Cosmetic Dentistry Midland Texas

Country: United States
State: Texas
City: Midland

Overview of Teeth Whitening

Teeth whitening is used to correct discoloration of the teeth by removing the brown and yellow staining. The term "teeth whitening" can refer to a number of techniques to improve the brightness of the patient's teeth. Among them are chemical whitening, mild acid whitening, abrasive teeth brightening and the newest technique, laser teeth whitening.

Teeth Bleaching

Teeth bleaching is chemical process used to lighten the color of the patient's teeth. The procedure can be performed entirely in the cosmetic dentist's office or it can be performed by the patient in their home, using a materials provided by the dentist. The home method is often used because it saves the patient from having to make an office visit for each treatment.

Before the patient embarks on the home teeth whitening regimen, the cosmetic dentist creates a custom mouth tray for the patient. The custom tray is a critical component of the treatment. It ensures that the correct amount of whitening solution is used and that the patient's teeth are properly exposed to the whitening solution. The custom made mouth tray provides for a better fit than a one-size-fits-all mouth tray to help increase the margin of patient safety.

The steps in the home teeth whitening regimen are fairly straightforward. The cosmetic dentist's office provides the patient with the materials and instructions and also answers questions the patient may have about the routine. Your dentist's office can also provide you with off-site supervision should you have any questions once you've begun.

A home whitening session can last for two to three hours, during which time you will have the tray and solution in your mouth. Depending upon your needs and desired results, your dentist may instruct you to keep the tray in your mouth overnight. Typically, you will follow your home teeth whitening regimen for two to three weeks, after which time you will return to your cosmetic dentist for a follow up visit.

TOOTH WHITENING

Sometimes a single tooth becomes discolored causing it to look out of place with the rest of your smile. In these cases you may want to consider having the tooth whitened to match the rest of your teeth. If you'd like to learn more about what causes the discoloration and what can be done about it, please follow the links below.


How much can a tooth be whitened?

How white an individual tooth can become from bleaching and whitening is a common question. Some whitening procedures claim they can whiten your teeth by up to nine shades, but that is highly unlikely. A change of two or three shades will make a significant difference in just about anyone's smile. There is no one standard system in the dental field to measure and determine tooth color. However, the Vita shade guide is the most used. This guide divides individual tooth color into four basic shade ranges:
A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray).
In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.

Not all of your teeth are the same natural color. As strange as it may sound, usually your eye teeth are darker than the others, and your front teeth are almost always the whitest, and molars tend to be a shade between those two. When your cosmetic dentist is whitening one particular tooth, they will take this into account. The goal for everyone is to achieve an overall whiteness while still looking natural. During your first consultation for tooth whitening, your dentist will go over what you personally can expect for your specific smile. How a white tooth will become will vary from person to person. The structure of your tooth and the type of procedure implemented will affect the outcome.

The following chart will give you some idea of what to expect. As everyone's circumstances are different, options should be further discussed with your cosmetic dentist prior to making a decision. Most people are not seeking a gradual whitening of an individual tooth. The laser whitening procedure affords the cosmetic dentist the needed control and the patient the instant results sought.

Procedure: Usually Lasts For: May Cause During and Shortly After Procedure: Time for Procedure: Changes in Shade: Average Cost:
Laser 12 - 18 Months Minor Discomfort 2 - 3 Hours 7 - 8 $ 300.

ROOT CANALS

Dental Root Canals for Your Teeth

Many of us have heard the comparisons of painful things to the root canal procedure. It's not that bad. There are tiny canals within your tooth that may become infected. This leads to the pulp inside your tooth also becoming diseased. Either your dentist or an endodontist to remove any infection performs the root canal procedure. The canals are then filled and the tooth receives either a filling or a crown. Crowns are more common in most cases as they add strength to the tooth itself. The procedure itself takes one to two visits.

What are Root Canals?

There are tiny canals within your tooth that may become infected. This leads to the pulp inside your tooth also becoming infected as well. Either your dentist or an endodontist to remove any infection performs the root canal procedure. The canals are cleaned and then filled and the tooth receives either a filling or a crown.

How much do dental root canals cost?

Expect the cost of a root canal treatment to be about $400. to $600. per front tooth and about $500. to $800. for a molar. The difference is because front teeth usually have only one root canal and molars usually have three or more. The costs for a crown or permanent filling are additional. Costs for a second root canal, hopefully not needed, on the same tooth are slightly higher.

How much do tooth veneers cost?

Porcelain Veneers typically cost between $900 - $2,500. per tooth and require two or more visits one to two weeks apart. Veneers made of porcelain provide a greater longevity than plastic, typically ten years to fifteen years or more.

Composite Veneers cost significantly less, around $250 per tooth or more, but only last from five to seven years typically.

Generally speaking, the price of tooth veneers and whitening increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover the cost of the tooth veneers procedure.

How to select a color for your veneers.

When considering veneers a common question is how white the veneers should be. Usually, the answer is to whiten your natural teeth to either the level of whiteness you want or to the brightest they can be. Your cosmetic dentist will then have the veneers made to that color. Teeth are of course not monochromatic, so typically more than one color is used to create a very natural look. This color variation is critical in avoiding fake or artificial looking teeth. It is the internal contrast of colors that help create vitality. The internal play of light on the porcelain in the restoration helps to create this vitality. Surface texture is also very important, and helps to break up light reflections and make the crown or veneer look more natural.

There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:
A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray).

In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.

Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural.

Most dentists will show you a shade chart (like the above mentioned Vita Shade Guide) for you to pick from. Keep in mind, with a good cosmetic dentist this is merely a starting point. Other considerations when determining the color of veneers for each patient are your complexion, hair color, the color of your natural teeth and even your eye color.

Overview of tooth contouring and reshaping

Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session. This procedure is even a substitute for braces under certain circumstances. This is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.

How is tooth contouring and reshaping accomplished?

Preparation for dental contouring and reshaping is a team effort with your cosmetic dentist. Some dentists in cosmetic dentistry even use computer imaging to show you how you will look after the procedure.

Your cosmetic dentist will take x-rays to evaluate the size and location of the pulp of each tooth to ensure that there's enough bone between the teeth to support them.

The cosmetic dentist will mark your teeth with a pencil prior to performing the procedure. This helps the cosmetic dentist in their sculpting process. As your cosmetic dentist sculpts the tooth, imperfections are artfully eliminating or minimized. A sanding drill or laser may be used to remove small amounts of surface enamel gradually. Abrasive strips are then moved back and forth between your teeth to shape the actual sides of your teeth. Then the teeth are smoothed and polished. Usually anesthetic is not needed. Teeth contouring and reshaping usually takes one to three visits.

Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping to achieve a beautiful smile.

How much does tooth contouring and reshaping cost?

Your dental insurance is likely to cover tooth contouring and reshaping only if it is needed as a result of an accident, but this is a relatively inexpensive procedure. The cost depends on how much the dental reshaping is needed, but average costs are approximately $50 to $350 per tooth.

Pros and Cons of a tooth contouring and reshaping

Advantages:
Your dentist can remove only a small amount of tooth enamel, contouring your problem tooth into a more pleasing shape for an improved smile. The tooth contouring procedure is quick, simple, painless, and inexpensive.

Disadvantages:
There are limits. You may be at risk for tooth breakage and decay if too much enamel is removed your teeth. If your teeth were uneven because you grind them, they'll become uneven again until the grinding issue is resolved. Your dental insurance is likely to cover tooth contouring and reshaping only if it is needed as a result of an accident.

Overview of dentures

Dentures are removable replacements for missing teeth typically made out of an acrylic resin which may at times incorporate porcelain or metal for additional structural support. There are two main types of dentures, complete and partial. Both Complete dentures and partial dentures are finely crafted and custom-fitted to the patient. If you properly maintain your dentures they will appear natural and provide a perfect smile. Additionally, dentures help strengthen muscles controlling your expressions that require the support of your teeth, rid you of pronunciation problems caused by missing teeth and aid with chewing.

How are dentures accomplished?

It is somewhat common to require for some teeth to be extracted, and surgery in some cases is necessary to improve the bony ridges that stabilize your dentures.

The procedure begins with a wax bite impression of your mouth that will give your dentist exacting measurements. A try-on appointment will fine tunes color, shape, and custom-fit.

After your final dentures are fabricated, they will be placed and informed of their required care.

Pros and Cons of a Dentures

Advantages:
Dentures definitely provide a great smile with a very natural appearance. They're made of very durable materials and last very long when properly taken care of. Typically dentures last from five to ten years. They also correct several problems, from speech to chewing, for many patients.

Disadvantages:
There's no doubt that dentures take a little getting used to. There is maintenance involved, and initial speech issues to overcome (these are temporary and last only a couple of days). Mouth irritation or sores may occur, but are usually caused by poor dental hygiene, and not removing your dentures when needed. It is common that your mouth change over the life of your dentures, so even though they last long, they may need to be replaced to achieve a better fit before they are worn out. With a denture a person typically chews at only 15-23% efficiency compared to a person chewing with their natural teeth. In the case of a full upper denture, the upper palate is covered which can reduce taste of foods you're chewing.



Who is a candidate for dental caps?

If you grind your teeth, have an improper bite, have fillings or tooth decay you have contributing factors to the wearing down, cracking or breakage of your teeth. Dental caps cover the entire visible surface of your affected tooth and add strength, durability and stability.

A cosmetic dentist will usually be able to identify problem areas in your mouth that might lead to tooth damage and a need for caps. Chewing patterns play a big role too. By selectively grinding the tips of your middle and back teeth (cusps) will alter your bite to reduce the stress on your at-risk teeth.

How are Dental Caps Attached to your Tooth?

A cosmetic dentist will make an impression (mold) of your tooth and a dental laboratory will create the needed custom cap. You will typically leave the office with a temporary cap to wear while the permanent cap is being made - this takes about fourteen days. The permanent cap is then cemented onto your tooth. Typically, only two visits are required for this part of the procedure. Often, a preliminary restoration of your tooth may be needed before the permanent cap is actually placed. To stabilize your tooth, a filling must first be put in place prior to placing a cap to counter any loss of your original tooth structure.

It is important to discuss with your cosmetic dentist that the cement color used for your permanent cap will be the same as used for the temporary cap (try in paste). The color of the cement does affect the overall color of a porcelain cap, so this needs to be discussed well before your temporary cap is placed.

In some cases your cosmetic dentist may choose to use a Flipper instead of a temporary cap. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent cap.

How much do dental caps cost?

Porcelain caps cost more because they are usually more time-consuming than gold caps. Porcelain and gold caps will average between $500. to $3,100. in total cost.

The relatively new reinforced resin or bonded all-porcelain type of caps cost more, and may exceed your insurance plan coverage for caps.

Usually, the price of dental caps increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover all the costs of the dental cap procedure.

Pros and Cons of Dental Caps Types

Dental caps in general add a good deal of strength to a weakened or worn tooth, and last ten to fifteen years. Depending on your habits and the condition of your gums, there may be some drawbacks for you. Your cosmetic dentist will advise which is best for you given several factors, such as how important appearance is to you. The following are the advantages and disadvantages of the most common types of caps.

Gold Caps

Advantage: The preparation of your tooth for a gold cap is the simplest and least complicated preparation. There is minimal tooth structure removal with as much as possible of the healthy tooth structure remaining untouched. As porcelain is hard by comparison, it may cause wear on opposing teeth over the years where gold is not as likely to do this. Gold is also easier to place to the area where the tooth and cap meet for a better fit. Gold is also a healthier environment for the gum tissue.

Disadvantage: The biggest disadvantage to gold caps is cosmetic, unless it is being used in the back of your mouth.

Porcelain Caps

Advantage: Porcelain caps or the new reinforced resin types are considered to be the most aesthetically pleasing, as it is so easily matched in color to your surrounding teeth.

Disadvantage: The thickness of the porcelain required for pleasing aesthetics also requires that more tooth structure is removed. Also, it is more difficult for your cosmetic dentist to get an ideal fit where your gum meets the cap. Gingival inflammation is typically more common with porcelain caps than gold caps.

Porcelain Fused-to-Metal Caps

Advantage: Porcelain fused-to-metal caps have a very natural and pleasing appearance.

Disadvantage: They have a metal substructure and require an opaque below the porcelain, which can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the cap, by your gum as your gum recedes with age.

What are dental implants?

Dental implants are fixtures of titanium which are surgically screwed into your jaw bone. The implant is an anchor for a naturally-appearing false tooth or a set of false teeth. The success rate of dental implants depends on where the implants are placed and their purpose. They are typically best placed in the front portion of your lower jaw. Implants are great for replacing missing teeth. It is important that you have enough bone in the area of the missing teeth for the implants to be attached to. Implants are not only used to replace one tooth, but rather people missing most, if not all, of their teeth benefit greatly as well. Implants are increasingly being used to replace certain types of bridges and removable partial dentures.

Who is a candidate for dental implants?

