Dental Crowns

Why are Dental Crowns needed?

A crown (or cap) completely covers the tooth above the gums and holds the remaining tooth together, providing excellent longevity.

Dental Crown Process

A crown involves preparing all around the tooth and over the chewing surface to make room for the new crown. Then a mold of the prepared tooth is taken and sent to the laboratory where the crown is made. A temporary crown is made to protect the tooth while the final crown is being constructed. There is an enormous difference in the quality between laboratories. We use the best laboratories we can find. Once the crown returns from the lab (around 2 weeks) we remove the temporary crown and cement the final crown in place.

Indications

Crowns (caps) are indicated for:

• Severely cracked teeth
• Large breaking-down fillings
• Back teeth which have had root canals
• Teeth with little remaining natural tooth structure
• For aesthetic reasons

Types of Dental Crowns

There are three basic types of crowns we offer:

• Porcelain fused to metal (PFM) crown
• All-ceramic crown
• Full gold crown (FGC)

Porcelain fused to metal (PFM) is a tooth colored crown with high strength. The metal core makes a PFM many times stronger than an all-ceramic crown. The metal core can be made of many different materials. In our office the metal core is only “high noble”, which means almost all gold, over 96% or 23 carat (an additional 2.6% is platinum). We only use high noble metal due to the better-fit, extremely rare allergies and sensitivities, and better aesthetics. Tooth colored porcelain is baked on the outside of the gold. We only use the highest quality porcelains (a combination of beauty, biocompatibility, and strength). Because there is metal under the porcelain it blocks natural tooth translucency and is not as pretty (aesthetic) as an all-ceramic crown. There are many different marginal configurations (the area where the crown meets the tooth) with a PFM. How well the margin of the crown fits affects the health of the gums and ultimately the longevity of the crown. We choose to do a porcelain butt margin, which is the most aesthetic (also the most challenging for the dentist and the laboratory technicians to perform well). A porcelain butt joint, when done well, is aesthetic, healthy for the gums, and durable. Back teeth receive as much as 10 times the force of front teeth. Therefore, PFMs are usually indicated on rear teeth that show very little when you smile.

An all-ceramic crown (or porcelain with ceramic substrate) is the most beautiful of all crowns. There is no metal so translucency is usually excellent (dependent on the type of materials used for an all ceramic crown). These crowns are usually indicated on front teeth or teeth that are highly visible. We use only the best materials (a combination of beauty, biocompatibility, and strength) for our all-ceramic crowns.

A full gold crown (FGC) is composed of gold and looks gold. We only use high noble metal for our gold crowns (about 72% or 18 carat gold, 3.5% platinum). High noble metal fits better and is much less likely to result in allergies or sensitivities. Full gold crowns are indicated on back teeth with low visibility and are performed rather than a PFM at patient’s request. The primary benefit of a full gold crown is durability.

Other types of crowns include stainless steel (indicated for baby teeth that will be lost), noble metal (less gold and platinum) and base metal crowns (usually do not fit well, documented sensitivities and allergies, and a weaker bond to the overlying porcelain).