Bad Porcelain Replacement Dentistry
Captek Crown Restoration Failures
Captek Porcelain Crowns have long been known as a premium restoration product used in reparative dentistry, smile makeovers and full mouth reconstruction. The patented and very unique fabrication processes developed by Captek can create, in the hands of a well tenured restorative dentist, tooth replacement choices that can mimic the best of what Mother Nature can offer.
An inner layer of gold is used, as seen in the adjacent Captek photo, yet is only one of several technical aspects that must be monitored when a restorative dentist determines the amount of layered porcelain to produce the cosmetic results that Captek is famous for.
Creativity and Talent
As with nearly any procedure in smile makeover dentistry, experience plays a determining role in how creative a dentist can be with the task of reproducing natural appearing teeth. Talent too, is also required for the more challenging treatment plans.
Technical Errors beget Cosmetic Disappointments
In dentistry, as with anything in life, errors can and do occur. Restorative products in dentistry (crowns, veneers, bridges, dental implants, etc) that fail, are rarely caused by product failure. Rather, failures are of a technical nature.
Common Errors in Porcelain Crown Tooth Replacements
Our patient, a 30 something female, presented in our office complaining of recently undergoing restorative treatments with 4 Captek crowns on her upper anterior teeth. She felt they didn’t match her existing teeth, appeared bulky, caused swelling of gum tissue and had the beginnings of tell-tale black lines at the edges of her gum line.
Tooth Prep and Restoration Errors
The close up photo of the patient’s upper arch readily shows the swollen gum tissue. The black lines can also be observed. Indications of technical errors (tooth and restoration preparation) quickly emerge. Papilla tissue is nonexistent on the treated teeth (ultra thin gum tissue that lines each gingival arch).
The differences in color shading are also evident. Although matching shades of new restorations with existing teeth is difficult, it is suspected that the repeated use of temporary restorations weren’t practiced to the degree needed that would produce the precise result the patient wanted.
Dentists provide the technical data to dental laboratories to design a tooth with several different properties. Shape, width, incisal edge characteristics, along with the physical characteristics of the modified original tooth structure are fabricated with different thicknesses of porcelain.
Our third mid-treatment photo shows the process of removing the Captek crowns. The groove created by Dr. Winter shows the actual gold component of the crown.
This method of crown (veneers also) removal is an effective procedure for removing, usually, old and worn out restorations. A grove is carefully created on the entire restoration to aid the removal process.
A precise amount of porcelain, in different locations (especially with Captek’s gold film) is required to produce the exact cosmetic goal. Too much or too little porcelain in the wrong areas will change how the tooth appears.
A picture representing a cross section of the Captek crown is shown, demonstrating how porcelain is distributed throughout the entire restoration.
But, by maintaining a watchful eye on the technical considerations and working with a dental lab that routinely uses Captek products, quite amazing effects can be created that are unattainable with all porcelain restorations.
The Captek Porcelain Standard
Extensive use of articulation studies, diagnostic waxups and sufficient try-ins of temporaries, which can be tedious, give patients the control they want for achieving a precise cosmetic result.
Our last photo shows the cosmetic results our patient had originally wanted. Tooth sizing that fits her smile. Color shading that is so natural it is difficult to determine which teeth are natural and which teeth are porcelain.
After a few weeks of healing, the gingival arches on all treated teeth regained the natural appearance and regrowth of the papilla. The gum tissue was no longer swollen nor inflamed, a primary indicator of healthy bonding and preparation of bonding surfaces.
The Captek crowns now produce the cosmetic result that was originally sought by the patient.
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