I have two veneers on my two front teeth. I need the veneers replaced. My dentist wants to crown one of my teeth as I had a root canal a few years back. The other tooth is perfectly healthy but needs a new veneer. My dentist also wants to do a crown on this tooth as he says it will be easier for the dental lab to match two crowns than match a crown and a veneer. These are my two very front top teeth. Does this sound right?
Dental Crowns or Veneers for Two Front Teeth?
Doctor Answers 11
2 Veneers is the way to go!
In dental school, dentists were taught to automatically crown a root canal tooth. With advances in adhesive esthetic dentistry we no longer have to follow that rule with anterior teeth.
The root canal tooth should be fit with a fiber post to give it added strength without compromising esthetics and both teeth prepared for porcelain veneers. The veneers should be designed in such a way so they look much like 3/4 porcelain crowns for added strength and longevity.
I have done this many times over the years with great success.
Crown and veneer combo should be fine
There is a valid argument to a full crown on the tooth that had the root canal, but if were me, the veneer would remain a veneer on the adjacent tooth. If the crown is going to be with a metal core, then yes, matching the color would be hard. I just wouldn't recommend the metal core type. I would ask for a brand of all porcelain crown and veneer called empress, and the color matching should not be too difficult.
Dental Crowns or Veneers for Two Front Teeth?
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Dental Crowns or Porcelain Veneers for Two Front Teeth, One of Which had a Root Canal
I don't think I can give an accurate answer without knowing more, seeing a photo of the tooth in question and the radiograph (x-ray). However, there is a changing consensus in dentistry on whether or not to place a veneer or crown on a root canal tooth. The old thinking was to always place a crown on a root canal tooth. The newer thinking is to preserve as much of the tooth as possible, meaning place a veneer rather than a full crown restoration. One thing happens when the dentist prepares a tooth for a full crown, he removes the bump on the backside (tongue side) of the tooth, called a cingulum. Some studies have show that when this is drilled away for full crown preparation that the tooth becomes 50% weaker compared to a tooth that had a porcelain veneer and did not have the cingulum drilled off.
I have done many cases where one of the front tooth is a porcelain veneer and the other is a porcelain crown. However, you get the best match in color, shape and contour when both front teeth are prepared the same way (i.e. either for full crown or porcelain veneers).
So, saying all of this, but not having the opportunity to actually evaluate your teeth, all I can say is that if you consulted ten cosmetic dentists my bet is that you would get three different answers. Several would agree with your dentist and do one crown and one veneer. Several would want to do full crowns on both teeth. And the remaining, like me, would prefer, if possible, to do two porcelain veneers.
One last thought. Your dentist might recommend placing a post in the top 2/3 of the root canal tooth. This is a good idea, as it will strengthen the root canal tooth considerably. However, make sure he uses a bonded fiber post (it's like kevlar fiber, strong as metal, often used in bullet proof vests), and does not use a metal post. A metal post can't effectively be bonded into the root canal space and also may case a dark shadow that will make that tooth, and veneer or crown, look darker than the non-root canal tooth.
Crown or Veneer
The dentist is correct that it will be easier to match the two teeth if they are both crowns. This comes at the expense of removing healthy tooth structure.
I would base my decision on the darkness of the teeth. If the tooth with the root canal is very dark then I would recommend a crown to block out the discoloration. If the tooth is not discolored then you might be able to get away with another veneer. What you do with the other tooth depends on the skill of the dental technician. Some labs are very good at getting a veneer to match a crown, some not so much.
Porcelain Crown Or Veneer For Root Canal Treated Front Tooth?
This is difficult to say for sure without pictures, but typically we could do a crown and veneer and make them match perfectly. We always want to be as conservative as possible without sacrificing aesthetics. Hope this helps.
Dental Crowns of Veneers on two front teeth
Your end goal is important here and I imagine aesthetics would be one of your main concerns considering these are your two front teeth. The Two front teeth set up your whole smile and since aesthetics is tied in closely to bilateral symmetry it is important your two front teeth match as close as possible. In fact in Comprehensive smile design we use the front two teeth to guide the aesthetics of all the teeth involved in the smile design.
Matching two front teeth, one a crown and one a veneer along with your natural teeth can be a challenge, but as pointed out, todays materials (ex. eMAX, Empress) can be matched up very well.
A few things have to be taken into account to achieve the best result if you are only restoring two front teeth. You are going to be limited in terms of space and colour based on your natural teeth beside the ones being worked on. Also, the shade of the two teeth being restored, (under the old veneer and crown) will determine how thick the veneer and crown will have to be and what materials are best to use under your particular circumstances.
A well trained Cosmetic dentist and lab will work together to give you the best possible solution, pick best material, the best ingot, etc. for your specific needs.
In your case, maybe two crowns would be the way to go. without pictures and radiographs (X-rays) it would be hard for any of us to give you a definitive treatment plan. Hopefully the comments here will at least give you a good starting point to have an open discussion with your treating doc.
Cant say without a visusl exam.
This is a very good question. Unfortunately it simply cant be answered definitively without an exam.
Although some of the other doctors have given you definitive answers, there are just too many variables. Indeed it is quite possible that you would have a superior esthetic result if you chose 2 crowns of the exact same material.
If you are interested in two veneers rather than two crowns, I would recommend a in person consult with an experienced cosmetic dentist.
New materials match
With the newer materials we have today there should not be a problem matching crowns and veneers on front teeth since they can be made with the same materials without metal underneath the porcelain. Whether or not a root-canaled front tooth needs a crown depends on how much strong tooth structure is remaining. I prefer to preserve as much tooth structure as I can, so I lean toward a veneer if possible.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.