Addressing Occlusion Issues with Full Porcelain Crowns: Key Concerns - Dentistry

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Occlusal issues with all-ceramic crowns?


I had full porcelain crowns placed on my front eight teeth, and I am currently wearing temporary dentures.
I have a concern regarding my deep bite; my dentist mentioned that when the full porcelain crowns are installed, some of my lower teeth will need to be ground down to match the height of the dentures.
The inner side of the temporary dentures has already been ground down very thin and is close to breaking.
I am wondering: 1.
Shouldn't the dentures be adjusted to fit the natural teeth? 2.
Will not grinding the natural teeth place a burden on the joints? 3.
Is there still a way to correct the bite after the dentures are installed?

Iris, 20~29 year old female. Ask Date: 2016/10/14

Dr. Lin Jiayong reply Dentistry


Hello: 1.
Due to the necessary thickness of dentures, it is sometimes unavoidable to remove opposing natural teeth, which is a regrettable necessity.
2.
Yes, if the height is increased by more than 2mm, literature indicates that there is a potential risk of joint injury.
3.
If you are a patient who demands perfection and requires a flawless outcome, it is advisable to consider orthodontic treatment before proceeding with all-ceramic crowns.

Reply Date: 2016/10/14

More Info


When it comes to addressing occlusion issues with full porcelain crowns, particularly in your case where you have undergone significant dental work, there are several important considerations to keep in mind.
1. Understanding Occlusion and Its Importance: Occlusion refers to the way your upper and lower teeth come together when you bite. An ideal occlusion allows for even distribution of forces during chewing, which is crucial for the longevity of your dental restorations and the health of your jaw joints. If your occlusion is too deep, as you've mentioned, it can lead to excessive pressure on certain teeth and may cause discomfort or even damage to the dental work.

2. Temporary vs. Permanent Restorations: Temporary crowns are designed to protect the underlying tooth structure while your permanent crowns are being fabricated. However, they should also mimic the occlusion of your natural teeth as closely as possible. If your temporary crown is already wearing down significantly, it may indicate that the occlusion is not ideal, and adjustments may be necessary before placing the final crowns.

3. Adjustments and Communication with Your Dentist: It’s essential to communicate your concerns with your dentist. If they suggested grinding down your natural teeth to accommodate the height of the crowns, it’s important to understand the rationale behind this decision. Ideally, the goal is to achieve a harmonious occlusion without compromising the integrity of your natural teeth. If you feel that your concerns were not adequately addressed during the initial evaluation, seeking a second opinion from another dentist may be beneficial.

4. Impact of Not Grinding Natural Teeth: If your natural teeth are not adjusted to fit the new crowns, it can lead to an uneven bite. This misalignment can place undue stress on the temporomandibular joint (TMJ), potentially leading to discomfort, jaw pain, or even headaches. Over time, this can contribute to more significant dental issues, including wear on the crowns themselves.

5. Possibility of Further Adjustments: Once your permanent crowns are placed, there is still potential for adjustments to be made. Dentists can often reshape or adjust the occlusion of crowns to better fit your bite. However, this should ideally be done before the final placement of the crowns to prevent unnecessary wear on both the crowns and the natural teeth.

6. Long-term Considerations: It’s crucial to consider the long-term implications of any dental work. If your bite is not corrected, it can lead to complications down the line, including the need for additional dental procedures. Regular follow-ups with your dentist after the placement of your crowns will help monitor the situation and make necessary adjustments.

In summary, addressing occlusion issues with full porcelain crowns requires careful consideration and communication with your dental professional. If you feel that your concerns are not being adequately addressed, it is within your rights as a patient to seek a second opinion. Your dental health is paramount, and ensuring that your bite is properly aligned will contribute to the longevity of your dental work and your overall oral health.

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