Definition & Overview
Dental crowns and bridges that have been detached or have fallen off for any reason can be reattached through a dental recementation procedure. This is a type of restorative dentistry typically performed in a dental clinic or office.
A dental crown is a cap placed on the top surface of a tooth to restore its shape and strength. It is cemented in place and serves to cover the tooth to protect it. It also functions to prevent the tooth from breaking apart. In some cases, it is placed to cover a misshapen tooth or protect a tooth following a root canal procedure.
On the other hand, a dental bridge is a set of dental prosthetics meant to replace the gap created by one or more missing teeth. It is composed of one or more false teeth placed in the gap, with dental crowns covering the natural teeth on both sides. The false tooth is typically made of alloys, porcelain, gold, or a combination of these materials. Aside from its aesthetic benefits, a dental bridge also assists in the person’s ability to chew food properly, maintain the shape of the face, prevent misalignment of remaining natural teeth, and allow proper enunciation of words.
Who Should Undergo and Expected Results
Patients whose dental crown or bridge have become detached and fell off would be advised to undergo the recementation procedure as soon as possible. In most cases, the detachment is caused by the decay of the underlying or supporting natural tooth. Even if the crown was placed to prevent decay, some exposed areas of the tooth are still susceptible to bacteria and could undergo slow decay.
Dental crowns and bridges can also be detached due to trauma. In some cases, people who experience injury or trauma to the jaw or mouth area would need to have their dental crown and bridge recemented back to the supporting natural tooth or teeth. A crown or bridge can also get loose or dislocated from biting down with too much force. Sticky food can also be the culprit.
In some cases, the supporting tooth may have been improperly prepared prior to the initial cementing of the dental crown or bridge. The cementing material may also erode over time and cause the crown to come loose and eventually detach.
This dental recementation process is considered a safe and simple procedure. Most patients report immediate satisfaction following the placement of these dental prostheses. The process typically involves the analysis on why the dental crown and bridge fell off in the first place. Patients are encouraged to take proper care of their teeth to avoid the need for additional dental procedures later on.
How is the Procedure Performed?
There are several types of dental cements that dentists use for re-attaching dental crowns and bridges. Some prefer to use resin cements due to its compatibility with materials used for dental crowns and bridges. There are also non-polymeric cements available while some dentists use glass ion polymer cements.
Before the recementation process, the dentist has to reevaluate if the affected tooth can still be restored or would need to be removed altogether. At the start of the procedure, the dentist has to clean the fitted tooth surface and make sure no cement remnant is left. If there is a need, the surface is microetched using aluminum oxide powder to create a surface suitable for cement adhesion. The surrounding teeth are also cleaned to give the dentist a clean space to work with. In cases where the crown or bridge has been dislodged for some time, there may be a need to remove some of the gums that have tightened over the crown margins and in the space where the false teeth were placed. When there is a need, the dentist removes any overgrown gum using diode laser.
Cementing material is then added to the tooth surface, and the crown or bridge is placed in position. The patient is then asked to bite down on the prosthesis to keep it in place while the cement hardens.
Possible Risks and Complications
Some patients report sensitivity and discomfort following the procedure. If a nerve has been exposed during the recementing procedure, the patient may experience a stinging sensation when the affected tooth is exposed to cold or hot temperature. As with the initial cementation process, a dark line near the gum line may develop. This is particularly evident when the crown is made up of porcelain fused with metal components.