Patient Factors in Dental Crowns

Patient Factors

• Pre-existing allergies to any component of the crown material (metals, alloys, or cement) are a contraindication due to potential severe allergic reactions. A thorough patient history is essential.
• Inadequate oral hygiene increases the risk of gingivitis, periodontitis, and other oral infections around the restoration. Addressing hygiene issues is necessary before placement.
• Active oral infections, including active periodontal disease, acute or chronic infections (abscesses), or untreated caries, are contraindications. Dental infections jeopardize the long-term success and stability of the crown. Treat infections before placement.
• Medications influencing blood coagulation, such as anticoagulants and antiplatelet agents, require careful consideration and possible medication adjustments due to potential complications during and after surgery.
• Poorly controlled systemic conditions like uncontrolled diabetes, autoimmune disorders, and certain cardiovascular diseases may increase complications during the procedure or negatively impact long-term crown success. Consult with the patient and their physician to balance risks and benefits, potentially modifying the treatment plan.
• Anxiety, fear, and lack of cooperation from the patient can cause complications and affect long-term oral health. Managing patient concerns and ensuring adequate dentist communication and support are crucial.

Technical and Clinical Factors

• Inadequate tooth structure after preparation can lead to crown instability and fracture, including narrow/short teeth or significant loss of structure.
• Teeth with anatomical irregularities or severely weakened structures (attrition, abrasion, malocclusion) may not be suitable for full-metal crowns.
• Limited supporting tooth structure or poor occlusal contact relationships negatively impact the long-term stability and strength of the crown. Assess opposing dentition and bite patterns for a viable treatment plan.
• Unstable or poor prognosis adjacent or opposing teeth may make full-metal crown placement less optimal, causing potential stress or strain on the supporting structures.
• Excessive bone loss/resorption around the tooth root compromises crown stability. Carefully consider bone density surrounding the teeth for long-term restoration success.

Other Factors

• Patient preference should preclude further consideration if a patient expresses a strong preference (and has valid reasons) against the procedure, regardless of other factors.
• Financial constraints may make a full-metal crown unaffordable. Consider alternatives.
• Resin composite restorations, inlays, onlays, or other restorations are alternatives if they offer a successful outcome with reduced risk, particularly for teeth nearing full-loss or root loss.

This quiz covers critical patient factors that must be considered before the placement of dental crowns. Topics include pre-existing allergies, oral hygiene, active infections, and the impact of medications on blood coagulation, all essential for ensuring the success of the dental restoration. Test your knowledge of these important contraindications.