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Question:
Cracked surface on bridge: I have a 5 tooth porcelain bridge in the front of my mouth.
One of the teeth has a cracked surface which has become stained from food. My dentist has been unable to polish it off. It is very unsightly and I would like to have it corrected.
Is there some way to improve the appearance without replacing the entire bridge which would cost several thousand dollars?
Is it possible to put a veneer on the one tooth of the bridge? Is there some other procedure? Is there something that would bond to the porcelain to repair this site? ...Visitor from TX
Answer:
It is always unfortunate when one crown of a bridge breaks. There may be several ways to repair the broken tooth.
One is to use a strong acid called hydrofluoric acid on the chipped porcelain, then apply silane and then dental adhesive. This is followed by adding white filling material. It may work for a while, but will always be less strong than the original crown, and the filling material would be susceptible to staining.
Another option is to "re-crown" the tooth. It is very difficult to match the shade exactly when you are replacing one tooth of five. The dentist would remove some of the cracked crown, take an impression, and then cement or bond a facing of porcelain over the tooth. Again, this will be less strong than the original.
A lot of the decision process would include how old the original bridge is (over 7 years old and I would probably opt to replace the whole bridge). Another is if the bridge is actually all-porcelain or metal covered with porcelain. I think that all-porcelain would be more predictable to repair.
If you decide to replace the bridge, have a consultation with your dentist to research materials that are less likely to break again. Some new materials are Procera and Lava, but everything comes with potential problems.
These materials are very strong, but I am hearing that sometimes one side will come loose from the cement (these materials are cemented, not bonded). All-porcelain such as Empress is not strong enough for a five tooth bridge.
A stronger porcelain material is called Eris. It is not as beautiful as Empress, but is more reliable for a bridge.
Still another choice is Captek, which is gold foil over the tooth covered by porcelain. The gold is a true gold color which shines through the porcelain like the inner dentin layer of your natural tooth. This material also keeps the gum tissues healthy because it resists plaque.
I have had a lot of success with Captek for anterior bridges because it is strong and looks great.
Corinne Scalzitti, DMD, MAGD
Austin Reconstructive Implant Dentistry
Texas Periolase
3900 RR 620 South
Austin, Texas TX 78738
(512) 263-3330
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