Dental Crowns Explained

Dental crowns are used to fix broken, decayed or damaged teeth. They are usually made out of metal, porcelain or ceramic. They are often used to correct a tooth that has undergone root canal therapy.

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For crown preparations that have subgingival margins, tissue control is important during the preparation stage to ensure visibility and adequate bulk of impression material. This will improve the occlusal clearance and resistance of the crown.

Porcelain

Porcelain is the traditional dental crown material, and one that’s known for its strength. It’s made from feldspathic porcelain that’s fired at high temperatures to create strong crystal structures that are lifelike in appearance. The custom layered design of these crowns allows them to either bond directly to natural teeth (which transmits the underlying tooth colour through), or they can be bonded over a pre-built core (typically metal alloys like those found in PFM or VMK crowns – see point #2 above).

These crowns are commonly used for front teeth that may need help with their shape, size or aesthetics. They can be used to close gaps between teeth, restore the height or length of a tooth, or even replace a missing tooth entirely.

Having good, healthy looking teeth is not only important from a functional perspective – it also impacts self-image and boosts your confidence. Your dentist will be able to advise you as to the best option for your unique goals.

To prepare the tooth for a porcelain crown, your dentist will file it down, and take a series of radiographs known as periapical or bite-wing to check the fit and alignment. These will be reviewed at your next appointment along with the temporary crown, before the permanent restoration is permanently cemented to the tooth.

Zirconia

Zirconia is a popular crown material due to its many confirmed benefits for dental patients. It’s an extremely strong, non-porous material with a natural appearance. It also resists staining much better than composite ceramic or acrylic crowns. This makes it ideal for people who are concerned about the color of their teeth or who are committed to a whiter smile. Zirconia is also biocompatible, which means your body will likely treat it as if it were part of your own tooth structure. This is especially important for patients with metal allergies or sensitivities.

Unlike traditional crowns that require a putty-like impression of your mouth, newer technology allows a digital scan to be used to create a custom fit for your new zirconia crown. This process is more comfortable and more accurate than taking a traditional impression. It also eliminates the possibility of an inaccurate bite that can lead to discomfort.

There are several types of zirconia dental crowns, but layered and monolithic zirconia are most common. Monolithic zirconia is the most opaque style of zirconia and is recommended for posterior crowns because it requires less occlusal clearance than other crown styles. It may not be ideal for visible front teeth, however, as it can’t replicate the translucency of natural tooth enamel and dentin.

Layered zirconia crowns are made from a porcelain layer that’s fused to a solid zirconium substructure. They’re a bit more fragile than monolithic zirconia, but they can withstand the forces of mastication and bruxism without chipping or cracking as easily. They’re also more versatile and can be shaped to achieve the aesthetics that you’re looking for.

All-ceramic

Using a photo of your tooth your doctor will digitally scan it to create a virtual design model. This is then sent to an on-site milling machine that fabricates the restoration out of a block of ceramic material. Your doctor will then check to make sure that the crown fits, feels and looks like your natural tooth before securely bonding it in place. All of this is done in a single appointment!

This CAD/CAM (computer-aided design and manufactured) crown is made from multiple types of porcelains with differing shades and translucencies. These are colour matched and layered to produce a highly aesthetic lifelike result. The crown is then fused to a metallic base, which gives it durability and resistance to fractures. These crowns are referred to as ITEM 613 on our treatment plans and invoicing from your dentist.

Leucite reinforced pressable porcelain crowns are fabricated using a CAD/CAM process to provide a high level of aesthetics with good durability. They are able to transmit the shade of adjacent teeth to achieve a highly realistic appearance and are ideal for restoring a broken tooth. However, correct use of these crowns requires meticulous case selection, tooth preparation and bonding protocol to ensure long term success.

Metal

Traditionally, metal crowns have been fabricated from gold or other precious metal alloys, but they can also be made of cheaper base metals such as nickel-chromium and cobalt-chromium. Metal crowns are exceptionally strong, and they withstand chewing pressure very well. They don’t wear down the teeth they bite against as porcelain crowns can, and they are ideal for molars that are very far back in the mouth. Metal crowns require less healthy tooth structure to be removed compared with other types of dental crowns, and they bond very well to teeth.

Despite their strength, metal crowns can sometimes chip. If this happens, it is possible to repair them with a composite resin or even replace the crown completely if the damage is extensive. In addition, the cement can wash out under a metal crown, which can allow bacteria to leak in and cause decay to the remaining tooth.

Allergies to metal can also be a problem for people with metal crowns, which may lead to inflammation and other symptoms. While these reactions are rare, some patients choose not to get metal crowns for this reason. A ceramic crown or a porcelain fused to metal crown is more bio-compatible and safer for those with metal allergies. These types of crowns are also much more aesthetically pleasing than their metal counterparts, and they can be matched to the natural color of teeth.