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With the movement of modern cosmetic dentistry into all porcelain crowns from traditional porcelain fused to metal crowns (PFM crowns), many have wondered if the

Porcelain Crowns Marielaina Perrone DDS

The Natural Look of Porcelain Crowns

porcelain crowns would be as effective in the long term. Well, recent studies have shown that they are just as strong and maintain their beauty over time as well.

The main differences in porcelain crowns are the type of porcelain used, and how they are fabricated. Different porcelain types and strengths are used for different reasons. Remember also, that a lab created porcelain crown, is of higher fabrication quality and fit, than an in office computer milled crown.

Porcelain Crowns Long Term Study

The researchers at the Medical University at Innsbruck studied a little over 1,300 all porcelain crowns placed between 1987 and 2009. They were tested for predictability and strength and found to have a high,(93.5% probability of survival) success over a 10 year period. The study was published in the International Journal of Prosthodontics). The study included those with root canal teeth, and those who grind their teeth.

A total of 302 patients (120 men and 182 women) participated in the study. They were examined at the university during regularly scheduled visits for dental examination. Patient-specific data about sex, age, tooth sensitivity, smoking, and grinding  were noted, as well as self-reported data regarding their level of

Cosmetic Dentist Marielaina Perrone DDS

satisfaction with their restorations: excellent, good, medium, or none. The porcelain crowns were broken down into areas of mouth as well, into front( anterior), and back( premolar, and molar) regions.
All 1,335 porcelain crowns had been placed at the university between November 1987 and December 2009. Of these porcelain crowns, 451 were observed over a 10-year period, 84 for 15 years, and 24 over 20 years.

Dental examinations were completed by two dentists in the spring of 2010. One dentist had placed the majority of porcelain crowns, whereas the other dentist involved in examinations had placed none of them. California Dental Association/Ryge criteria were used to rate each porcelain crowns as a success, relative failure, or absolute failure.

Any porcelain crowns that had severe enough issues to warrant replacement were considered an absolute failure. If a finishing procedure or polishing was able to fix the issue, the porcelain crown was labeled a relative failure.

Of the 1,300+ porcelain crowns in the study, only 95 porcelain crowns were rated as failures, 79% of which were absolute failure. Most failures occurred in the anterior region, with 65, while 19 occurred in premolars and 11 occurred in molars.

Success rates remained strong over time. The estimated survival rate was 97.3% at five years, 96% at eight years, 94% at 10 years, 85.8% at 15 years, and 78.5% after 20

Porcelain Crowns Marielaina Perrone DDS

The Beauty Of Porcelain Crowns

years. Almost half of all porcelain crown failures happened in the first 8 years..

The most frequent reason for failure was fracture,(cracks) of the ceramic, according to the researchers, followed in order by cracks in the ceramic and decay.

Root canal teeth and patients who grind their teeth, had higher failure rates.

Patient responses to questions about satisfaction were very positive. With 96% rating it as excellent and 4% rating it as good. The surprising thing about this study was that even patients with failures thought that porcelain crowns were an ideal dental restoration and would do it all over again.

Porcelain Crowns Conclusion

Porcelain crowns are a proven part of cosmetic dentistry and with recent advances in dental porcelain (like e.max porcelain crowns) these results will be even better into the future. Porcelain crowns are an ideal restoration due to their color, shape, and light reflecting properties. The study just proves that they are an asset to any dental patient.

 

Porcelain crowns have long been the cosmetic dentist’s best friend. They  provide a long lasting, beautiful restoration that is very esthetic.   The cosmetic enhancement uses of porcelain crowns include, changing color of teeth, closing gaps between teeth, fixing teeth that are crooked or crowded, changing shape or size of teeth. Porcelain crowns

e.max porcelain crowns Marielaina Perrone DDS

e.max porcelain crowns look natural.

are also used to cover and protect damaged teeth, (tooth that had root canal treatment, broken, cracked, large fillings), and to act as a new tooth in the case of dental implants.

