Types of Dental Crowns

Ever imagined you’d be sizing up materials like gold or silver outside of a jewelry store? Bet they don’t offer ‘tooth-colored’ gems or custom shades to match your other ‘jewels’!  As we venture through this post, we’ll unearth various types of dental crown materials; like porcelain, zirconia, gold, and review their strengths and weaknesses. Being informed about the types of materials dentists use in your mouth can help you be more informed of your own dental care.

A Crown’s Purpose

Dentists use different types of dental crowns for various restoration purposes. These crowns serve to repair damaged teeth, address decayed teeth, restore strength and functionality, and enhance aesthetics. Whether your tooth is weakened due to decay or you are concerned about potential allergic reactions, discussing options with your dentist can help you be an active participant in the treatment and ensure a great experience from start to finish.

Quick Review: Steps of Treatment

During a dental crown procedure, preserving the natural tooth structure is a top priority. The dentist will begin by removing any decay present in the tooth, ensuring that only the damaged portion is eliminated. This helps maintain as much healthy tooth structure as possible. Afterward, a dental impression will be taken. This serves as a blueprint for creating a custom crown that fits perfectly.

While the permanent crown is being fabricated, a temporary crown will be placed to protect the tooth and help maintain its integrity and prevent any damage. This temporary crown made of composite resin ensures that you can comfortably eat, speak, and smile while waiting for your final restoration.

Once the permanent crown is ready, you will return to the dentist’s office and they will remove the temporary crown and replace it with your new custom crown, designed to blend seamlessly with the color of your natural teeth.

Types of Crowns

How do dentists achieve a perfect smile? Magic! Not really; it is with the use of soft metals, gold alloys, or a combination of materials that make up the artfully designed tooth.

Permanent Dental Crown Types

All porcelain aka ceramic crowns – The most natural looking restoration option is made completely of porcelain. These can also be referred to as E-Max crowns, which is more of a brand name.

Zirconia crowns aka zirconium – Zirconia has cosmetic properties like porcelain but is much stronger. This is one of Dr. Hale’s top choices for crown restorations for back teeth.

Porcelain-fused-to-metal – This option is also a durable solution, with a porcelain surface and core metal structure, but it is not as aesthetically pleasing as porcelain or zirconia.

Stainless steel crowns – Silver crowns are prefabricated in a tooth-shaped cap. These are typically used in pediatric restorations, such as baby teeth, after child pulpotomy (aka root canal treatment).

Complete Porcelain Crowns

Porcelain crowns are highly regarded for their natural tooth-like appearance and are an excellent choice for individuals seeking aesthetics alongside functionality. They are a popular choice among patients and dentists alike. One significant advantage to this option is their lifelike appearance, as they closely mimic the color, translucency, and texture of natural teeth. This makes them virtually indistinguishable from your existing teeth, ensuring a seamless blend with your smile.

Advantages

1. Top Cosmetic Choice: In addition to their aesthetic appeal, ceramic or porcelain crowns are also stain-resistant, allowing them to maintain their natural color over time. This makes them an excellent long-term solution for individuals concerned about discoloration or staining issues.
2. Best for Front Teeth: Porcelain restorations can be a great solution to front teeth since the front (anterior) teeth don’t take on as much biting load as molars.
3. Safe and Effective: Most importantly, porcelain-based dental crowns are biocompatible, meaning they are well-tolerated by the body. This makes them a safe and suitable option for most patients, even those with metal allergies or sensitivities.

Disadvantages

1. Lack of Durability: Compared to other options, porcelain is one of the more fragile materials for crowns. They can be prone to chipping or fracturing, especially in cases where excessive force is applied, such as teeth grinding or biting on hard objects. If you have habits that could potentially compromise the durability of the crown, your dentist might recommend an alternative option.

Overall, porcelain crowns can effectively restore the shape, size, and color of your front teeth, enhancing your smile and boosting your self-confidence. However, it is important to note that porcelain crowns may not be the best option for all situations. If you’re one to chew on ice or crack nuts with your teeth, these are not going to be a great option.

