Dental crowns, the patient's guide

Last Updated: 21.11.2023

Author: George Ghidrai, MD  

What is a dental crown ?

A dental crown is a prosthetic restoration which completely caps or encircles a tooth or dental implant.

Dental crowns are fixed dental restoration. Unlike removable dentures, which can be taken out from the mouth by the patient, crowns are cemented onto existing teeth or implants, and can only be removed by a dentist.

When would I need a dental crown?

Crowns can be indicated in many situations. Here are some of the most common indications:

• Advanced tooth destruction

  Crowns are often needed when a large cavity threatens the ongoing health of a tooth. A badly broken or decayed tooth needs to be strengthened with a crown because this cannot be done with a filling alone.

  

  advanced tooth destruction;
  a tooth crown is indicated

  The crown will keep the cracked tooth together and protect it; thus, it prevents or delays having to have the tooth extracted.

• Tooth shows large fillings that need replacement

  Many times, after removing large old fillings, a crown is indicated to strengthen the tooth and make it aesthetically more pleasing.

  

  tooth with large fillings that need replacement (left);
  a tooth crown was constructed (right)

  
  

• Tooth fracture

  The tooth is broken and can no longer be restored with fillings. The tooth may crack or fracture due to a dental trauma or because of the progression of a dental decay that destroys the dental tissues.

  In such situations, a post and core is often indicated to replace the missing tooth structure and to support the crown.

  

  broken tooth

  

  a post and core is manufactured and cemented in place

  After the post and core is cemented in place, a dental crown will be manufactured to cover the post and core.

  
  

• Improving tooth aesthetics

  Dental crowns may be designed to improve the appearance of a tooth. For example, the tooth shows large, unsightly fillings, discolorations or the tooth is stained or unusually shaped. Many patients simply want to have their smile aesthetically improved.

  For best results, porcelain crowns are preferred.

  

  improving aesthetics with porcelain crowns

  
  

• Endodontically treated teeth

  It is well known that endodontically treated teeth are often missing significant solid tooth structure and become less resistant. Sometimes they may also change color.

  A crown may improve both the aesthetic and resistance of an endodontically treated tooth. In fact, there are many practitioners who argue that all endodontically treated teeth should be protected with crowns.

  
  

• To cover dental implants

  Dental implants are placed into the jawbone to replace one or more missing teeth. Once placed and properly integrated into the bone, implants may then be fitted with a number of different prostheses: dental crowns, bridges or removable dentures.

  

  implant-supported dental crown

  
  

• Retainer crowns for dental bridges or dentures

  A bridge is a fixed dental restoration used to replace a missing tooth (or several teeth) by permanently joining an artificial tooth to adjacent teeth or dental implants. In this case, the adjacent teeth are covered with dental crowns.

  In this situation, dental crowns are utilized to attach bridges and hold them in place. Dental crowns can also be used to attach removable partial dentures or overdentures.

  

  dental bridge attached by two anchor crowns

  
  

• Other indications

  • Dental abrasion

  • Advanced dental erosion

  • Bruxism: involuntary habitual grinding of the teeth, typically during sleep

  

  dental erosion

  

  dental abrasion

What types of dental crowns are available?

Dental crowns can be made from a variety of dental materials, depending on the clinical situation as well as the budget and preferences of each patient.

Click on the corresponding link for extensive details of each type of crown.

• Porcelain crowns

  Porcelain crowns are highly aesthetic and durable dental crowns. Various types of porcelain crowns are available, including porcelain fused to metal crowns and all-ceramic crowns.

  

  porcelain fused to metal crown

  

  all ceramic crown

  
  

• Zirconia crowns

  Zirconia is the hardest known ceramic in industry and the strongest material used in dentistry.

  

  zirconia crowns

  Zirconia crowns are extremely durable and tough but also highly aesthetic because they do not contain any metal in their structure (zirconia is a type of white ceramic). The zirconia core structure can be layered with aesthetic porcelain to create the final color and shape of the tooth.

  
  

• Dental composite crowns

  Composite crowns are not as durable as gold, zirconia or porcelain crowns and do need to be replaced more often. Composite crowns can have a metal shell but there are situations when it is possible to manufacture full composite crowns.

  

  full composite crown

  

  metal composite crowns
  with partial veneer and fully covered

  
  

• Full metal crowns

  All-metal crowns consist entirely of a single piece of alloy.

  Metals used in crowns include gold alloy, other noble alloys (for example palladium) or a base-metal alloy (nickel, chromium or titanium). Stainless steel or aluminum-prefabricated crowns are used as temporary crowns.

  

  full gold crown

  
  

• Dental acrylic crowns

  Dental acrylic crowns are still used in certain parts of the world as permanent restorations. However, since higher quality materials have emerged, their main indication is for temporary prosthetic devices.

  

  metal acrylic dental crown

  
  

• Temporary crowns

  A temporary crown is a provisional, short-term restoration cemented in place with a soft temporary dental cement until the definitive restoration is completed.

  Temporary crowns are usually constructed from plastic-like materials (such as acrylic or composite resins) or stainless steel.

  

  stainless steel temporary crown

How long do dental crowns and last?

With proper care and maintenance, dental crowns can last up to 15 years (or even more).

The most important step you can take to ensure the longevity of your crown is to practice good oral hygiene. Also see your dentist regularly for checkups and professional cleanings and report any discomfort you may notice as soon as possible.

Further reading

• How is a tooth prepared for a dental crown?
• Shade selection
• Dental laboratory stages
• Permanent cementation
• Risks and complications