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September 27th, 2012

When a tooth has been extensively filled or decayed, often the treatment of choice is to place a crown (sometimes referred to as a cap).  Crowns cover the entire surface of the tooth and provide strength that resists further breakage with normal function.  But what material is best? As with many options, it depends on the circumstances.
All metal, often gold, crowns were the standard of the past.  They are strong and very versatile and can be made very thin, but are not very esthetic by today’s standards.  The most common type done today is the porcelain fused to metal crown.  The metal “thimble” provides strength and fit while the porcelain on the surface provides excellent esthetics.  In the front of the mouth, we may want even better esthetics to match natural teeth and an all ceramic crown might be the choice.  These are translucent like natural teeth but, are not as strong as the other types.  An even newer class of ceramic crowns has come on the scene that have a zirconia glass core for the fit and strength of metal, and porcelain on top for excellent esthetics and strength.
The newest ceramic crowns are pressed glass and are quite strong.  They are produced with the aid of CAD-CAM (computer aided design – computer aided manufacture) and are producing some spectacular results.  Some bridges are even being made without any metal structure.  The materials for crowns are constantly evolving to be more like real teeth in both function and appearance.
What to choose?  Well the choice involves a lot of questions.  Are you involved in contact sports which need a stronger crown?  Are there other crowns near this one that we want to match?  Is there a career in movies or TV involved?  Is the bite very close providing only room for a very thin crown?  All of these things and more can be involved in the decision.  Your dental team will always assist you in choosing what is right for the best result.

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