Dental Crowns

Our goal is to provide dentistry that is undetectable. We replace existing dental crowns and fillings with restorations that look and feel like your natural teeth. Where damage to a person’s teeth is extreme, and apparently beyond repair, we can use porcelain or porcelain fused to gold crowns to make the smile appear “as new”. This is an extremely reliable technique for repairing the most severe of dental problems, even permanently replacing missing teeth to offer a complete smile and a functional bite. We are renowned for the quality of our work and the fantastic changes we make for people using this technology. These treatments are used for a long-lasting correction of major dental problems. It is usual for these treatments to last for 20 to 30 years, which is as close to permanent as dental treatment can get.

How long does it take to fit a dental crown?

Fitting a crown requires at least two visits to our office. Initially, we will remove decay, shape the tooth, and fit it with a temporary crown of either plastic or metal. On the subsequent visit, we will remove the temporary crown and then fit and adjust the final crown. Finally, we will cement the crown into place and you have a new beautiful looking tooth.

Key Benefits of Dental Crowns

  • Replaces missing teeth
  • Offers support for misshapen teeth or badly broken teeth
  • Looks completely natural
  • Fixes “smile” and functional chewing problems

What are the capabilities of crowns?

Crown and bridgework is a very reliable solution for major dental problems caused by accidents, diseases or wear and tear. Major problems can usually be corrected using these techniques. The material used in these repairs is either high-grade porcelain or porcelain bonded to gold. A higher strength of the porcelain and gold materials is recommended to treat the most serious of dental problems. Where accidental damage has occurred, resulting in lost teeth, or where teeth have broken away through excessive wear, or as the result of old fillings breaking, dental crowns and/or dental bridges can be used as a long-term solution. Many people have unexplained pain from filled back teeth, which is usually due to hairline cracks in the chewing part of the tooth. Placing crowns on these teeth relieves the pain and allows a return of full dental function for these teeth. In front teeth, older fillings can both weaken the teeth and cause “appearance” problems due to staining or chipping. Porcelain crowns and bridges are suitable in cases where porcelain veneers are not. In teeth with root canal fillings, crowns can prevent breakage.

 

                  

TYPES OF DENTAL PORCELAINS USED FOR CROWNS AND VENEERS

 

Crowns are often used to restore a tooth to beauty and full function when a substantial amount of tooth structure has been lost due to breakage, decay, or a large old filling that has failed.   The all-ceramic version can be more aesthetic and will never develop an ugly black line at the gum line caused by the metal crown margin showing.  Ceramic restorations can be made thinner thus requiring less tooth reduction. These restorations can be made to closely match the light transmitting properties of natural teeth and will not stain or change color. Ceramics are more biocompatible than most metals which may reduce the potential for gum recession and lead to a more long-term healthy result.

E Max

E Max is the newest cosmetic porcelain.  It is both strong and has true-to-nature shade behavior and excellent light transmission for highly esthetic solutions.   EMax is both biocompatible and has the long term wear characteristics like that of enamel. It can be used for minimally prepared veneers or crowns to as thin as 0.2mm.

E Max is ideal for fabricating single-tooth restorations or complete smile makeovers. This ceramic two layer system (pressed coping and custom stacked superficial layer) produces highly esthetic results and is 2.5 to 3 times stronger than other glass-ceramic systems used today.

E Max Monolithic

When a newer all porcelain crown or veneer chips or fractures, it is likely that the break occurred in the superficial veneering porcelain. It is the veneering porcelain that is the weak link in all of these systems. E Max Monolithic does not have a veneer porcelain. Unlike the other systems, the EMax HT (high translucency) coping material can be used without a veneering layer due to improved optical characteristics.  This coping material can be used alone to create beautiful and incredibly strong restorations.  This restorative option is ideal for patients who are nightimebruxers or tooth grinders.

Empress

These beautiful restorations can be produced with excellent fit and the characteristics of natural teeth. Empress has two layers; a base coping made of medium-strength pressed ceramic, and a highly customizable superficial glass layer  that can be hand stacked and fired on top of the supportive pressed base coping.  With only modest strength, this restorative material should never be used in high occlusal risk situations.

Feldspathic

Many cosmetic dentists feel that this is the most beautiful porcelain.  This custom stacked monolithic ceramic (one layer or no supportive base coping) is difficult to work with and requires the technician to have very high skills.  Only high end dentists will use this ceramic system.  These restorations are very technique sensitive to place and are more costly to produce in the laboratory.

Procera

Procera is a two layer system.  They are made with  an aluminum oxide base coping that is custom milled with CAD technology and a superficial stacked feldspathic layer that is used to make the restoration attractive and lifelike.  Due to the opacity of the coping, the tooth needs to have a more aggressive preparation to allow enough veneer thickness to mask the bright white coping.  These restorations can also be beautiful when crafted by a master ceramist.

Zirconium

Zirconium onlays, caps or crowns are similar in design to Procera with a two layer system. This porcelain option is used commonly for anterior bridges and implant abutments.  Zirconium has no capability of bonding and should not be used for veneers.  In addition, the high opacity and unnatural whiteness of the strong zirconium base coping can require more tooth reduction to give room to conceal it with a thicker veneering porcelain layer. There are many brands of this product and some have higher clinical success rates.

 Do zirconium crowns and/or onlays break?

Yes, everything can break including zirconium and natural teeth. A zirconium base coping is extremely strong, in fact much stronger than natural tooth structure.  Due to the lack of natural optical characteristics, the coping must be covered for esthetic parity. When dentists have limited knowledge of occlusion or the patient grinds their teeth, it is common for restorations to break. Zirconium is attractive to some dentists due to a false impression of superior strength. The veneering porcelain has the same low shear strength as for all of the other porcelain 2 layer systems and is the weak link rendering it no stronger than any of the other systems. The exception is when no veneering porcelain is used. Due to heavy marketing directly to dentists promising superior strength, many practitioners are choosing base coping only (monolithic) zirconium restorations.  These restorations can be very abusive to the opposing dentition and exhibit low esthetic quality.  Also they can be very difficult to remove without hurting the underlying tooth. No matter what you hear or read, all dental restorations have a finite life span and eventually need replacement. 100% Zirconium inlays and onlays are not recommended.

Cerec and Sirona

Cerec and Sirona technology is becoming more popular in average dental offices because it cuts out the lab technician.  The brand names Cerec and Sirona are “in-the-dental-office” CAD milling machines. Monolithic ceramic blocks are milled into onlays, veneers or for full coverage.  Monolithic means one color.  No natural tooth is one color.  These restorations can be created in one visit and are strong but they can only be customized by using surface stains.  Surface staining creates opacity and metamerism and is not life like.  Surface stains wear off over time.

“PORCELAIN CROWN” MATERIAL SELECTION FACTORS:

Strength, esthetics, the abrasiveness of the material against the opposing teeth, and the skills of the dentist. There is no single porcelain choice that is clearly superior for all situations.  For example, feldspathic or E Max HT (high translucency) are better choices when avoiding black lines at the gumline. Many cosmetic dentists will have several types that they use for different situations. There are subtleties in working with all of these ceramic materials that need to be mastered by the dentist and the ceramist to produce the most beautiful result.