut thread with your veneers).  If not abused, veneers can easily last for ten years or longer.

Minimal Preparation Veneers ( 0.3 mm. thick ) – On the first image you can actually see the background color through the semi-transparent veneer

For other case pictures of Dental Veneers, see the Treatment Examples heading in the menu bar at the top of this page.

Complete Dentures are false teeth that have no remaining natural teeth onto which the appliance can clasp or anchor. Upper dentures cover all of the ridges as well as the palate for stability. If the ridges are short or if the palate is shallow the complete upper denture (CUD) becomes unstable and goopy adhesives or sticky powders may be required to help keep them in place. The complete lower denture (CLD) is horseshoe-shaped because the tongue resides in between the ridges, so it will have less of a platform for stability. When the ridges resorb and become shallow it is very difficult to keep a CLD in place because speaking and swallowing causes the tongue to deflect the denture out of place. Because the jawbone ridges continually resorb throughout life once teeth have been removed, the more years a person has been wearing dentures, the more trouble they will have holding them from dislodging out of place.

Since the advent of dental implants, it has become possible to stabilize wobbly dentures by using implants as anchors. In the lower jaw, which is commonly the most problematic arch, as few as 2 implants can transform the misery of having an unstable CLD into a situation of much greater satisfaction. Because the bone in the upper jaw is spongy and not as durable a minimum of 4 or preferably more implants are usually required. Fixed connector bars can be made where multiple implants are possible. This in turn provides even greater stability and longevity. The dentures then clip overtop and onto the implant bars but can still be detached for cleaning. Bars on implants can last for more than 20 years. The overdenture itself, however, being made of plastic (acrylic) may need to be changed every 6 to 10 years.

For pictures of Bar Overdentures, see the Treatment Examples heading in the menu bar at the top of this page.

Specialists generally will charge more than General Dentists.

Comparative Fees Chart: