A dental crown is used to replicate the part of a natural tooth which is above the gum line and encases a damaged, decayed or heavily filled tooth to give strength, function and better appearance. Crowns are also used to restore a missing tooth when a dental implant is placed. So, it’s a kind of cap which sits on top of what is left of the natural tooth or on top of an implant which looks and feels like your natural tooth.
Dental Crown Materials
There are a lot of different materials and manufacturing techniques when it comes to dental crowns. Frankly, it can be quite confusing. The combinations of different types of dental porcelain (or ceramic, these terms are basically interchangeable), the different manufacturing techniques, firing temperatures, and crystalline structure need an expert knowledge to full understand.
We recommend that you take the advice of a knowledgeable dentist who can select the right materials for your particular situation and budget. Crowns can either be made while you wait, Cerec crowns, or more commonly will take about a week to be hand made in a laboratory.
Crowns are made by highly skilled dental technicians – the skill of the dental technician is often far more important than the material itself. Great quality material in the hands of a poor technician will still be a poor result. Very often the best looking crowns are not perfect but blend in naturally with the remaining teeth. You do not want your dental restoration work to be obvious!
Porcelain or Ceramic Fused to Metal Crowns (PFM)
PFM crowns are made up of a visible and functional part made up of a tooth coloured ceramic which is fused at high temperature to an underlying metal alloy structure which provides additional strength and durability to the ceramic. The metal base is bonded to the remains of the natural tooth using a cement. The metal is not visible but may sometimes give the finished crown a slight grey effect.
PFM crowns are still the most commonly used worldwide and are the most cost-effective solution. Your dentist will use high quality porcelain/ceramic and your dentist and technician should be able to get the size, shade and shape just right for you. However, people with sensitivities or allergies to the metal alloy should avoid these type of crowns.
Porcelain or Ceramic Fused to Gold or Titanium
The porcelain, functional, part of the crown can also be fused to gold, gold alloy or titanium instead of a base metal alloy. These materials are as strong or stronger, mould more easily to fit the underlying tooth more snugly, and in the case of gold can be easier to mask with the layers of porcelain over-topping the metal base.
Titanium is considered the material of choice for this purpose due to its excellent bio-compatibility and resistance to infection. It is said that gold crowns have the potential to last longest and are often recommended for back teeth where the pressures are greatest.
Porcelain only Crowns
Porcelain only or full ceramic crowns also come in many types and may be made up of one material (monolithic) or more commonly are also made up of layers of one ceramic or porcelain fused to a base made of another ceramic. Porcelain only crowns are considered by many to be more natural looking and in many situations can be extremely hard-wearing and long-lasting. Your dentist will advise you whether they are suitable for the whole or part of your treatment based on your individual requirements and bite characteristics.
It is very important to consider not only the look and functionality of the crown itself, but also the effect that a very hard material might have on the tooth above or below it – you do not want a super hard-wearing crown to cause damage to your own teeth through excessive force during chewing or teeth-grinding at night!
Zirconium is normally used just for the front teeth with standard crowns being placed in the back of the mouth if needed. High quality porcelain is fused to a structure made from Zirconium. This is one of the strongest man made materials on the market and is white in colour. Unlike metals the white of the zirconium material shines through the porcelain making the tooth look even more natural. The clear advantage over any of the metals is excellent aesthetics without losing strength. This is ideal for both cosmetic dentistry and patients who have sensitivity to metals.
There are also crowns which are made purely of Zirconia (again its not very helpful when dentists use the two terms interchangeably, Zirconium is in fact a metal element and Zirconia is an oxide of the metal, but you will see them both used).
Emax Crowns (IPS e.max)
These are quickly becoming the crowns of choice for both patients and dentists. It is made of Lithium disilicate (e.max) which is the strongest ceramic material. Emax crowns can be made purely of Emax or have an Emax core and then be layered with porcelain or have a zirconia core and be layered with Emax.
Due to the strength of the materials you need to take into consideration what the opposing tooth is made of when choosing the crown. This material is strong, looks very natural due to their translucency, and can be used reliably for very thin veneers or crowns without the need to remove so much of the underlying tooth.
Cerec stands for Chairside Economic Restoration of Esthetic Ceramics or CEramic REConstuction. The Cerec machine is on the dental premises not in a dental laboratory and allows the production of crowns while you wait, typically a couple of hours. The process is as follows.
- Your tooth is filed down
- A digital image is taken of your tooth using an intraocular camera
- This is sent to the Cerec machine which will make a virtual 3D image of the tooth.
- The dentist makes a crown on the screen using this model.
- This virtual crown is digitally sent to an onsite milling machine.
- The dentist puts a plaque resistant ceramic block, stained to match your teeth, in the machine.
- Your ceramic crown is ready to be fitted.
As your crown will take over a week to make in the laboratory and your tooth will have been filled down, you will need a temporary crown to protect the tooth. The dentist will make this usually out of ceramic, steel or resin and then use a soft temporary cement to keep it in place so that it can be removed easily. The temporary crown is important to protect the gum, the tooth, and also for cosmetic purposes. You may use it to chew on soft food.
Some dentists include the cost of the temporary crown in the cost of the permanent crown and others don’t. Please check this when you receive a quote.
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