You’re about to have a crown done, and you are told that you need a “build-up.” Why do you need a build-up? You may want to refer to the drawings in this chapter as you read this.
Most teeth that need crowns have lost a lot of tooth structure due to fillings, decay, or fractures. So much tooth structure has been lost that the remaining tooth structure is weak and will not retain a filling predictably. The crown is the remedy for such tooth destruction.
The remaining tooth structure needs to have the proper length, width, and smoothness to effectively retain a crown. The tooth needs to be prepared in such a way that the walls of the tooth preparation for the crown have only a slight taper. That way, the crown has good mechanical retention and is not as reliant upon cement to hold it in place. How the tooth is prepared has everything to do with the success of the final restoration. If the tooth is not prepared properly, the crown can loosen. That is not only a nuisance for you. A loose crown can also result in premature decay of the tooth under the crown.
As stated above, most teeth that need crowns have already lost a lot of tooth structure. The remaining tooth structure may be too short to retain a crown and have irregularities that would prevent the proper seating of the crown.
To remedy that problem, we do a “build-up.” A build-up is done to re-establish the desired contour of the crown preparation so that a crown may be retained properly. The build-up is created by your dentist out of a filling material specially formulated for that purpose. It is bonded to the remaining tooth structure and then shaped to the proper length, width, and smoothness to effectively retain a crown.
A properly done build-up is your assurance that your crown will be long-lasting with a minimal chance of crown loss.
Lee N. Sheldon, DMD