Chairside Talk

Dental Crown Differences

Which One is for You?

Late one evening while finishing up at the office, one of my patients stopped by my room to seek some information. She was appointed for some crown work in the near future but didn’t know what kind of crown she was getting. I looked at the chart and told her what the doctor was doing. It was at that point I realized a lot of patients are unaware or uniformed about the different types of crowns.

For those of you that don’t know, a crown or cap fits over the tooth to hold it together after being treated for decay, breaks or fractures. Ultimately her concern like many others was getting one that was long lasting, functional and good looking.

I let her know expressing those concerns to the dentist is a great idea. It may or may not alter the treatment plan but it assures you are on the same page. The dentist really has to use their best judgment when evaluating which type of crown to use. Now-a-days, there are many different types, and the success rate of the crown depends on many factors.

PFM

Currently the porcelain fused to metal or PFM crown is the most prescribed lab manufactured restoration. A metal liner fits snuggly over the tooth and then a porcelain layer is fused over the metal for aesthetics. This makes for an attractive yet durable restoration. A high noble metal mostly of gold is preferably used due to its biocompatibility and flexibility. There is also less chance of an adverse or allergic reaction. These crowns are strong and can withstand a lot of occlusal or biting force; great for people who clinch and grind. Although, some people do get bummed out when metal can be seen at the edge of the crown near the gums and the porcelain chips. Not that this happens all the time, but it can.

All Ceramic

These crowns are the most natural looking available. Two common types of all ceramic crowns are the Lava crown and the Cerac crown. The Lava crown is milled at the lab and has a wonderful translucent appearance making the restoration look real. They are a good choice for front teeth but the dentist will have to use their judgment when it comes to back teeth. They are more fragile. The Cerac crown uses a harder more durable ceramic and has similar aesthetic qualities. It’s not as strong as a PFM, but works great in a broader spectrum of situations. Since it is milled at the dental office, the details of anatomy depend upon your dentist’s artistic ability. One very big benefit of the Cerac is having the crown made in one appointment and no temporary crown.

Zirconium

Another very popular choice for crowns are the Zirconium crowns. Similar to ceramic crowns in the sense they are very natural looking. The difference being price and strength. These crowns do cost a little more but they are more durable and a great option for patients who do not want metal in their mouth no matter what.

All Metal

Metal crowns have been around forever and for a good reason. They are made of gold or mostly gold due to the metal’s unique properties. Gold is extremely durable, fits with precision, doesn’t chip or break, withstands strenuous chewing conditions, and has a slower rate of wear. Metal crowns are probably the most reliable and long lasting of all the crowns today, but aren’t the most popular. Less and less are being fabricated because they are unnatural looking and gold is expensive. If they are used, it’s usually for teeth not visibly involved in the smile.

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Dental Crown Differences

Late one evening while finishing up at the office, one of my patients stopped by my room to seek some information. She was appointed for some crown work in the near future but didn’t know what kind of crown she was getting. I looked at the chart and told her what the doctor was doing. […]

Read More