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Can a crown crown a crown?

1/10/2018

TO LAST BLOG---12-18-2017--Implants, Bone & "Eating"

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MUSCLES: ' What does this question even mean?
Sounds like doggy-talk to me. Would you
please break it down and explain? '

 Dr Skerpan:   Sure. It's meant to be a play on words. Often people use terms
interchangeably & that can lead to confusion. Let's break it
down into 3 parts. Firstly the first "crown" in the question
refers to the restoration a laboratory makes, commonly also
called a "cap". Here we mean that the top-part-of-the-tooth
needs to be en-"cap"-sulated for some reason like for
  rebuilding, protecting, or reshaping. Rebuilding---if the
top-part-of-the-tooth is greatly broken-down and not
functioning. Protecting---if the top-part-of-the tooth is
brittle, like after a root canal. Reshaping---or "better-
looking", as in cosmetic dentistry or smile makeovers.

MUSCLES: ' What happens if there is only a smaller bit of the top broken
or decayed? What happens then? '

Dr Skerpan: If a little is gone, a filling can be done. If more is gone,
   a buildup, an onlay or a 3/4 crown may be fabricated
depending on the amount of structure left.
But let's "stay" with the concept "crown" for now.
Let's look at some pictures to clarify.

Image of front tooth on lab-model shaped to make ROOM for the

On this lab-model, the top-part-of-the-tooth is shaped to make ROOM for the "crown". The upper arrow points to where the "crown" will end at the gum-line.

On this lab-model, the lab-made "crown" is fitted over the top-part-of-the-tooth to en-"cap"-sulate it.

The lab-made "crown", for the upper front top-part-of-the-tooth, is seated completely down.

   MUSCLES:   ' I don't want to get confused, but when I look in my mouth I see
sharp-shaped "teeth", but when I look at your mouth I see funny
flat-topped "teeth"---right? '

  Dr Skerpan: Actually, you don't see any WHOLE teeth at all. So, the third "crown"
in the question would be referring to the anatomical name for the
top-part-of-the-tooth. For example, you see the WHOLE-TOOTH
when the WHOLE-TOOTH is extracted. In reality, the WHOLE-
TOOTH is not just what you see above the gum-line. The WHOLE-
TOOTH is made up of the ROOTs PLUS the top, which is also called
the anatomical "CROWN".

MUSCLES:   ' B-Wow-Wow-Wow a minute! Backup--let me see more pictures! '

Image of upper WHOLE-TOOTH in a clear model, with bone-level, ROOTs & anatomical

This is an upper tooth in a clear model. The bone-level is out-lined in blue. The upper arrow points to the ROOTs which are surrounded by BONE. The lower arrow points to the top-part-of-the-tooth which is ABOVE the BONE----OR the anatomical "CROWN"!

Again, an X-Ray explaining the same thing. Here the bone-level is out-lined in blue. You can see the ROOTs are anchored inside the BONE. The anatomical "CROWN" is the part you see in the mouth above the bone.

Drawn close-up picture of a WHOLE-TOOTH showing ROOTs in-the-bone PLUS the

To summarize---the ROOTs in-the-bone PLUS the "CROWN" seen above-the-gum == the WHOLE-TOOTH.

MUSCLES: ' I like the idea of the "bone"! But what does the second "crown" in
the original question mean? '

Dr Skerpan: The second "crown" in the question adds to the confusion.
Sometimes you may hear it said that a tooth needs to be "crowned".
In this context it actually means that the top-part-of-the-tooth
needs to be "covered" with a crown--as we said before, when the
top-part needs rebuilding, protecting or reshaping. The "covering"
("crowning") acts to simulate a functioning-shape, and restore the
healthy-state on the top-part-of-the-tooth.

MUSCLES: ' Then it IS possible that a "crown" (or a lab-made "cap") can "crown"
(or "cover") a "crown" (or the "anatomical" top-part-of-the-tooth).
But I still like the idea of the "bone"! Can we talk more about that? '

Dr. Skerpan: We can discuss more about the bone later, when we tackle the
the "periodontal" aspect of dentistry.