If you're missing one tooth or all of your teeth, implants may well be for you. So long as you have enough bone in the area of the missing tooth to facilitate the anchorage of the implants, this procedure can yield terrific results. If you don't have enough bone for this purpose, a bone graft may be necessary. If you have a small dental bridge or partial dentures (removable type), implants will be a welcome alternative. Implants are an alternative to a fixed bridge. The implant will last a lifetime, but the crown on top of it will last ten to fifteen years.

How much do dental implants cost?

Dental implants can be a costly procedure. An entire team of professionals are needed to deliver a long-lasting smile. Implant procedures demand a great deal of the doctor's and staff's time and effort. The prosthodontist intensely studies your health profile, and then develops a plan to meet your unique needs. Additionally, surgical staff and the laboratory perform several services to produce the desired result. The materials used to construct implant prosthodontics are also very expensive. Bone grafting, if needed, is additionally costly.

While a basic implant is typically $1,250. to $3,000., depending on your circumstances additional costs for things such as in the case of a posterior mandible, bone regeneration, sinus elevation, and wide diameter or narrow diameter implants quickly escalate to as much as $15,000 to $30,000. for the complete procedure for the upper or lower jaw.

Pros and Cons of Dental Implants

Advantages:
As our life span increases, a permanent dental replacement like implants is increasingly important as we get older. While dentures and removable bridges are usually loose and unstable, implants provide you with dental replacements that are both natural looking and very functional. Implants look much better, and feel better, than traditional removable bridges, and offer the same force for biting as bridges that are fixed in place. Implants will last your lifetime.

Disadvantages:
Implants are a major investment and not without risk. The extensive use of implants can cost tens of thousands of dollars to achieve a great result. It is also a very time consuming procedure when having many implants placed. As this procedure is surgery, it is very important to research and find a well credited cosmetic dentist that you are comfortable with. For some people there are varying degrees discomfort or pain, which subsides in a couple of days. As with similar types of surgery, bruising and minor swelling might also develop shortly after the procedure. The crown (false tooth placed on top) will need to be replaced in ten to fifteen years.

How to choose the color of dental implants?

When considering dental implants a common question is how white the dental implants should be. Usually, the answer is to whiten your natural teeth to either the level of whiteness you want or to the brightest they can be. Your cosmetic dentist will then have the dental implants made to that color. Teeth are of course not monochromatic, so typically more than one color is used to create a very natural look. This color variation is critical in avoiding fake or artificial looking teeth. It is the internal contrast of colors that help create vitality. The internal play of light on the porcelain in the restoration helps to create this vitality. Surface texture is also very important, and helps to break up light reflections and make the dental implants look more natural.

There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:
A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray).
In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.

Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural.

Most dentists will show you a shade chart (like the above mentioned Vita Shade Guide) for you to pick from. Keep in mind, with a good cosmetic dentist this is merely a starting point. Other considerations when determining the color of dental implants for each patient are your complexion, hair color, the color of your natural teeth and even your eye color.

How long does tooth bonding last?

While the traditional silver fillings last about seven years, these composites should last about seven to eleven years.

DENTAL BRIDGES

What is a dental bridge?

A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. The two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.

In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but will last as many ten years or more.

Who is a candidate for dental bridges?

If you have missing teeth and have good oral hygiene practices, you should discuss this procedure with your cosmetic dentist. If spaces are left unfilled, they may cause the surrounding teeth to drift out of position. Additionally, spaces from missing teeth can cause your other teeth and your gums to become far more susceptible to tooth decay and gum disease.

Overview of dental bridge procedure

If you a space from a missing tooth, a bridge will be custom made to fill in the space with a false tooth. The false tooth is attached by the bridge to the two other teeth around the space - bridging them together.

How is dental bridge accomplished?

Your cosmetic dentist will prepare your teeth on either side of the space for the false tooth. You will be given a mild anesthetic to numb the area, and the cosmetic dentist will remove the an area of each abutment (teeth on either side of the space) to accommodate for the thickness of the crown. When these teeth already have fillings, part of the filling may be left in place to help as a foundation for the crown.

The dentist will then make an impression, which will serve as the model from which the bridge, false tooth and crowns will be made by a dental laboratory. A temporary bridge will be placed for you to wear while your bridge is being made until your next visit. This temporary bridge will serve to protect your teeth and gums.

Your cosmetic dentist may have you use a Flipper appliance. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent bridge is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent bridge.

On your second appointment, the temporary bridge will be removed. Your new permanent bridge will be fitted and checked and adjusted for any bite discrepancies. Your new bridge will then be cemented to your teeth.

