The most beautiful crown for a tooth is, without
question, all-porcelain or all-ceramic. With porcelain fused to
metal crowns, there has to be an opaque layer put over the metal to block
out its color. This makes it impossible to have a translucent restoration that
mimics the translucency of natural teeth. Only with pure porcelain or pure
ceramic can you have such translucency.
To define some terminology, porcelain is a
particular type of ceramic that is built by stacking and firing. When we say ceramic,
we include porcelain—porcelain is a type of ceramic.
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The reason all dentists don't use all-porcelain
crowns for front teeth is that the technique for placing them is very
demanding and isn't generally taught in dental schools. They are
translucent, and their color is influenced by the color of the underlying
teeth. General dentists aren't usually very skilled at color manipulation
in these situations. Also, placing them requires the use of sophisticated
bonding techniques that aren't fully taught in dental schools. At
mynewsmile.com we recommend that if you want one of these beautiful crowns
for your front tooth, have it done by an expert cosmetic dentist such as
we have listed on our site. See our referral page for
referral to an expert cosmetic dentist.
Here is a photograph of a patient's front teeth.
One of these teeth is an all-porcelain crown, done by an expert
cosmetic dentist in our referral network. Can you tell which one it
The crown is on the patient's left lateral
incisor, the smaller tooth just to the right of the two larger front
teeth in our photograph.
(click here for larger photo)
The work was done by Dr. Duane Delaune, of Metairie, Louisiana. Notice
how closely it mimics the appearance of the natural teeth. For contact
information, see our page of
Louisiana cosmetic dentists.
CHOICES IN ALL-PORCELAIN AND ALL-CERAMIC CROWNS
There are various types of all-porcelain or all-ceramic crowns. Let's explain
the differences between some of them:
- Feldspathic porcelain is the standard, traditional porcelain that is
used for crowns. Many cosmetic dentists feel that this is the most
- The Empress crown - Empress is strictly speaking not a porcelain,
but is more like a glass. It can be called a ceramic material. The
Empress material is cast rather than baked as a feldspathic porcelain
crown is. The fit of Empress is more precise than the baked
feldspathic porcelain. However, the color in Empress is mostly baked on the outside. Empress can be very beautiful.
For appearance's sake, some expert cosmetic dentists prefer the
feldspathic porcelain, and some prefer the Empress.
- The Procera crown - Procera is a milled ceramic on the inside with a
more traditional porcelain baked onto the outside. The advantage of Procera is its exceptional strength. However, the milled ceramic
core is opaque white, so many cosmetic dentists feel that it isn't as
natural-looking as the more translucent materials. An advantage of Procera
is that it doesn't have to be bonded to the tooth but can be
cemented with ordinary crown and bridge cement, a technique familiar to
- The Lava crown - Lava is similar to Procera, but the milled
ceramic on the inside is a more translucent Zirconia,
rather than an opaque white material. The Zirconia is shaded, and then
the final esthetics of the crown are achieved in the baked-on outer
layer. The Lava crown can also be cemented with traditional techniques.
However, any crown cemented with a traditional crown and bridge cement
is going to be susceptible to a compromise in the appearance if that
cement line ever shows.
- Zirconia crowns, if they
are done right, can be translucent enough to look natural. And if they
are bonded to the teeth, instead of being cemented with conventional
dental cement, they won't show a black line at the gumline.
- The Cerec crown - Cerec is are also
milled from a block of very hard ceramic material. What's unique about
Cerec is that the crown is milled by a computer in the dentist's
office rather than in a separate dental laboratory. Thus, the
dentist doesn't have to send out for it to be made—it
can be made on the spot. So, no second appointment is required, and
no wearing of a temporary crown between appointments. Cerec is milled
from a block of ceramic that is a single color, so it is generally not
considered esthetic enough for demanding cosmetic dentists. A few exceptional
dentists who are artists, however, are able to custom stain Cerec
for front teeth so that they are truly beautiful. Some even make
Cerec veneers that can be placed the same day.
To be precise, Cerec is actually a technique and not a material. There are
several companies that make ceramic materials for use in Cerec machines.
- The InCeram crown - InCeram is made of a very dense and very
tough aluminous porcelain. It also has excellent esthetics, but is
more opaque than feldspathic porcelain. InCeram is also strong
enough to be cemented with traditional dental cement.
- There are other types of all-ceramic crowns. We're not going to list
all of them here.
ADVANTAGES AND DISADVANTAGES OF ALL-PORCELAIN AND ALL-CERAMIC CROWNS
Let's compare all-porcelain with porcelain fused to metal.
- All-porcelain is generally not as strong as
fused to metal. It has to be bonded to the tooth in order to have
adequate strength for oral function. The bonding technique is very
demanding and is not fully taught in dental schools. We recommend that
you only have an expert cosmetic dentist place this type of crown.
- With porcelain fused to metal, the porcelain has to be opaque in order to block
out the appearance of the metal underneath. They all also eventually
develop an unsightly dark line at the margin where the edge of the crown
meets the tooth.
- Some of the all-ceramic systems that have an inner ceramic core with
an outer layer of porcelain baked on require more tooth reduction.
Grinding away more of the tooth is often not desirable.
- Some of the ceramic materials that are very tough and fracture resistant are
also quite abrasive against the opposing teeth. Of the crowns listed
above, the Empress is the kindest to the teeth it chews against.
GENERAL RECOMMENDATIONS FOR ALL-CERAMIC CROWNS
- There are several factors that need to go into the selection of a
crown material: strength requirements, esthetic requirements, the
abrasivity of the material against the opposing teeth, and the
skills of the dentist. There is not a single crown that is clearly
superior for all situations. Many cosmetic dentists will have several
types that they will use, each for a different situation.
- It is generally a poor idea for a patient to go to a dentist and
request a specific type of all-porcelain or all-ceramic. We have
received many e-mails from patients who have done this and have been
very disappointed with the results, because they were pushing their
dentist to use a material the dentist was not comfortable with, and many
dentists will try very hard to conceal from patients any discomfort they
feel with a procedure. There is also the factor of the dental ceramist,
whom you will most likely never meet. The material that is used for the
crown should be intimately familiar to the dentist and to the ceramist for the best
- You cannot learn, as a patient doing online research, which crown is
best. First of all, there simply isn't one all-ceramic material that is
always best. Second, in a web page such as this, we can't list all the
properties of all them. Third, in evaluating these crowns, there
is a great deal of background information needed in order to evaluate
which research claims are fully established and which claims should be
- Our recommendation, at mynewsmile.com, is that you find a cosmetic
dentist you can trust and that understands your needs and is passionate
about creating beautiful dentistry. Then ask that expert cosmetic
dentist to use the technique that he or she is most comfortable with in
creating the all-ceramic crown that will be best for you. The choice of
the material is secondary to the skills of the dentist and of the
ceramist in working with that particular material. There are subtleties
in working with all of these all-porcelain and all-ceramic materials
that need to be mastered by the dentist and the ceramist to produce the
most beautiful result.
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