Having had 4 metal based porcelain caps fitted to my four bottom teeth

Q. Having had 4 metal based porcelain caps fitted to my four front bottom teeth can the 15year old bonding on my 2 upper big front teeth above the caps be replaced with new bonding. My dentist refuses to do this and states that they must be restored with all porcelain caps ie Lava. I hate to have good teeth filed down for caps. Help please.The original bonding was put on in the States. Thank you do much for your time. Sincerely

A. Hi , you can have the bonding replaced but don’t have it done with your dentist. He may not be able to do it very well and the fact that he suggested Lava crowns for your anterior teeth means he doesn’t have a grasp of the different types of restorations that are suitable for anterior teeth. Lava crowns require 2.5mm reduction around the whole tooth which is a lot considering veneers can be done in 0.2 mm thickness. Lava is a zirconia restoration which is very opaque and many cosmetic dentists do not use this material in the anterior region due to this fact. Have an opinion from a restorative/cosmetic dentist to find out your options for the two upper front teeth.
Kind regards

Dr Komal Suri

Dr Komal Suri

Smile Design Dental
33 High Street, Wendover, Buckinghamshire HP22 6DU
Web: www.smiledesigndental.co.uk  Tel: 01932 223 479

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December 7th, 2008 at 08:47 PM
Mathew Carmichael Says :

It is unfortunate that Dr. Suri was so quick to pass judgment on your case without looking in your mouth to view the teeth in question. If your two front teeth are already heavily restored with composite (white filling) material which needs to be replaced the next logical step may be a full coverage restoration (ie. a crown or “cap”). Dr. Suri was also mistaken when she said that Lava crowns require a minimum of 2.5mm of tooth reduction around the entire tooth as they in fact need only .3mm for the zirconia coping plus a minimum of .5mm – 1mm for the porcelain for a total of 1mm -1.5mm (please refer to 3M ESPE website for discussion of the reduction necessary). Furthermore, Lava crowns are an extremely esthetic restoration as the comping is much more translucent than a metal coping, which allows light transmission through the crown much like what occurs in your natural teeth. Also, Lava by 3M now provides 7 shades of copings which allows your dentist to closely match the margin (outer border/edge) of the crown to your natural tooth structure. I encourage you to go to the 3M ESPE website to further educate yourself about Lava crowns. Another very esthetic restoration is Empress crowns by Ivoclar. Good Luck.

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