Dental crowns, the patient's guide
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.
What are the main benefits of dental crowns?
-
The tooth is restored both functionally and aesthetically
A dental crown can restore the tooth back to its original size, shape, and color. Besides that, a crown surrounds the tooth and makes it strong again, so badly broken or decayed teeth can be strengthened with dental crowns.
A crown can cover up a stained or unusually shaped tooth or close spaces between teeth and correct minor rotations and positions of the teeth. Dental crowns can improve the general appearance, adding to patients self-confidence and giving a nicer smile.
dental crowns can improve aesthetics and the general appearance
-
A crown protects the tooth against further decay
A crown that fits correctly over the tooth can protect the tooth against tooth decay.
-
Few appointments are needed
Dental crowns require little time to be completed compared to dental bridges, removable dentures or implant-supported prostheses. Depending on the type of crown, the execution may vary between 2 and 4 appointments.
-
Patients get used to dental crowns before long
Because of their small size, patients get accustomed to dental crowns in a short time. Generally, after a period of 1 to 4 weeks, a dental crown should feel and function like a regular tooth.
What are the main drawbacks?
-
Requires tooth preparation
If performed on natural teeth, dental crowns require irreversible tooth preparation (grinding or polishing). This operation leads to the loss of large amounts of healthy tooth tissue and sometimes even endodontic procedures that lead to tooth devitalization.
natural tooth before preparation
the tooth after preparation
-
Higher cost
Dental crowns (especially porcelain or zirconia) entail a much higher cost compared to a filing. Nevertheless, a badly broken or decayed tooth needs to be strengthened with a crown because this cannot be done with a filling alone.
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 indicatedThe 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
-
Dental crown contraindications
There are only several situations when a simple dental crown has a clear contraindication.
-
General conditions that make anesthesia or tooth preparation inadvisable
Some serious conditions may restrain certain dental treatments. These include serious heart diseases, recent strokes, and others. These situations require a medical examination performed by the appropriate specialist.
-
When the tooth can be restored with fillings or other restorations
When a tooth can be restored with other types of restorations that do not involve such an extensive preparation (such as composite fillings, inlays, onlays or veneers), it is pointless to prepare the tooth (by grinding) and thus destroy a significant amount of dental tissues.
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
E-book or Paperback
The book is written in an easy-to-understand language, and each topic is clearly illustrated.
This lets you walk through each stage and quickly grasp the information you need.
Buy the E-book for just $5.