Of the many types of full-coverage restorations, three of the most common are conventional, porcelain crowns, and CEREC crowns. However, there is not a best type. Each is the best in its only light, so the best choice depends on several different factors.
- Is full coverage necessary? When a large portion of the tooth is damaged of badly decayed, full coverage is necessary. Significant cavities, breaks, cracks, or fractures can all result in all-around protection needed. Full coverage is also suggested after root canals, to provide a protective coating on teeth that become brittle.
- What preparations are necessary? The steps to prepare a tooth for full-coverage are typically the same, though the reason the cap is needed may change the process somewhat. The shape of the tooth is altered to fit the cap. This is done to be sure the fit is natural and the restoration has the same shape as the tooth before any damage occurred. The dentist will correct any damage or decay, and build the tooth back up if necessary. Impressions are generally taken, as well, though the process could vary depending on the type of restoration.
- Conventional. Porcelain fused to metal is the most common type of crown. Made in a dental lab by a specialist, they begin with a metal alloy base for strength. Layers of porcelain, the color of teeth, are added and baked on for a natural appearance. This method is used on all teeth and in almost all circumstances, because it provides the best of both worlds. However, because they are made in a lap, the process takes time and a temporary cap will need to be worn.
- Porcelain. Porcelain caps are very similar to the conventional, but without the metal base, making them more natural looking. When aesthetics are very important, in particular for teeth toward the front of the mouth, porcelain tends to be used. They are not as strong, nor do they hold up as well in the back of the mouth, due to the lack of metal base. But, they do perform well on front teeth where the biting is not as strong. These also take a couple of weeks to make and will require a temporary cap to be worn.
- CEREC Crowns. Though there are various types of CAD/CAM machines, CEREC crowns are best known by patients because they’re marketed more and made in the dental office, using a special computer system and milling machine. They are originally a block of material containing resin and porcelain. The machine carves the restoration using a digital image of your tooth and the dentist cements it in place the same day. Due to the considerable amount invested in the equipment for these crowns, not every office will offer them. They are just as strong and last as long as the conventional or porcelain crowns, but some dentists feel more comfortable using the other options on back teeth when someone has a strong bite or grinds their teeth. It is also hard to achieve perfect aesthetics with the CEREC crowns, so dentists will sometimes choose the porcelain route over them for the front teeth.
Ultimately, an experienced dental professional will look at all aspects, including how your teeth come together, your bite, your habits, and what they believe is best, before deciding which restoration to suggest.
This article is brought to you by Enfield CEREC crown provider Dr. William Cummiskey.
