Tuesday, October 18, 2016

Restorative Material Choices for Dental Crowns -Pros and Cons.

Innovation in dental materials over the last decade has made a number of choices available for restoring teeth with full coverage restorations. Although gold crowns, considered the gold standard have proven predictable in the long term, improvements in the beauty, strength and durability of materials like porcelain and zirconia  have made more natural looking and lifelike cosmetic restorations possible.

What is the right crown material?
Consider the following aspects to help with the decision.
Why do I need a crown?
Do I grind my teeth?
Is the restoration on a front tooth or a back tooth?
Is the tooth visible in my smile zone?
Are my teeth sensitive?
Am I allergic to any materials?
What is the long term predictability with each material option?
What is my periodontal condition?
Frequency of periodontal maintenance
Is my opposing tooth a natural tooth or restored?
If restored, with what material?

Answering the above questions will make the selection of crown material far more predictable and comfortable.

Four types of crowns are available:

Porcelain fused to Metal (PFM) is the most commonly used crown. PFM, or porcelain dental crowns, are lined by metal on the inside (See figure 2.) and shaped with tooth colored porcelain which is baked onto the metal inside, simulating the natural tooth in shape, shade and anatomy.

All Ceramic crowns are a popular esthetic choice and their strength characteristics are comparable to the strength of porcelain. With the range of ceramics currently available, ceramic crowns can be used to fabricate crowns or bridges both in the front and back of the mouth. Their esthetic qualities are the best in dentistry. Since ceramic crowns have no metal, these restorations are best suited for individuals with metal allergies or those who find the grey discoloration of a metal margin objectionable.

Gold Alloy has been used in dentistry for over 100 years and crowns fabricated in gold are still the most long lasting crowns. Other than its objectionable color in the current esthetic age, gold alloy is still most compatible in wear and other properties to the natural teeth. With good hygiene practices, good crowns usually last a lifetime and are a great choice for teeth in the back of the mouth.

Resin Crowns are the least used in dentistry but can be used in a bite that is aggressive to prevent wear of the opposing teeth. Gold crowns wear through and porcelain wear outs the opposing teeth in a heavy bite. Resin crowns do wear and roughen over time.

Cost is not significantly different for the different material (except resin) and the choice is based on what is best suited for the mouth and patient preference. Regardless of the material choice, crowns do last a long time and considered to be the most successful procedure in dentistry. Contact us today for tooth crowning in Chino CA.
Figure 1. Outside: PFM (Left) vs. Ceramic (Right) 

Figure 2. Inside: Ceramic (Left) vs. PFM (Right)  

Figure 3. Variety of Crown Materials