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Patients who live abroad can only stay in Korea for a limited time, so scheduling dental treatment can be difficult. In particular, when an old front tooth crown needs to be replaced and tooth whitening or treatment of discolored teeth is also needed, patients often ask, "Can treatment be finished while I am in Korea?"
Treatment time varies with the condition of the teeth and gums and the type of treatment needed, so not every front tooth treatment can be completed in a short period. Today we introduce the re-treatment of a front tooth crown for a woman in her 40s who lives abroad and had only about 10 days in Korea.
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She had 10 days available for treatment in Korea
This patient is a woman in her 40s. She had front tooth prosthetic treatment in Seoul a long time ago, and she visited us to have the restorations redone because she was bothered by the color of her existing front tooth crowns and the area around the gums. She now lives abroad, so the time she could spend on treatment in Korea was limited to about 10 days.
On examining the front teeth before treatment, the gums around the existing crowns were red and swollen, and a dark shade was visible at the border between the restorations and the gums. A fractured area was also found on part of the existing restorations. The patient felt that the existing crowns looked brighter than her surrounding natural teeth, and she wanted the new crowns to be made in a color and shape that blend with the neighboring teeth.
Before replacing the front tooth crowns, we whitened the natural teeth first.
The patient wanted her natural teeth whitened along with the replacement of the front tooth crowns. In this situation, it helps to check how the natural tooth color changes before deciding the shade of the final crowns, because restorative materials such as crowns do not become lighter with tooth whitening.
Therefore, for this patient the treatment plan was to whiten the natural teeth first and then decide the shade of the final crowns in light of the changed tooth color.
After she visited and had her teeth whitened, we checked the changed color of her natural teeth.
When the existing crowns were removed, discolored teeth were revealed.
After whitening, the existing front tooth crowns were removed. On checking after removal, the four central front teeth had undergone root canal treatment, and dark discoloration was observed in the teeth themselves. For teeth that have had root canal treatment, discoloration may be difficult to change as desired with ordinary external tooth whitening alone.
After checking the condition of her teeth, we performed internal bleaching, in which a whitening agent is applied inside the discolored tooth that has had root canal treatment. The response to internal bleaching and the number of visits needed can vary depending on the cause and degree of discoloration and the condition of the tooth.
We observed the gum condition with temporary teeth.
On the day the existing crowns were removed, temporary teeth were made for her to wear. Because the gums around the existing restorations were red and swollen before treatment, we adjusted the shape of the temporary teeth with the relationship between the gums and the restorations in mind. Temporary teeth do more than simply cover the empty space until the final crowns are completed. During the treatment period they protect the teeth, and they can be used to check the shape and length of the teeth and their relationship with the gums, and to plan the final restorations.
After 3 days, we checked the changes in the internally bleached teeth and the gums.
A few days later she visited again, and we checked the condition of the internally bleached teeth and the surrounding gums. In the teeth that had been discolored, the dark shade had decreased compared with the beginning. The surrounding gums also showed changes in shape and swelling compared with her first visit. However, internal bleaching does not respond at the same speed and to the same degree in every tooth, and the color may change again over time.
We prepared the final crowns to match the changes in the gums.
While observing the gums during treatment, we confirmed that the shape of the previously swollen gums had changed and that part of the root area had become more exposed. Rather than explaining this change simply as the swelling having gone down, it is better to regard it as a process that requires re-checking the condition of the existing teeth and gums and their relationship with the restorations. After checking the changed gum line and the remaining tooth structure, we reorganized the margins and shape of the final restorations and performed an intraoral scan.
We fabricated zirconia crowns.
The final front tooth crowns for this patient were made of zirconia. Zirconia is one of the dental ceramic materials; it has high strength and can be made as tooth-colored restorations, so it is used for front tooth and molar crowns.
The final restoration is affected not only by the material itself but also by several factors such as the condition of the remaining tooth, the design and fit of the restoration, the bite, bonding and subsequent care. For this patient, the restorations were fabricated from the intraoral scan data, and the shade, shape, fit and bite were checked in the mouth before final placement.
We completed the 10-day front tooth re-treatment.
This patient lives abroad, and the time she could spend on treatment in Korea was limited to about 10 days. In this case, treatment proceeded in this order during that period: tooth whitening → removal of the existing front tooth crowns → internal bleaching of the discolored root-canal-treated teeth → observation of the gums with temporary teeth → intraoral scan → fabrication and placement of zirconia crowns.
Comparing the photos before and after treatment, the existing restorations were replaced with new crowns, and changes in the color and shape of the teeth and in the surrounding gums can also be seen. However, the fact that 10 days of treatment was possible for this patient does not mean that every front tooth crown re-treatment can be completed within 10 days.
Can every front tooth crown re-treatment be done in 10 days?
Treatment time differs from patient to patient. A longer treatment period may be needed if there is decay under the existing crown, if root canal retreatment is needed, if there is a lesion around the root, or if gum treatment or gum contouring is needed. Internal bleaching may also require several visits depending on the condition of the tooth.
Especially when the stay in Korea is fixed, as with patients living abroad, it is more important to first check the condition of the teeth and gums and plan the possible scope of treatment and schedule than to force the treatment to finish within the schedule at all costs.
For this patient, we were able to complete treatment through the final front tooth crowns within the approximately 10-day stay in Korea while checking the examination results and the changes during treatment. The before-and-after photos of this case are published with the patient's consent.
Treatment methods, treatment time and results vary between individuals. Depending on the condition of the existing teeth and gums, additional treatment such as root canal or periodontal treatment may be needed, and in some cases treatment within a short period is difficult. The response to internal bleaching and how long the result lasts also vary between individuals, and sensitivity or discomfort after crown treatment, or fracture or loss of the restoration, may occur. The specific treatment method and period are decided after an examination.
In what order is front tooth crown retreatment carried out?
Front tooth crown retreatment starts with removing the existing crown and checking the condition of the tooth and gums. The duration and order of front tooth crown retreatment differ depending on discoloration, gum condition and the remaining tooth structure, and front tooth crown retreatment does not finish within the same period for every patient. If you are considering front tooth crown retreatment, please get a plan explained after an examination.
Related cases:
Front Tooth Crown in Seomyeon, Busan: A Gum Contouring Case for a Patient From Canada
Front Tooth Crown Retreatment in Busan Seomyeon: A Case With Root Canal Retreatment and Non-Vital Whitening
Front Tooth Crown in Seomyeon, Busan: Non-Vital Tooth Whitening and Gum Surgery Together
Related information: Same-day crown & one-day restoration guide · General dental information is also available on the Korean Dental Association.
