At some point in our life, most of us may end up needing a dental crown….
Going in for a dental procedure can be a little intimidating and confusing. Dental crowns can involve a significant financial investment, and it is imperative to make the right decision as it can affect your oral and overall health.
Therefore, it always helps if you are equipped with trustworthy information before entering your dentist’s clinic.
This article will brief you on everything there is to know about ceramic and composite resin dental crowns, so keep reading ahead.
What are dental crowns?
Before we dive deep into ceramic and composite resin crowns, let’s first address the basics of a dental crown.
A dental crown is a covering or a cap that fits over the top or visible part of the tooth. It restores a compromised tooth’s shape, size, structure and colour. Moreover, it provides adequate reinforcement to the tooth and ensures its increased life in the oral cavity.
Crowns also form a part of dental bridges and aid in the restoration of missing teeth. Usually, two teeth adjacent to the missing space are used as support and receive dental crowns, and with the help of these false teeth (also known as pontic) are suspended. The crowns and the pontic are manufactured as a single unit.
Why would I need a dental crown?
Wondering why your dentist has advised you a dental crown?
There are several reasons you may need a dental crown which may include:
- When dental cavities become too extensive and destroy a significant chunk of the tooth structure, they can no longer be adequately restored with the help of dental fillings. In addition, the affected tooth becomes weak and is susceptible to breakage. In such a situation, a dental crown is advised after the removal of the decayed tooth structure. Dental crowns adequately restore the tooth structure and establish its function. It also provides the tooth with added stability and protects and saves it from further damage and eventual removal.
- Dental crowns also help restore fractures and broken teeth. It helps keep the weak and broken tooth parts together.
- Dental crowns also serve aesthetic purposes as it helps restore severely misshapen, worn down or stained teeth.
- Dental crowns are often indicated after a large dental filling and in cases of root canal treated teeth (especially large back teeth).
- It holds the dental bridge in place.
- Dental crowns also help restore dental implants.
What are the different types of dental crowns?
There are different types of dental crowns that are advised and customised according to individual patient needs.
Traditional dental crowns cover all the surfaces of your teeth and require extensive preparation. However, if your needs fit a less comprehensive and more conservative approach, your dentist may advise you on 3/4th Crowns and Inlays/Onlays or Veneerlays.
These types of restoration do not cover the entirety of your tooth structure and provide a more conservative approach as compared to full coverage crowns. The dentist will remove the affected part of the tooth and perform minimal reshaping to fix a 3/4th crown or an onlay. However, it is essential to remember that these can only be used when the damage or decay is small or localised to a particular area.
These restorations are used when the damage is too significant to be repaired by a straightforward dental filling but small enough not to need a complete coverage crown.
What materials do dentists use for making your dental crowns and bridges?
Base metal alloys
Base metal alloys crowns or simply metal crowns are made from stainless steel, titanium, chromium, nickel and cobalt alloys. Metal crowns provide superior resistance and support. However, one of the most significant disadvantages of metal crowns is that they are aesthetically undesirable as it gives your smile a metallic appearance. Moreover, there is always a risk of galvanised shock in patients who have multiple metal dental fillings or prostheses.
Metal crowns are still widely due to their long life span but are only reserved for back teeth.
Gold was also used for making dental crowns because of its noble metal properties, high value and good resistance. However, it too has aesthetic concerns and is not used anymore.
Porcelain fused to metal (PFM)
PFM crowns, as the name suggests, are a combination of metal and porcelain (ceramic). The core or the inner layer of the crown is made from a base metal alloy like stainless steel. Over this, a layer of tooth-coloured porcelain is added. These crowns ensure aesthetics and good support. However, the outer porcelain coating tends to chip off, revealing the metal underneath, which in the long run compromises aesthetics. The layer may come off entirely which mandates replacement.
PFM crowns are also used to restore the back teeth as they bear the brunt of chewing forces and need added reinforcement which metal provides.
