Porcelain Crowns

porcelain crowns

Back before the days of bonding technology, dental crowns nearly always needed to be made with a metal foundation. Today, we can make them out of pure porcelain or other ceramics. There are still occasions on the back teeth when the durability of a metal foundation in the crown makes it the restoration of choice. But when it shows prominently in your smile, wouldn’t you rather have one that looks as natural as possible? See photos at the bottom of the page that show the beauty of pure porcelain.

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Why Porcelain Crowns Are 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.

all porcelain crownsYears 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.

Variations on Porcelain Crowns

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. They have some esthetic limitations in the hands of all but the most artistic of dentists.

Empress crowns are also a variation of all-porcelain which uses the Empress pressed ceramic material. Other ceramic materials are Procera, In-Ceram, zirconia, and feldspathic porcelain. A good 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. I recommend strongly against urging a dentist to use a material or technique that he or she doesn’t recommend.

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 fully 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. They can also create a porcelain butt margin that tends to minimize this dark line, but it doesn’t eliminate it. However, these crowns 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, click here.

Before  Click here to see a larger photo.

Before
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After Click here for a larger photo.

After
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The Beauty of All Porcelain Crowns

Here is another example on a patient of mynewsmile.com network dentist Dr. Duane Delaune of Metairie, Louisiana.  This patient had a mal-formed lateral incisor that made her self-conscious. Notice the beauty of the crown in the after picture that blends so perfectly with her natural teeth. You have to view the larger version of this case to fully appreciate it:

Before Click here for a larger photo.

Before
Click here for a larger photo.

After Click here for a larger photo.

After
Click here for a larger photo.

Read about dental bridges, and about the ovate pontic technique for creating the illusion that the false tooth is growing out of the gum.

You may also want to read Dr. Hall’s blog posts about porcelain crowns, where he answers questions from visitors.