Darkness around front PFM crown, change to All Ceramic?

[fishey5884]

I had a root canal, post and core (i think it was metal) and porcelain fused to metal (PFM) crown placed on one of my front teeth 10 years ago. Over time I noticed a darkness around the margin of the crown and in the gum above the crown. I want to get the crown redone to a all ceramic crown to get rid of the darkness. Is it a good idea?

The crown I have now is completely sound and cavity free. The endo looks fine too. Would just changing the crown to all ceramic make the darkness go away? Or will the post need to be changed too? Do metal post show thru all ceramic crowns? How about Zirconia?

I'm afraid of the worst, ie like the root fracturing. But I'm only 25 and I would like my front tooth to look natural since I do have a gummy smile.

My expectations are to have the darkness go away and for the shade of the crown to match the adjacent tooth.

What do you guys think? Any recs for great cosmetic dentist in NYC? There are soooo many out there.

[prosman]

a top quality dentist should be able to help you with this problem

[fishey5884]

a top quality dentist should be able to help you with this problem

Do you think PFM with porcelain butt is better? Or Zirconium all porcelain crown to mask the darkness? Will PFM with porcelain butt still cast darkness through the gum?

[prosman]

To be honest it doesn't matter as much as people think, it is the skill of the dentist and the technician that is the most important.
Sometimes a PFM will be better than an all ceramic, although as I do mostly all ceramic restorations, I know there are ways to get the best out of all ceramics on dark and or non vital teeth, so usually prefer them over a PFM.
Best to ask to see some photos of the work that has been done by the dentist who is proposing the treatment and see if you are happy with the standard.

[fishey5884]

I have a question about bleaching. Since I'm going to get #9 redone, should I bleach my other natural teeth? Is it hard to maintain? Will it be hard to rebleach my teeth in the future to match the new crown? Will my teeth get sensitive from having to bleach so often to maintain the color?

To be honest it doesn't matter as much as people think, it is the skill of the dentist and the technician that is the most important.
Sometimes a PFM will be better than an all ceramic, although as I do mostly all ceramic restorations, I know there are ways to get the best out of all ceramics on dark and or non vital teeth, so usually prefer them over a PFM.
Best to ask to see some photos of the work that has been done by the dentist who is proposing the treatment and see if you are happy with the standard.

[prosman]

Since I'm going to get #9 redone, should I bleach my other natural teeth?

Only if you want lighter teeth

Is it hard to maintain?

Not really, it is best to do some top up home bleaching every 6 mths or so, for a night or two.

Will it be hard to rebleach my teeth in the future to match the new crown?

No

Will my teeth get sensitive from having to bleach so often to maintain the color?

any sensitivity is only transient and goes away a day or two after you finish the proceedure

[Steph in Sac]

I have the same exact scenario except I also have an amalgam tattoo on my gum due to the amount of amalgam they packed into my crown. I just had my old crown taken off and was also worried the tooth would be broken. It turns out the entire tooth all the way under the gum is covered with amalgam. I currently have a temporary crown and it looks so much better already. The dentist cut my gum with an electric device (because it was much lower on that tooth). She is replacing the crown with an all porcelin so the light can show through a bit. My old crown was PFM and very opaque--it has never looked real. Because of all the amalgam underneath the crown, it will eventually show through when my gums recede some day and will need to be replaced again.

I can't wait to see the permanent in 2 weeks and hope it meets my expectations! Best of luck in your situation.

[evan28]

I posted this in its own thread, but looks like it maybe should have been put here. any advice? thanks in advance

I had a crown fitted on a front tooth 10 years ago which was never that convincing, with a dark visible line on the gum line. The tooth underneath is dead and black (impact injury, nerve taken out), so the gum also looks slightly discoloured.

Last year i finally decided I wanted a more natural looking tooth so I went to have it replaced and was advised a porcelain crown. I went with this, the dentist was helpful and friendly and I left pretty happy with the results, although the join to the gum did look slightly hard, square and white.

But now a year later i've started to notice a faint, dark line appearing on the gum join, becoming increasingly visible over the past few weeks.

It seems like the gum is receding and the dark tooth becoming visible underneath, either that or the the top of the crown is wearing down (?)

Does anyone know where I stand regarding this? It seems like a lot of money to be spending for such temporary results, it's not a million miles away from where it was before (although the rest of the tooth looks better), I cant help feeling it was a waste of money since i went in for purely cosmetic reasons.

Do i have any rights regarding replacement or compensation or is it just tough luck since the crown is still attached? I look after my teeth, so it's not like they're getting neglected

Sorry if this question has been answered else where. Any advice/knowledge anyone could provide would be much appreciated.