Archive for July, 2009

What kind of crown is best?

Tuesday, July 28th, 2009

My back molar on the left bottom side is cracked from a 30-year-old silver filling and the dentist says I need a crown. I am deciding between Cerec, all porcelain, gold, and porcelain fused to gold. I don’t know which one is best for me. I was told Cerec is very hard porcelain and not likely to break. I went to another dentist today who’s a friend of my husband’s and he recommended a gold crown.

My main concerns are the amount of tooth that has to be removed, the effect on the surrounding and opposing teeth, and how soon the crown would need to be replaced. The second dentist said a gold crown would last 20 plus years, a porcelain 10 to 15, if I remember correctly. The Cerec crown appeals to me because I could have it done in one day and wouldn’t need a temporary crown.
- Diane from California

Diane,
If appearance isn’t an issue, then it’s no contest – the gold crown is far superior to any of the other dental crowns. It requires the least tooth reduction, lasts the longest, is the easiest on the opposing teeth, fits the best and is the strongest. It’s only when you get to appearance issues that it makes sense to consider any other type of crown. All porcelain is the least strong but the best looking. Porcelain fused to gold looks pretty nice and is pretty strong, but requires more tooth reduction and because of shrinkage issues with the porcelain doesn’t fit as well as all gold. All crowns that have porcelain in them are abrasive to the opposing teeth and tend to wear down the opposing teeth.

Related links:
You may also want to read about gold fillings.

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Can I get a porcelain veneer over my crown?

Thursday, July 9th, 2009

I have a porcelain crown on my front tooth that I have had since I was 13. It still looks good but has a small crack in it.  Could I have a porcelain veneer put over the top of this instead of getting a new crown made? I just am worried that the crown is going to break. – Georgia from Oregon

Georgia,
Yes, you can get a porcelain veneer put on top of a porcelain crown. But what you really need is a new crown. And there are two excellent reasons.

The first is that if the underlying crown is cracked, then the porcelain veneer that is bonded on top of it will probably crack, too. Porcelain veneers by themselves aren’t very strong – they derive their strength from the underlying tooth and from being bonded to the tooth. Bonded on top of cracked porcelain will make it likely crack.

The second reason is that at most dentists it costs pretty much the same to get a porcelain veneer as it does to get a porcelain crown. It’s about the same amount of work, and the laboratory fee is usually the same. And a new porcelain crown will last much longer than your patched crown. So why patch the crown, pay the full price, and then in two or three years need a new crown anyway? That’s unnecessary expense.

I might add that if the crack in your porcelain crown isn’t noticeable, it could be just a craze line and the crown could last for quite a bit longer. If it’s a crack that goes all the way through, then the crown would probably need to be replaced. But if it’s just a superficial craze line, it may not need to be.

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