Gangnam Dental Clinic: Retreating Old All-Ceramic Crowns

Hello. I'm Park Jonguk, director of Dream Dental Clinic, a Gangnam-area dental clinic.

Treatment that makes the front teeth look prettier is called esthetic tooth reshaping.

Among the methods of reshaping, there are two: all-ceramic crowns and veneers.

As is widely known, veneers

are a treatment that minimizes tooth reduction

while beautifully transforming the tooth,

while an all-ceramic crown

is a treatment that, in certain situations, reduces the entire tooth

and caps it like putting on a hat, changing the tooth's shape.

There are cases where an all-ceramic crown is absolutely necessary.

1. When severe discoloration has occurred from root canal treatment

2. When a tooth has fractured, making veneers impossible

3. When decay is so severe the tooth needs to be fully capped

and other similar situations.

At our Gangnam-area clinic, we help patients with retreatment using the most appropriate method.

Just as no dental treatment lasts forever,

all-ceramic crowns, too, sometimes need to be redone for various reasons as time passes.

Today we'll look at a case of retreating an all-ceramic crown for esthetic reasons.

This patient had received metal-based crown treatment on four front teeth a long time ago.

It seems to be such an old case that,

at the time, veneer treatment likely wasn't widely known yet.

This method is almost never used these days, so it's probably been over 15 years.

The color and shape of the teeth

were awkward enough that it was hard to call them natural teeth,

and since it had been so long, the gums had receded significantly as well,

so beyond the many esthetic problems,

since the teeth were splinted together,

they were also difficult to maintain,

so we decided to proceed with retreatment at our Gangnam-area clinic.

We analyze the current state of the teeth.

We measure the tooth proportions

and check how to adjust the size differences between the teeth.

We also check the degree of protrusion,

and decided to resolve the protrusion as much as possible.

Because the gums had receded so much,

we also thought through how to address the esthetic aspect of the gums.

From a feeling that was too wide and too short,

we set the width-to-height ratio of the teeth to match the facial proportions,

and based on that, we also decided the shape and size of the tooth beside it — the lateral incisor.

We removed the old crown.

Crown treatment on front teeth

requires a fixed amount of reduction.

The amount can vary slightly depending on the material,

and while I do wonder how it might have gone if veneer treatment had been done instead of a crown from the start,

since veneers weren't as widely known as they are now, not that long ago,

I think this was simply an unavoidable case at the time.

We make temporary teeth

and discuss the size and proportion of the teeth.

We explain the degree of protrusion,

the tooth size, and the size proportion relative to the neighboring tooth,

and listen to how the patient feels about it.

Unless there's a special reason,

most patients hope

for their mouth to pull in and their teeth to become smaller,

but there are limits set by the skeleton and the original tooth position,

so we make adjustments as far as is possible.

The fabrication of the all-ceramic crowns is complete.

Rather than making the whole tooth a single color,

we vary the shading by area

and add translucency and a range of effects at the incisal edge.

For the shape of the teeth as well,

we design them with dimensionality so they can look smaller.

The treatment at our Gangnam-area clinic is complete.

A natural tooth color comes through well.

A tooth isn't pretty just because it's white —

it has to express this kind of varied coloring,

and the color needs to be adjusted

to match the patient's age group and skin tone.

It was designed to bring out a translucent feel toward the incisal edge.

Translucency is a characteristic of young teeth,

so if you want to look youthful, it's good to preserve some degree of that translucent feel.

The treatment was finished so it also blends well with the gums.

This was a case where we were worried about how well the gums would blend, given the severe recession,

but by using temporary teeth

to let the gums adapt well,

we made sure there would be no problem once the all-ceramic crowns were seated.

Natural beauty

Since 2006, Dream Dental Clinic, a Gangnam-area dental clinic