Gold crowns:
I recommend gold crowns when they will not be obvious when a patient talks or smiles. They will never break and the wear rate is essentially the same rate as enamel. A well made gold crown can serve for 20 to 70 years.

Porcelain veneer crowns:
Porcelain veneer crowns are made with a thin metal cast crown to fit the prepared tooth precisely and the porcelain is then bonded (baked) to the metal. These crowns can be very cosmetic but the porcelain can still break. When the porcelain breaks the cast metal core stills protects the tooth.

The patient makes the final decision as to the type of crown made. Many patients choose the all porcelain or porcelain veneer crown over the gold because they want to match the color of their natural teeth.

A nightguard serves to protect porcelain crowns and protects the natural teeth at the same time.

Bridges:
Bridges are either:
1. cemented (fixed) in place over natural teeth

Before
After

or:
2. removable bridges, which are generally referred to as removable partial dentures

Both types may replace one missing natural tooth or several natural teeth. Cemented (fixed) bridges are made utilizing different types of crowns.

If you are you missing one tooth and reluctant to have the adjacent teeth cut down for a cemented bridge, placing an implant with a crown attached to the implant is an obvious choice.

Special bonded bridges:
(healthy adjacent teeth are required)
Example of Maryland Bridge:

One is the Maryland Bridge- Using this technique, adjacent teeth can have minor reduction of tooth structure and this type of bridge can be bonded to the teeth. I have a Maryland bridge myself (replacing the two upper central incisors) because I did not want the adjacent perfect teeth cut down. All Maryland Bridges will eventually fail (because of loss of the bond between the metal and the bonding cement), and I was willing to accept that risk.

A second type of bridge is a metal free technique by which using a porcelain false tooth (pontic) bonded to adjacent teeth utilizing a combination of bonding materials. Under the right circumstances this is an excellent option.

A Solopontic bridge can be used. This technique utilizing bonded materials, looks great, but is not as strong as other bridges. This would be an excellent bridge to use for a short term need.

Another option is bonding the crown portion of a patient’s natural tooth to adjacent teeth if the patient has a sound tooth that must be extracted because of bone loss around the root or similar reason. I have utilized this technique for as much as 22 years, and I know that one of the bonded bridges is still in place after 19 years of service.