Full porcelain crowns, unlike porcelain fused to metal crowns, has translucency.  The porcelain’s translucency allows it to reflect light much like natural teeth. There are many different types of porcelain utilized in many different ways, however, the limiting  factor has always been strength against fracture. E.max porcelain crowns have combined optimum translucency and strength.

What are E.max Porcelain Crowns?

E.max porcelain crowns are a highly esthetic crown originally developed to be used on implants. Dental implant porcelain crowns require greater strength against fracture than crowns on natural teeth. E.max porcelain crowns (due to superior strength) can also be made thinner than other porcelain crowns, allowing for more natural translucency and beauty.  E.max porcelain crowns are made from a single block of lithium disilicate ceramic. This type of porcelain is considered a very high grade material which has been harvested for its toughness, durability and opaque qualities which make for a highly prized crown.

E.max porcelain crowns are considered to be a perfect match against the backdrop of your natural teeth. The transparent color, lifelike shape, along with its light reflection properties create the ideal restoration. There is no metal framework on e.max porcelain crowns which means there is never a chance of a grey line of metal showing through your gums. They are strong, long lasting and unlikely to crack or fracture as compared to many other types of crowns. They are considered to be at less risk of chipping compared to zirconia porcelain crowns.

The beauty of this technology is that e.max is not limited only to porcelain crowns. The same techniques and materials are available for porcelain veneers, porcelain inlays, porcelain onlays, and porcelain crowns over dental implants.

E.max lithium disilicate glass ceramic delivers the fit, form, function, and esthetics demanded by modern cosmetic dentistry but with the enhanced strength and light reflecting properties dentists demand as well. Since the e.max porcelain crown system was introduced almost 40 million restorations have been  and they have been proven effective for use.

 Any Disadvantages of e.max porcelain crowns?

-The main disadvantage of e.max porcelain crowns is with the cost. The lab equipment and highly specialized lab training to make this crown are the reasons why the quality comes with a higher price tag.

-The second disadvantage with e.max porcelain crowns is that it can not be used to make a porcelain bridge, and fusing of  more than 2 teeth is not recommended.

-The third main disadvantage is, as with most porcelain crowns, there tends to be a higher chance of sensitivity after the crown is cemented in place. The sensitivity may last days or weeks.

Conclusion

E.max porcelain crowns have proven to be a very useful cosmetic dentistry tool. Dentists and patients no longer need to compromise when it comes to the esthetic look of the final restorations. You no longer need to worry about crowns looking unnatural. E.max porcelain crowns will give you something to smile about!

Porcelain crowns have been a staple in cosmetic dentistry for years. It gives the dentist and patient a much more aesthetic appearance as a final product. In the past crowns and bridges were traditionally made of porcelain fused to metal (PFM). With the development of modern porcelain, which are incredibly strong and reflect light similar to natural teeth, full porcelain crowns can be used in most areas in which porcelain fused to metal crowns were used. This is especially true in a cosmetic area of the mouth.

Porcelain crowns are very versatile and used in many ways. The cosmetic enhancement use of porcelain crowns include, changing color of teeth, closing gaps between teeth, fixing teeth that are crooked or crowded, changing shape or size of teeth. Porcelain crowns are also used to cover and protect damaged teeth, (tooth that has a root canal, broken, cracked, large fillings), and to act as a new tooth in the case of dental implants. Their versatility gives the dentist a greater flexibility in using them to fix potential issues for the patient.

cosmetic dentist emax crown

Emax Porcelain Crowns

The first step often times includes impressions for study models and photos. The patient and dentist can then discuss and plan what the end result should be. The treatment includes preparation of the tooth surface for the porcelain crowns. The outer enamel and sometimes a bit of  the dentin are removed. This allows room for the porcelain crowns to fit over the teeth and be in perfect cosmetic alignment with the others. Impressions are taken of the newly reshaped teeth and temporary crowns are made.  The porcelain crowns are custom made in the laboratory. The porcelain crowns are then cemented or bonded onto the teeth using an adhesive bonding material. The placement of the porcelain crown will normally take about 30 minutes (depends on amount of porcelain crowns being placed). Once completed,  the patient can eat normally and enjoy the benefits of a beautiful new porcelain crown that matches and blends perfectly with the patients existing teeth. Only you and the dentist should know anything was done.