Pros and Cons of a Dental Bridge

Advantages of dental bridges:
Bridges are natural in appearance, and usually require only two visits to your dentist. If you maintain good oral hygiene, your fixed bridge should last as many as ten years or more.

Disadvantages of having a dental bridge:
It is common for your teeth to be mildly sensitive to extreme temperatures for a few weeks after the treatment. The build up of bacteria formed from food acids on your teeth and gums can become infected if proper oral hygiene is not followed.

TOOTH CROWNS

What are Tooth Crowns?

Grinding your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental crowns cover the entire visible surface of your affected tooth and add strength, durability and tooth stability.

Who is a candidate for Tooth Crowns?

Grinding your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental crowns cover the entire visible surface of your affected tooth and add strength, durability and tooth stability.

Your cosmetic dentist will usually be able to spot problem areas in your mouth that might lead to tooth damage and a need for crowns. Chewing patterns play a big role as well. By selectively grinding the tips of your middle and back teeth (called cusps) will alter your bite to reduce the stress on at-risk teeth.

In other instances, crowns are used to replace a actual missing tooth. These crowns are anchored to the teeth on either side, with a bridge section connecting the two crowns. Instead of bridges, single tooth dental implants may be used that eliminate the need for supporting the crowns.

How are Tooth Crowns Attached to your Tooth?

Your cosmetic dentist will make an impression of the tooth and a dental laboratory will create the crown. You will typically leave the office with a temporary crown to wear while the permanent crown is being made - this takes about two weeks. The permanent crown is then cemented onto your tooth. Typically, only two visits are required for this part of the procedure. Often, a preliminary restoration of your tooth may be needed before a crown can be placed. To stabilize your tooth, a filling must first be put in place prior to placing a crown due to the loss of original tooth structure. Tooth crowns usually last ten to fifteen years.

Be sure to discuss with your cosmetic dentist that the cement color used for your permanent crown will be the same as used for your temporary crown. A try in paste is used for this purpose. The color of the cement does affect the overall color of a porcelain crown, so this needs to be discussed long before your temporary crown is placed.

In some cases your cosmetic dentist may choose to use a Flipper instead of a temporary crown. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent crown.

Types of Tooth Crowns
There are basically three types of crowns, those made of gold, ceramic crowns and ceramic-veneered gold crowns. Gold and metal-ceramic crowns are extremely durable and are normally used in molars, where the forces from chewing and grinding are most prevalent. Ceramic crowns are used primarily for front teeth, since they can best resemble the natural tooth color.

Resin and Porcelain Crowns
The new reinforced resin or bonded all-porcelain type of crown has the nicest appearance. This crown can be made from pure ceramic or a new reinforced composite resin, and is almost indistinguishable from natural teeth. The new bonding technology involved provides an exceptional bond your tooth. It is metal-free, and thus satisfies the needs of patients with metal sensitivities. When correcting your back teeth with bonding, the cosmetic dentist will perform a tooth colored onlay. This type of procedure is used to correct only those parts of the tooth that are in need. This is a metal-free procedure.

Crowns Made of Gold
Gold crowns are appropriate when appearance is not a priority to you. The gold metal is extremely workable making gold crowns a more precise fit than any other type. While there exists a slight possibility of chipping with porcelain crowns, gold crowns provide no such possibility.

Porcelain and Metal Crowns
For a very natural appearance, porcelain fused to metal crowns are the answer. However, they have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the crown, near to your gum when it recedes with age.

Types of Porcelain
There are basically two types of porcelain you're likely to hear and read about most - the felspathic and pressed ceramic porcelains. The felspathic type is the original method that has been around for 20 years. A Ceramist in a dental lab bakes porcelain onto tin foil and then heats it in an oven. The Ceramist is able to create tints and opaques inside the porcelain to give the natural look we seek.

Pressed ceramic is created from a single ingot. The single ingot is milled in one piece to create the desired shape. The stains and opaques are applied only to the surface of the porcelain to give a natural look.

How much do tooth crowns cost?

Expect to pay more for porcelain crowns because they are usually more time-consuming than gold crowns. Porcelain, porcelain over metal and gold crowns average between $600. to $3100. each in total cost.

The new reinforced resin or bonded all-porcelain type costs more than other types, require more skill from your dentist and the lab, and may exceed your insurance plan coverage for crowns.

Generally speaking, the price of tooth crowns increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover all the costs of the tooth crown procedure.

   

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