One of the most popular justifications for getting porcelain crowns, and a reason for their good reputation, is that they offer excellent results when it comes to aesthetic treatment — and this is especially true when one seeks to improve the shape, size, color or alignment of one’s teeth. They are also an excellent resource for those cases where natural teeth have been severely damaged by cavities, fractures, or multiple restorations; and again, they are often the choice of restoration for a tooth that has undergone a root canal.
But before elaborating further, we have to be clear on what a porcelain crown actually is: Porcelain crowns are dental restorations that completely cover the tooth — or more precisely, they are restorations that cover the part of the tooth that is outside the gum (this part of the tooth is called the “clinical crown”).
The main goal of the porcelain crown is to protect and conserve the remainder of the tooth that is left within, thereby giving the tooth functionality again. If we wanted to use a simple analogy, we could say that a crown is like a helmet resting upon the head of a motorcycle rider.
Crowns are also known by other names, like “porcelain jackets,” “tooth caps,” or “dental caps.”
Even though today the vast majority of crowns are made out of porcelain or zirconia, it’s important to know that these are not the only alternatives. There are also crowns made entirely out of metal: these can be made out of precious metals (with a high gold content), semi-precious metals, or non-precious metals.
As you can imagine these crowns are not aesthetically appealing and are used only in special cases such as when patients tend to clench their teeth or grind them together.
Metallic crowns are not used for frontal teeth. Another alternative is the use of mixed metal-porcelain crowns which are metallic on the inside and porcelain on the outside.
These crowns are used less and less since porcelain and zirconia crowns are today both aesthetically and functionally superior.
Porcelain crowns — when should one say yes, when no?
Even though a treatment with porcelain crowns has many advantages, this treatment should only be carried out when it fulfills the right criteria. Two of the most important reasons to consider using porcelain crowns are the following:
To improve the aesthetic appeal and functionality of a tooth.
Ideal for teeth that are fractured or worn down, have inadequate shape, or are misshapen because of developmental anomalies. Since porcelain crowns become the visible part of the tooth, both changes to a single tooth and improvements to a person’s overall smile (by placing porcelain crowns in several teeth) may lead to aesthetically significant results. However, choosing porcelain crowns solely in order to improve one’s appearance may be the wrong choice, since oftentimes there are less invasive treatments available, such as veneers, porcelain restorations, “contact lenses,” or a whole array of options offered by adhesive dentistry that can attain similar effects on appearance without wearing down the patient’s teeth.
To strengthen the tooth.
Ideal for those teeth that have been severely damaged by cavities, have lost a great deal of dental tissue, or have undergone root canals, as well as for those cases where a dental filling lacks the necessary characteristics to serve as the option of choice in the restoration of a tooth. If you’re interested in learning how to avoid the need for a porcelain crown for your teeth, click on our article detailing 6 suggestions on how to avoid crowns.
Advantages of a crown as opposed to direct restoration
One might think that direct dental restoration, using a resin, might be a better alternative to a crown; however, there are important considerations that suggest that dental restoration is not always the optimal choice.
- Crowns are made in a dental laboratory, either by a specialized technician or through some of the most sophisticated dental technology in existence, such as the CAD-CAM system. This allows for a detailed analysis of your bite and jaw movements from multiple angles, the use of a microscope to corroborate the details, and, afterwards, the fabrication of a crown whose form and function will be ideally fitted to you.
- Direct restoration, on the other hand, is performed in a constricted space (since the procedure takes place inside the mouth), under conditions of limited visibility, and with a larger risk of contamination (since saliva is impossible to avoid).
- The most important reason for choosing a crown, however, is that the longevity, aesthetic value, and overall functioning of a ceramic crown or zirconia crown is far superior to that of a dental filling.
How long does a porcelain crown last?
All of this takes us to the next question: do porcelain or zirconia crowns last forever? Unfortunately, the answer is no. A well-made crown, sealed correctly and properly adjusted to take into account the patient’s masticatory contact tooth patterns, can last for many years, but it does not last forever. Studies have shown that over 90% of crowns still function well after 10 years of usage (Pieterssun 2007), and over 80% continue to be successful after 25 years of usage (Walton 2013). These are considered very favorable statistics, if one takes into account the demanding use that is required of dental prosthetics by the people that use them. There are certain factors that determine how long a crown lasts — be it porcelain, zirconia, or any other type of dental crown:
- How subject the crown is to being worn down (due to the strength of the bite, clenching, grinding, or physical traumas occasioned by accidents).
- Dental hygiene — that is, how well the crown is protected from dentobacterial plaque.
- If the crown was made by a prosthodontist (a specialist) or by a general dentist.
How much does a porcelain crown cost?
Several factors intervene in this instance, such as: The type of material the crown is made out of, the fabrication technique of the crown (computerized or manual), and some factors that in theory should not play a large role in determining the cost — such as the size of the city, or even the country where the treatment is being carried out — but which do end up having an effect.
In the following table, we show the cheapest and most expensive options for different kinds of crowns, as well as the prices offered by our clinic, Salud Oral Dental Center.
All this information will help you in defining clear criteria when it comes to choosing a porcelain crown.
or analyzing its advantages and disadvantages. If you have any questions, do not hesitate to get in touch with our clinic, Salud Oral, whether by email or by phone. It will be a pleasure to help you in whatever way we can. To access further information about aesthetic treatments and their advantages, you may also see our brochure.