Why Do I Need a Crown?
If your tooth is missing a large area of the biting surface, your dentist may recommend a crown. Crowns are a good choice if you have a cavity, an old filling that is too large, large amounts of decay, or a fracture. For small amounts of damage, fillings will suffice, but larger jobs call for stronger solutions. A crown will strengthen the tooth without leaving it susceptible to fracturing. Thanks to modern dental bonding technology, crowns can be made from pure porcelain or other ceramics, allowing for a more natural appearance. A porcelain-fused-to-metal crown is still an option for crowns needed in high-volume chewing areas, but if you prefer a more natural look for your crown, porcelain is a good choice no matter where the crown is placed in the mouth.
Variations of Porcelain Crowns
We would like our patients to know about the three types of porcelain crowns available: bonded all porcelain, extra strength all ceramic, and porcelain-fused-to-metal crowns. We are well-versed in using all three, and want to guide our patients to what is the best choice for them.
Extra Strength All Ceramic
Here at LA Healthy Smile, Dr. Khashayar Khodadadi is well versed in the use of zirconia crowns. Zirconia is so strong it is also known as ‘ceramic steel’. While zirconia can be made translucent, it is milled from a single block of ceramic; therefore, it is less aesthetically pleasing than pure porcelain. Since the block of ceramic is a solid color, individualized color changes are not easy. However, by combining it with porcelain, you can achieve the strongest yet most natural looking crown available.
Porcelain crowns are given their strength through the material used to bond it to your natural teeth. They are a great choice for your front teeth, but may be too weak to withstand the demands on a back tooth. However, Dr. Khashayar Khodadadi’s preferred technique is to create the zirconia crown, cut back the front surface, and replace it with porcelain. The porcelain is easier for master ceramists and cosmetic dentists to match to your teeth’s natural translucence and color. This way, you can combine the strength of a zirconia crown without sacrificing the beauty of an all porcelain crown.
Drawbacks of Porcelain-Fused-To-Metal Crowns
Porcelain-fused-to-metal crowns are widely taught in dental schools around the country, and therefore remain comfortable techniques for general dentists to use. What they lack in aesthetics they make up for in strength, making them a good choice for a crown on a back molar. Some health insurances only cover porcelain-fused-to-metal crowns, as they ‘fix’ any tooth issues at their most basic level. However, the downside to all porcelain-fused-to-metal crowns is that they will develop a dark, black line at the gumline. As the gumline recedes over time, this line becomes more apparent. This dark, black line, combined with a white-looking opacity creates an unnatural appearance, one that may lead to dissatisfaction or even getting them replaced with all porcelain or ceramic crowns down the line.
Compare these pictures of before and after pictures. Even someone with no dental training can tell something is not quite right in the picture on the left. This image shows the telltale dark line at the gumline that all porcelain-fused-to-metal crowns have. On the right, however, we can see what a difference redoing the crowns in bonded all porcelain has made. The teeth look much more natural, and the patient’s smile comes more easily.