WHY A PORCELAIN CROWN IS NEEDED
It is needed when a tooth is badly broken down - there are existing large fillings or a
large area of tooth decay, because a filling isn't strong enough. And in the front of
the mouth, you will want a porcelain crown that looks exactly like a
tooth. If done by an expert cosmetic dentist, it will be very difficult
for people to tell that it isn't real. For information on locating an
expert cosmetic dentist in your area, please see our
cosmetic dentist referral page.
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Years ago, it had to be fused to a metal framework in
order to create a crown strong enough to resist breaking in use. But
bonding technology developed since the 1980s has allowed dentists to bond
these ceramic crowns directly to the teeth. With
this strong bond, it becomes strong enough to function under even heavy
chewing pressures. The photo to the left shows one that is functioning even
under the heavy stresses of a molar tooth. |
A beautiful porcelain crown may have a cost that exceed your
dental insurance plan allotment.
If your interests are purely functional - you don't care how it looks -
then you may not want to spend the extra money.
On back teeth, many cosmetic dentists do
what are called
porcelain onlays. These
are very similar to all crowns, and sometimes the terms are used
interchangeably. Using the term onlay, however, means that we are grinding
away less of the tooth - we leave the healthy tooth structure alone as
much as possible. With an onlay, since we can keep the margins away from
the gum, we greatly reduce the tendency to gum inflammation that can occur
with dental crowns. It also is metal-free. However, under very heavy biting pressures, there is a cracking risk with a
porcelain onlay.
Dentists need special training in cosmetic dentistry in order to place these
restorations. If you would like referral to a competent cosmetic dentist
who is trained to do this type of work, feel free to
e-mail Dr. Hall with your
request.
The Cerec crown is merely a variation of
all-porcelain. It is made out of all ceramic, but rather than being made by a
laboratory technician, it is milled by a computer in the dentist's office.
The Empress crown is also a variation of all-porcelain which
uses the Empress pressed ceramic material. Other ceramic materials are
Procera, In-Ceram, and feldspathic porcelain. A cosmetic dentist will be
familiar with all of these materials and will use the best crown for each
clinical situation. They all have their advantages and disadvantages.
Porcelain fused to metal crowns have a
nearly natural appearance, subject to two limitations: Because they have a metal
framework underneath, they require the use of an opaquer to cover the
metal, which makes it
impossible to re-create the translucency of natural teeth. They also
eventually will show a dark line
at the edge, next to the gum. Dentists try to hide this line
under the gum, but sometimes they are unable to do this; and sometimes the line doesn't show when the crown is
first placed but shows later, as the gum recedes. But they are stronger
than all porcelain.
Below
is a comparison of the appearance of porcelain fused to metal with bonded
all-ceramic. Notice the picture on the left: Jo has several crowns across
the front. Even though I have never met this patient and know nothing more than
these pictures, I can pick out immediately the teeth that have crowns on them.
How? Because they are opaque and have a dark line near the gumline. Contrast
this with the after picture of Jo's
teeth on the right, which shows beautiful bonded all-ceramic work.
This work was done by Dr. Craig Carlson, a www.mynewsmile.com cosmetic dentist from
San Antonio, Texas. See how natural they look.
For contact information for Dr. Carlson, please see our
Texas cosmetic dentists page.
