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A dental crown mimics the entire crown of the tooth, with a hollow space inside -- like a cap. In order for the finished crown to fit correctly, the remaining core underneath the crown needs to be reduced to accommodate the crown on top. A crown is designed to securely fit the tooth, keeping bacteria out from underneath the vulnerable tooth structure.
Once the tooth and tissues have become numb, the dentist may decide to place a rubber dam over the teeth involved. The rubber dam is used to trap old filling material, tooth structure, and water from falling into your mouth.
Preparing the tooth for a dental crown involves removing very precise amounts of tooth and filling material from the tooth that requires the crown. During this step, the discovery of tooth decay underneath an old filling may occur. If that is the case, all of the decay is removed and a composite core is placed on the tooth. If your tooth has undergone a recent root canal, a composite core may be placed as well during this step.
Once the core is complete, your dentist will continue to shape the tooth, creating a fine margin around the entire core of the tooth, like a shelf, and continue reducing the biting surface of the core until sufficient tooth and filling has been removed.
Accurate impressions of your prepared tooth are an essential part of the dental crown procedure. Even the tiniest flaw in the impression can result in a ill-fitting crown.
Once the tooth has been prepared, your dentist may decide to use a gingival retraction cord to gently push your gum tissue away from the margins of the prepared tooth. A gingival retraction cord is a thin piece of cord, similar to a piece of yarn, that is gently inserted around the tooth, into the gingival sulcus. Some dentists have adopted other techniques for isolating the tissue, such as gingival curettage.
When the tooth is ready for the impression, your dentist will then take an impression of your teeth. Your dentist will begin the impression by applying a polyvinyl siloxane impression material around the prepared tooth. The dental assistant will begin filling the impression tray with a corresponding impression material. Your dentist will insert the impression tray over your prepared tooth, and ask you to bite down. It is very important for you to remain biting into the impression until the material is fully set. This impression takes between three and five minutes to fully set, so patience is certainly a virtue during this step of the dental crown procedure. Once the impression material has set, your dentist will remove the tray from your mouth and inspect the impression for any air bubbles or other void in the impression. It may be necessary to repeat the impression several times in order to obtain a very accurate impression. Using the small impression taken prior to preparing the tooth for the crown, the dentist or assistant will fill the impression tray with an acrylic resin material, in a shade appropriate for your case, and place it over the prepared tooth. Once the material has set, generally after one to two minutes, the impression is removed from your mouth. The temporary crown is shaped to fit your tooth and to remove any rough edges. Once it is ready, a temporary cement is used to secure the temporary crown onto your prepared tooth. The dentist will check to make sure your teeth bite together correctly and will ensure there are no rough or sharp edges around the temporary crown.
Temporary crowns are very important. Because your dentist has removed a substantial amount of tooth structure from the prepared tooth, the temporary crown acts as a barrier, keeping the prepared tooth in its place. Without a temporary crown, the prepared tooth can