Zirconia Crowns

Zirconia crowns are made from zirconium oxide. These are a popular option in dental restorations due to their strength and appearance. This material has some properties like porcelain, but the element zirconium is a metal. This sort of metal ceramic is extremely strong and can withstand forces much higher than any of the other types of crowns. Despite its strength, it is a very aesthetically pleasing material.

Zirconia crowns are tooth colored, just like porcelain crowns, and mimic the aesthetic properties similarly. Combining cosmetic appeal similar to porcelain with exceptional strength, zirconia crowns have become one of the preferred choices for crown restorations, especially for back teeth, according to Dr. Hale.

Advantages:

1. Enhanced Strength: Zirconia crowns are renowned for their remarkable durability and strength, making them highly resistant to fractures and chips. This robustness allows them to withstand the biting forces exerted on the back teeth, which endure significant pressure during chewing and grinding.
2. Aesthetic Appeal: In addition to their superior strength, zirconia crowns also possess excellent cosmetic properties. They can closely mimic the natural tooth color, exhibiting a translucent quality that reflects light in a manner similar to natural dental enamel.

Disadvantages:

1. Removal of Tooth Structure: One potential drawback of zirconia crowns is that they require the removal of a significant amount of tooth structure to accommodate the thickness of the crown. This reduction in natural tooth structure is irreversible, as the tooth will always require a crown for protection and restoration once the structure is removed.
2. Zirconia crowns offer a compelling combination of strength and aesthetic appeal, making them a sought-after choice in dental crown restorations. Their exceptional durability and resistance to fractures make them particularly suitable for back teeth, which endure substantial biting forces. Additionally, their ability to closely mimic the natural tooth color adds to their cosmetic appeal.

Porcelain-Fused-to-Metal Crowns

Porcelain-fused-to-metal (PFM) restorations were invented in 1950s as a stronger solution to all-porcelain crowns. This type of crown combines the strength of metal with the natural appearance of porcelain, making it a popular choice among patients seeking both functionality and a pleasing smile.

Advantages

1. Strength and Durability: These are more durable crowns. They can withstand the hard forces of biting and chewing. This makes them a suitable choice for both front and back teeth restorations.
2. Longevity: With proper care and regular dental check-ups, PFM crowns can last for many years, providing a reliable and durable dental restoration.

Disadvantages

1. Long-Term Aesthetics: The presence of a metal substructure in PFM crowns can occasionally cause a slight grayish tint near the gum tissue if gum recession occurs over time.
2. Color and Look: PFM crowns offer a pleasing appearance, but the porcelain layer may be more translucent than all-porcelain crowns.
3. Metal Core: Just as amalgam is no longer used in dentistry, the metals used in the substructure may cause negative reactions to those with known allergies or sensitivities, Patients should discuss this with their dentist before opting for PFM crowns.
4. Porcelain-fused-to-metal (PFM) crowns offer a reliable solution for dental restorations, striking a balance between the structural integrity provided by the metal substructure. Consult with your dentist to determine if PFM crowns are the right option for your specific dental needs.

Introducing Gold Crowns

When exploring different types of permanent dental crowns, it’s important to acknowledge gold crowns as a time-tested option known for their exceptional strength and durability. Gold crowns offer longevity and can withstand the forces of biting and chewing exceptionally well, making them a reliable choice for long-lasting dental restorations.

Advantages

1. Minimal Tooth Preparation: Compared to all-porcelain crowns, gold restorations require less tooth reduction during the preparation process. This preserves more of the natural tooth structure, promoting better long-term oral health.
2. More Affordable: Gold crowns tend to be cheaper than other crown options, but this depends on many factors such as your geographical location and the type of gold crown selected by your dentist.

Disadvantages

1. Appearance: Gold crowns may not be the preferred choice for those seeking a natural appearance due to their visible metallic appearance in the mouth.
2. Back Teeth Only: Unless requested, these crowns are never used for front tooth restorations.
3. They are commonly used for posterior teeth restorations (back teeth), prioritizing strength and functionality over aesthetics. Your dentist will consider factors like tooth location and personal preferences to recommend the most suitable crown type for you.

Stainless Steel Crowns

Stainless steel crowns, although commonly used for dental restorations in children, are not typically used on permanent teeth. The primary reason behind this distinction lies in the long-term durability, lack of customization, and poor aesthetic considerations that are more relevant to adult patients. While stainless steel crowns may serve their purpose well in temporary restorations for baby teeth, they are not designed to withstand the biting forces and wear experienced by permanent teeth over time.

