Dental crowns
Dental crowns are supporting structures which will protect teeth from splitting away when teeth are weak because of root canal treatment, or because of regular attrition or regular heavy bites, or because of chipping out by activities like some hits, falls. In all those situations, the tooth crown is placed above the tooth (which is exposed above the gum level).
Dental crowns have different common names amid common people: It is called a cap, cover or even protection.
Function of dental crown
First and foremost is protecting tooth from occlusal forces. Second function is esthetics, if these are around anterior region or visible areas. Third is it helps from too cold or too hot sensitivity when teeth have been whittled down because of attrition.
Dental crowns are made up of: different materials, depending on your requirements — it is catered.
Some dental crowns are made of metals. Some dental crowns are made up of porcelain fused with metal. Some dental crowns are made up of lithium disilicate, which are also commonly called as Emax, and some crowns are made up of zirconium.
Zirconium crowns and Emax are trending in dental crown world (especially in Nepal) which are preferred in the esthetic regions because they imposter or they look like natural tooth. But, based on durability, All crowns are durable, except Emax crown. Emax crowns are most natural, but they are softer as well. So when you are wearing emax crowns, you have to be extra cautious while biting or tearing your food from anterior regions. As I already said, it is used in the anterior regions because of esthetic concern it offers.
Regarding metal crowns and porcelain fused with metal crowns and zirconium crown, all three are strong, but porcelain fused with metal crowns are sometimes questionable, based on laboratory works, because Porcelain is fused with metal. First metal inner is made, and then it is painted by porcelain over it. So sometimes porcelain, which is painted or covered above metal (underneath), may chip out, and metal within may be exposed. So this may not be a good experience for the patient who is wearing porcelain fused with metal crowns.
So, I ( Dr Dinesh Karki ) first prefer metal crowns in the posterior regions for the people who do not have any esthetic concerns, who only have functional concerns. But there are people who even want their posterior reason with tooth colored crowns. I advise them zirconia crowns only because PFM or porcelain fused with metal crowns may betray them in the days to come, because, as I already said, porcelain fused over metal may be chipped out or come off, exposing the metal underneath. So it may turn out as good as metal in terms of look that would not be a good experience, or that would not be welcomed by the patient who wants esthetics in their posterior region as well.
So I advise them of zirconia crowns because they are esthetically good, functionally good, but they are not as flexible as PFM crowns (minus point). I tell them before they wear it.
Regarding costs,
Zirconium crowns are the most expensive in my clinical practice where I ( Dr Dinesh Karki ) work, it is 18 to 20 K,
PFM crown costs around six to seven K,
Metal crowns cost about five to six thousand.
And, eMax crowns, which may cost around 15 to 17K.
So to cap them off, to sumerize here, if you have only a functional concern, go for metal crowns. If you have absolute esthetic concerns in the posterior region (back side of oral cavity) , go for zirconium crowns. PFM crowns may or may not be lifelong support for your esthetic concern in the posterior regions. If you are ready to replace then PFM will be acceptable. (But the Zirconia is not fool proof.. but it comes with a 15 year warranty that can ensure its strength and durability).
And, emax crowns in the anterior regions. And,–they cannot be durable with our gurkhali bites or Nepali Bites. So, even around anterior regions, nicely crafted zirconium crowns are advised.
PS: Besides crowns– Veneers, Onlays and Inlays are also advised which preserves more of a natural tooth structure. We will talk on them in our next blog. And, Blogs are always editable–your advises and querries are welcome !