Advantages of All Porcelain Crowns

-No PFM gray or black lines at the Gum Line of Teeth. You may have noticed a person with a dark line in the gum area along a PFM crown edge. With PFM crowns, the soft tissue around the tooth can recede over time. This allows a reveal of the metal framework underneath. This cannot happen with an all porcelain crowns because they are metal free.

-Perfect Fit. Porcelain crowns are created in state of the art facilities. Porcelain crowns will fit so well you will even forget they are present.

-Cosmetically Perfect Match. All porcelain crowns have the ability with modern porcelains to match your existing shade of tooth color as well as mimic the light reflecting properties of your natural teeth. Porcelain crowns will be undetectable to anyone but you and your dentist. Dental porcelain can be shaped custom colored and sculpted to closely copy the look of your own natural tooth enamel. All the while providing the desired strength and resilience.

Some disadvantages of an all porcelain crowns:

-Higher cost over traditional PFM crowns.

-Durability. While porcelain crowns are very durable, they do not have the flexibility of natural teeth, they can fracture. Avoiding certain foods may be necessary. For example, Biting into sandwich with a hard bread. Patients who grind and clench their teeth will need to be fitted with a mouth guard to protect the porcelain crown from unnecessary and excessive pressures.

-Porcelain crowns may need a bit more reduction of tooth structure than traditional PFM crowns.

-Sensitivity may happen for a short time, (hot, cold sensitivity), especially with bonded porcelain crowns.

Follow-up Maintenance of All Porcelain Crowns

The maintenance of porcelain crowns is actually very easy.  They require routine brushing with non-abrasive fluoride toothpaste and regular flossing as well as regular visits to the dentist. A follow-up appointment will be scheduled to evaluate the porcelain crowns about 2-4 weeks after they are placed in the mouth This allows the dentist to review the work with tissues all healed and see how your oral tissues are reacting to the crowns. Even if you think the crowns are successful, this appointment is an important part of your future oral health.
There are several types of all porcelain crowns generally used in dental offices today. They have all proven to give the best cosmetic dental results.
-Zirconia Crowns or Lava Crowns (made by 3M Espe). This type of all porcelain crowns are made out of a zirconium core with porcelain pressed or layered over the crown to follow the natural contours of teeth. These crowns offer good strength and durability. Due to great strength, the material can be used to make a bridge.
-Procera Crowns (made by Nobel Biocare). These are made of an Alumina core with porcelain pressed or layered over the crown to follow the natural contours of the teeth. These crowns offer great strength and durability and are esthetically quite beautiful. Often used in the back of the mouth, (premolars, molars), these are cemented in with traditional cement and have less post-placement sensitivity.
-Empress II Crowns (made by Ivoclar Vivadent).These highly cosmetic porcelain crowns are used in the front of the mouth. They are used mostly for cosmetics, are very beautiful, but can fracture.
-eMAX Crowns or IPS e.MAX Crowns (made by Ivoclar Vivadent). These porcelain crowns are entirely made out of porcelain without a underlying framework. The absence of this framework offers a great advantage over Zirconia crowns, Lava crowns and Procera crowns in that e.MAX crowns allow for more light transmission through the crown translating to a more superior cosmetic dental result. The strength of these porcelain crowns is such that they can be used in any area of the mouth, can be made thinner than most porcelains, and can be used for an implant without much worry of fracture.
Cosmetic Dentistry is the art and science of creating a beautiful smile. The all porcelain crowns are just one more tool that the dentist can use to give you that smile you’ve always dreamed of.
Procera Porcelain CrownsLava Crowns Ivoclar VivadentPorcelain Crowns 3M Espe