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Porcelain Crowns
Crowns are often used to restore a tooth to beauty and full function when a substantial amount of tooth structure has been lost due to breakage, decay, or a large old filling that has failed. Dr. Fondriest prefers to use all-porcelain crowns over crowns made with metal. The all-porcelain crown can be more aesthetic and will never develop an ugly black line at the gumline. Porcelain restorations can be made thinner thus requiring less tooth reduction. All-porcelain crowns can be made to closely match the light transmitting properties of natural teeth and will not stain or change color. Porcelain is more biocompatible than metal which may reduce the potential for gum recession and lead to more long-term healthy result.
COMMON TYPES OF ALL PORCELAIN CROWNS:
Empress
These beautiful restorations can be produced with excellent fit and the characteristics of natural teeth. Empress porcelain restorations have two layers; a base coping made of medium-strength pressed ceramic, and a highly customizable superficial glass layer that can be hand stacked and fired on top of the stronger pressed base coping. With only modest strength, these restorations should never be used in high occlusal stress situations.
E Max
E Max is the newest cosmetic porcelain. It is both strong and has true-to-nature shade behavior and excellent light transmission for highly esthetic solutions. This is Dr. Fondriest’s preferred porcelain system for anterior teeth. It can be used for minimally prepared veneers or crowns to as thin as 0.3mm.
E Max is ideal for fabricating single-tooth restorations. This ceramic two layer system (pressed coping and custom stacked superficial layer) produces highly esthetic results and is 2.5 to 3 times stronger than other glass-ceramics.
Feldspathic porcelain
Many cosmetic dentists feel that this is the most beautiful porcelain. This custom stacked porcelain (no base coping) is difficult to work with and requires the technician to have very high skills. Only high end dentists will use this porcelain system for crowns and veneers. These restorations are very technique sensitive to place and are more costly to produce.
Procera
Procera crowns are a two layer restoration. They are made with an aluminum oxide base coping that is custom milled with CAD technology and a superficial stacked layer of feldspathic porcelain that is used to make the restoration attractive and lifelike. Due to the opacity of the coping, the tooth needs to have a more aggressive preparation to allow enough veneering porcelain to mask the bright white coping. These restorations can also be beautiful when crafted by a master ceramist.
Zirconium
Zirconium crowns are made similarly to Procera restorations. The opacity of the zirconium coping requires more tooth reduction. Zirconium crowns are attractive to some dentists due to strength. When dentists have limited knowledge of occlusion, it is common for their crowns to break. These crowns are very difficult to remove without hurting the underlying tooth. All crowns have a finite life span and eventually need replacement.
Cerec
Cerec technology is becoming more popular in average dental offices because it cuts out the lab technician. Cerec is an in the dental office CAD milling machine. Monolithic porcelain blocks are milled into onlays, veneers or crowns. Monolithic means one color. No natural tooth is one color. These restorations can be created in one visit and are strong but they can only be customized by using surface stains. Surface staining creates opacity and metamerism and is not life like. Surface stains wear off over time.
CROWN MATERIAL SELECTION FACTORS:
Strength, esthetics, the abrasiveness of the material against the opposing teeth, and the skills of the dentist. There is no single crown material that is clearly superior for all situations. Many cosmetic dentists will have several types that they use for different situations. There are subtleties in working with all of these ceramic materials that need to be mastered by the dentist and the ceramist to produce the most beautiful result.
This patient had crowns done due to an accident that chipped several of her front teeth. She had a beautiful smile before the accident and was always proud of her healthy white teeth. She was worried about how she would look with six front crowns. All-porcelain crowns were created to match exactly the shape, surface shape, brightness, and translucency of her original teeth. It is possible to make porcelain crowns with the same beautiful lifelike appearance as porcelain veneers. These crowns are made with the newest in porcelain technologies, E Max™ porcelain.
This patient wanted "natural coloration but just a little bit brighter", and perfect symmetry with the shapes of her new smile. She had bad crowns before that looked like crowns. She did not want black lines at the gumline or opaque, monochromatic crowns that would signal "Fake" to her friends. When she was done with treatment, her friends just thought that she had been exercising and had lost weight! Every upper tooth visible is a pressed lithium disilicate porcelain crown.
Procera all-porcelain crowns on the upper front 4 teeth.
Dr. James Fondriest is proud to serve the Chicago, Illinois area, including the North Shore suburbs of Winnetka, Highland Park, Northbrook, Northfield, Glenview, Lincolnshire, Deerfield, Lake Bluff, Libertyville, Vernon Hills, Gurnee, Grayslake, and Barrington.