Ceramic and Composite Resin Crowns
Owing to the disadvantages of metal crowns, a need for more aesthetically acceptable crowns and bridges arrived. This led to the invention of All ceramic and Composite resin crowns. These crowns have gained immense popularity in recent times and are vastly used.
Let us take an in-depth look at these two materials….
What are the major differences between Composite Resin Crown and Ceramic Dental Crown?
Composite Resin Crowns
Composite resin crowns are made entirely of composite resin, a combination of acrylic resin (polymethyl methacrylate) and glass (silicon dioxide). Composite resin material can be manipulated to have a colour that matches your natural teeth shade.
Composite resins crowns are primarily used a temporary restoration and protect the tooth until a permanent crown is manufactured. These crowns are often interim measures as they lack strength, wear down quickly and cannot withstand chewing forces adequately.
- Highly aesthetic
- It can be used as a permanent option for the restoration of front teeth
- It helps conceal stained and crooked front teeth
- Inexpensive compared to porcelain crowns
- Easy going on opposing teeth (does not wear them down)
- A good alternative to dental fillings
- It is a temporary measure.
- It cannot be used for permanent restoration of back teeth
- Short life span (3-4 years)
- Lacks resistance and cannot establish proper chewing or biting
- Requires greater tooth preparation for added support
Ceramic Dental Crowns
The entire crown is made of ceramic or porcelain. They have the highest aesthetic value compared to other dental crown materials. They can be easily manipulated to give your crown a glistening natural appearance and have a translucent hue like natural teeth.
Types of ceramic crowns
Feldspathic Porcelain Crowns are traditional or standard porcelain crowns and offer a natural appearance with adequate strength. These crowns are made in layers.
Are the most robust and aesthetically superior type of dental crowns. They are incredibly durable and highly resistant to fracture. They can effortlessly bear the brunt of biting and chewing forces.
Zirconia crowns can be manufactured from a single block (monolithic) which further contributes to their immense strength and longevity.
Aluminous Crowns (Procera, Empress and Emax)
Tend to be more porous and have excellent translucent light-reflective properties, which ensures a lifelike appearance to the crown. Procera, Empress and Emax are three different kinds of aluminous crowns.
Ceramic crowns can either be made in a dental laboratory or can be milled in the dental clinic with the help of CAD-CAM.
Advantages of Ceramic Crowns
- Excellent and most superior form of dental crowns.
- Highly pleasing aesthetics.
- Lifelike and natural appearance, especially with zirconia crowns.
- High strength
- Zirconia crowns can last up to 20 years or even more with proper care.
- Minimal to no chances of any adverse reaction and is very well accepted.
- Minimal tooth preparation
Disadvantages of Ceramic Crowns
- Ceramic crowns (especially zirconia, Empress, E-max and Procera) tend to be expensive as compared to other dental crowns.
- Needs proper care
Dental crown procedure
The procedure for all types of crowns remains the same. The dentist will use a dental drill to clear out any dental decay or damage and then trim the tooth to ensure it can receive a dental crown.
Porcelain crowns require less tooth preparation and offer a more conservative approach than composite or metal crowns.
Next, dental impressions are taken of your upper and lower teeth.
These serve as a guide for the fabrication of your dental crowns. Your dentist will also select the shade for your crown or bridge during this appointment.
In the next appointment, you will be called for a trial.
The dentist will check for the crowns or bridges fit, and once they approve, it goes for final fabrications and adjustment. In the subsequent appointment, your crown will be fixed with the help of dental cement.
In summary, dental crowns are used to restore teeth, protect weak and broken tooth parts, and serve aesthetic purposes. Ceramic and composite resin crowns are more aesthetically acceptable than metal crowns. Composite resin crowns are cheaper and can be completed in a single visit but are less durable. Ceramic crowns are more expensive and require multiple visits but offer greater durability and superior aesthetics.
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