Survey of the provision of crowns by dentists in Ireland

The literature is limited on the detailed description of the practice of Irish general dentists in the provision of crowns.

To review the provision of crowns by dentists in Ireland and identify opportunities for improving current clinical practices.

A questionnaire was posted to 500 general dentists selected randomly from the Irish Dental Register and 150 responded. Twenty-three laboratories used by these dentists were subsequently surveyed.

The Vita Shade Guide was the most commonly used shade guide. Crowns were mainly fabricated using porcelain bonded to metal (51%) followed by all-ceramic (42%) and gold (5%). Plastic Solo trays were the preferred tray for impressions and the laboratory prescription form was the primary means of dentist-technician communication. Dentists and technicians have different preferences for impression trays, impression materials and bite registration, while a significant percentage of dentists (18%) admitted to not disinfecting impressions. Resin or resin-based cements are the preferred means of crown cementation.

This study suggests that the accuracy of restorations could be improved by: adopting a multi-technique approach to shade taking; replacing Solo trays with metal or custom trays for impression-taking; upgrading of the putty-wash technique by using a custom tray with a 2 mm spacer and a heavy-bodied/light-bodied silicone; and, using a two-cord retraction technique, perhaps in combination with electrosurgery or soft tissue laser, to improve marginal accuracy where indicated.