When there is insufficient dental enamel to allow restoration with a dental veneer, a crown may be successfully used instead.
For best results, crowns require a certain amount of underlying tooth structure so they can be firmly anchored in place. Otherwise, tooth extraction, followed by placement of an implant, is advised.
Types of Crowns
Porcelain crowns (or all-ceramic) for back teeth are made of high-strength reinforced ceramic materials (e.g. lithium disilicate or zirconia). For front teeth, porcelain crowns may be made using an aesthetically pleasing ceramic material, or they may involve two layers: a high-strength material covered with an aesthetically pleasing material. All-ceramic crowns for front teeth give a very natural, pleasing appearance; they achieve the closest match to natural, healthy teeth.
Metal crowns, which are often made of gold alloy, have been around since the early 1900s and require very minimal tooth preparation, as the metal is strong even in thin sections. When designed and constructed well, metal crowns are very durable and resistant to fracture.
PFM crowns were introduced in the 1970s and appear much more tooth-like than metal crowns due the overlying porcelain. The metal core provides strength and durability. It is common to have a thin metal margin visible around the neck of the crown on the tongue side of the crown as this preserves more tooth structure.
What is the procedure for treatment?
In cases where a single tooth is missing, a crown fixed to an implant is the gold standard treatment.
Frequently Asked Questions
Dental crowns can still be subject to fracture and cavities, so it is important to look after them just as you would your natural teeth. If properly maintained through good oral hygiene and regular dental check-ups, crowns can last for many years. The material of your dental crown can affect the durability of your crown, but factors other than durability also need to be considered (such as aesthetics, survival rate and kindness to opposing teeth), so you are encouraged to discuss the different options with your dentist to choose the most suitable crown material.
Crowns perform just like your natural teeth. While they are very durable, you still need to maintain good dental hygiene and to brush and floss the crown just as you do with your other teeth. With regular dental check-ups, proper cleaning and the use of remineralisation toothpastes, you will be able to minimise the risk of decay around your dental crown.
Compared with veneers, crowns do require more of the natural tooth to be shaved back. Because this process is irreversible, crowns are generally unsuitable for younger patients.
The costs involved with dental crowns can vary depending on the tooth that requires the crown, the materials used, and the clinician who performs treatment.
When building up a damaged tooth, a large filling is a cheaper alternative to a crown. Similarly, when replacing a missing tooth, a denture is a cheaper alternative to an implant plus crown.