Question for dentist regarding crowns

You are not my dentist, etc. . .

Shouldn’t a dentist take impressions of your teeth before removing the surface for crowns?

Why would a dentist create temps that looked nothing like the original teeth?

The long version:
About 20 years ago I had veneers placed on teeth 4 to 13. I have an overbite so the mamelons never wore and at my request the veneers had them to match. They also matched my tooth color which is naturally very yellow due to thin enamel with the dentin showing through.

Fast forward to last year. Everyone has super white teeth. Everyone gets bleaching from the dentist or the pharmacy.
My veneers were starting to chip around the gum line and my gums have receded so I decide I wanted 4 to 13 super white crowns. I also decided to get crowns on 22 to 27 for cosmetic reasons and 19, 20, 28 and 29 existing crowns needed to be replaced.

I shopped around. Pretty much every dentist in my area did only porcelain over metal and the teeth looked like blobs of opaque white without any shading or shine and metal showing at the gum line.

August 2012 I went to a dentist who was highly recommended by a work friend. I told the dentist I wanted to replace the veneers with crowns but not have mamelons and have crowns on 22 to 27 the following year (2014). I said I wanted super bright shiny white; not opaque cheap looking teeth. He said I needed braces too. I agreed teeth 23 to 26 were very twisted and crooked but I had managed to smile with confidence every day after I got the veneers.

I was told my upper crowns and braces would be $22,000 with a 5% discount if I pre-payed. I agreed to the braces with the caveat that I must have my permanent crowns in place by 12/31/13 at 5PM. I paid.

I only needed braces for 42 weeks. Finally on 10/10/13 I had the appointment to prep 4 to 13 for the crowns. He gave me novocaine. He removed a tooth surface, took an impression, made and placed a temp, repeat. This process took over 8 hours and necessitated numerous additional shots of novocaine. 4 and 5 and 11 and 12 were one unit each with the other 6 separate teeth.

After a couple of days the novocaine and swelling finally diminished enough to open my mouth. To my horror teeth 6 to 11 looked nothing like my teeth They were over 1/4 inch longer, 1/8 thinner and severely angled out from the gum line.

11/26/13 He placed permanents 4, 5, 12 and 13. And made new temps for 6 through 11. He placed the temps, added material, drilled material, added material and drilled again and sanded and on and on and on for six hours. I was advised to go home and call in 7 to 10 days to make the appointment for scans photos and impressions to send to the lab for the permanent teeth.

I got home looked at my mouth. OMG! These were still long horse teeth that stuck out on an even worse angle. I immediately called to advise they still were not right still not shaped at all like my original teeth.

12/02/13 He admits he never took impressions of my original teeth. They took scans for the invisaligns and for the crowns lab. He said the lab would send him a wax mock-up he could use to make temps.

12/05/13 He places one solid unit temp of 6 to 11 which is a bitch to floss above. Finally though it is shaped like my original teeth only no mamelons.

12/12/13 More impressions with and without the temp in place. More photos and a video of me talking for the lab.

Before I beat the crap out of this dentist and my ex-friend from work I want to know if this situation is unreasonable.

My smile is really important to me because I never went to a dentist until I was 16 and could take myself. I paid for all the fillings and everything else I needed due to never being given or even told about a tooth brush let alone floss.

Dentist here.

I take pre op impressions of the existing teeth about 99% of the time, makes it a lot quicker and easier to make the temps.

Over eight hours for ten crown preps seems slow.

Double abutting the premolars 4-5, 12-13 is a bit unusual. Maybe he had a reason like strenght or retention. You won’t be able to floss between them, you’ll have to use a floss threader. It will be just like trying to floss the six unit temp he made. FWIIW sometimes I make a multiple unit temp if needed for retention.

Crowns here run about $1000 and braces $5-6000 but cost vary greatly by location.

A couple of days to be able to open after crown preps also seems odd, extractions sure, crowns not usually.

When he seated the premolars and made spent six hours making the temp he didn’t take the final impression? Didn’t he take it the first time? Not sure why he wouldn’t have done them all at once since he preped them all at once.

Don’t know if the situation is unreasonable, always two side to every story, but seems like what you’ve gone through sure isn’t average.(trying to be charitable here)

As for all the dentist in the area only doing porc. to metal crowns you might check the yellow pages(I’m old), online or the local dental society for someone who does Bruxzir crowns(no metal substrate). You could go to Bruxzir.com and find a lab in the area that does Bruxzir crowns and ask them who the dentists are that send them the cases.

Best of luck.

rsat3acr Thank you so much for the reply.
During the course of being his patient he did take impressions and scan using an iTero. However he said he forgot to take impressions immediately before removing the surface of the teeth when I asked him why he was not just making the temps from the mold he would get from the impression.

I thought the iTero scans were only for the invisaligns; but after checking the website of many labs that use BruxZir (thank you again!) I see the labs use that too.

I was so worried my permanent teeth would look as weird as the temps he made. But now that I know the lab utilizes the scans I feel a bit better.

If I wasn’t so shy I would post pics to show the evolution from the veneers to now. Some of the temps were laughably weird like a claws protruding from my gum.

Also, next year when I replace the lower teeth, 22-27, I will find another dentist using a backwards referral from a lab.

Thank you!

You are very welcome. Let us know how it all turns out.