Advantages

1. Good for baby teeth that will fall out within a few years.
2. On children, the material can withstand the force of biting and chewing.

Disadvantages

1. Poor fit due to their lack of customization options.
2. Low quality material that lacks durability.
3. Long-term prognosis is poor because they can wear significantly over time.
4. Cannot withstand the force of biting and chewing on permanent adult teeth.

Stainless steel crowns are the lowest quality crowns. A dentist will select from a few sizes and choose the size that closest fits your tooth. For this reason, Dr. Hale reserves these only for baby teeth that do not need to last a lifetime. Additionally, the thin nature of stainless steel can result in significant wear over time if used on permanent teeth. While cost-effective, it’s important to consider the longevity and suitability of stainless steel crowns for lasting dental restorations.

Materials in PFMs and Gold Crowns

Gold crowns and PFM crowns are, surprisingly, not made of 100% gold or one specific metal. If a patient chooses a gold crown or a porcelain-fused-to-metal crown, the dentist then has to choose between high noble, noble, or base metal. Here is a quick overview of crown composition:

High Noble Metals: Platinum, palladium, and silver are known as noble metals. For a crown to be considered “high noble,” at least 40% of its composition (within the 60% metal content) must be gold. This high noble composition ensures optimal quality.

Noble Crown: A noble crown must contain a minimum of 25% noble metals, including gold, platinum, palladium, or silver. These crowns offer excellent durability and functionality.

Base Metal Crown or Non-Noble Metals: A base metal crown does not contain any noble metals. It typically includes nickel, which some patients may develop allergies to. These crowns are best avoided if you have known sensitivities.

Remember, the higher the noble metal content, the better the crown fits and functions.

Considerations for Choosing the Type of Crown

All permanent crowns at Hale Family Dentistry are custom made with the help of dental laboratories and specialized technicians. Dr. Hale will take digital impressions and select the type of crown, and, if necessary, composition. Hale Family Dentistry typically uses porcelain for front teeth and zirconia for molar teeth, but there are always exceptions to these rules. Each person has a unique smile and situation that requires different considerations. Consistency is key in creating beautiful smiles. Here are a few considerations:

1. Tooth Location: If you’re looking for a natural-looking smile, then choosing a gold crown may not be the best solution. At the same rate, choosing a ceramic crown for a molar tooth is equally discouraged. Porcelain and ceramic do not hold up to excessive wear as much as zirconia.
2. Neighboring Teeth: If you are getting a crown near other teeth that have porcelain crowns, a porcelain crown would be highly recommended. If adjacent teeth are metal-based crowns, then that is the best option.
3. Cost and Budget: If you’d rather pay a little bit less (and it is not a significant difference) and you do not care about appearance, then a gold crown on a back tooth may suit you for life.

Conclusion

Understanding the different types of dental crowns is essential when making an informed decision about your dental restoration. All-ceramic restorations provide a natural and aesthetically pleasing option, particularly for front teeth restorations, but not without limitations. Porcelain fused to metal crowns have a wide range of benefits and durability. Lastly, gold crowns offer exceptional strength and durability, making them a reliable choice for back teeth if you don’t mind the gold or yellow color. By discussing your concerns and preferences with your dentist, you can determine the most suitable crown type to restore your smile and ensure long-term dental health.

Between the various types of restorations, one thing remains the same: oral hygiene. No matter what type of dental crown you and your dentist choose, it’s important to stay keep up on your oral hygiene at home and visit the dentist office twice a year for cleanings and checkups. Maintain a healthy oral hygiene routine by brushing and flossing every day and your crown should stay in tip-top shape for years to come.

Remember, a healthy and functional smile is within reach. Trust your dentist’s expertise and work together to find the crown that will help you maintain your oral health and restore your beautiful smile. If you have questions, be sure to reach out to your local dental professional or give our office a call. We can even do a free benefit check to see if a crown is covered on your dental insurance. Our dental team is always willing to help!

Learn more about why your dentist recommend treatment with a dental crown.

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