5 types of dental crowns and their respective prices

Why Do I Need Dental Crowns?

There are several types of crowns, each with a particular indication due to the material they are made of, It influences their resistance and aesthetics depending upon location.. However, in general terms, the following cases should be mentioned:

Caries: a tooth with advanced caries will present destruction of a large part of its structure, weakening it to such an extent that it could begin to fracture little by little until it leaves only the dental root in the bone. For this reason, dental crowns act as protectors of the tooth structure.

Stains: some diseases and habits can cause unaesthetic stains on the surface of teeth. Some  can be removed with prophylaxis or whitening, but others are extremely difficult to disguise, so crowns can be placed on the external surfaces of these teeth to improve their aesthetics.

Endodontics: certain teeth with large cavities may suffer from pulp involvement. This tooth will need a root canal treatment, leaving the tooth devitalized. It could begin to fracture, so the best reinforcement would be a crown over the tooth.

Implants: Spaces in the dental arch due to tooth loss can be rehabilitated with devices called implants. These are mini metal screws inserted into the residual bone that serve as support and a core to place a crown and thus make the space functional.

Fractures: it is common for patients who have bitten something hard at a meal or received a blow that caused the fracture of one or more teeth. Depending upon the severity of the incident, you can restore them with resins and, in other cases, with crowns.

Bite: Did you know that according to studies by the World Health Organization, only 5% of the population has a perfect bite. The other 95% have problems with the bite and position of their teeth. The treatment for early ages is basically  orthodontics; however, this does not work in adults, so crowns are ideal to achieve an efficient bite.

How Is A Tooth Prepared For A Dental Crown?

In order for a tooth to wear a crown, regardless of the material, it must be prepared by a dentistto create space and not to disturb the balance of the oral cavity. Following the indications of the American Academy of Periodontology, a crown must not interfere with basic functions such as chewing and the articulation of words. ome steps to follow:

• Reconstruction: The vitality and amount of tooth structure will be a consideration. If a tooth has suffered great wear, a part of it will have to be reconstructed  to create enough retention for the later crown. This reconstruction is generally done by first placing a pin and  with resins, the shape of the future crown stump will be given.
• Grinding: To place a crown, your dentist will grind down the surfaces of your tooth,known as tooth grinding. There are several factors that play a role in the amount of tooth to be worn down; the material of the crown will be one of them.
• Models: Once the material is chosen and the tooth is carved, models are taken so that the technician can fabricate the crowns tol fit perfectly. In some cases, with new technology, after the carving, it will no longer be necessary to take models; that is to say, it will be enough for your dentist with a small camera and a computer with a special program to scan your teeth. This digital model will be sent directly to the laboratory where a computer, thanks to the design and some modifications by the laboratory technician, will be able to print the crown, facilitating and accelerating the whole process.

What Types Of Crowns Are There?

Many factors are important when choosing a crown: these will include cost, hardness, and durability. On the other hand, these materials must be approved by the American Dental Association.  We  know the types of dental crowns by the type of material used in their manufacture and each one will have specific properties and indications for each case.

Metal Crowns

These crowns are made entirely of metal:generally gold, silver, copper, or alloys such as cobalt-chromium or nickel-chromium. 

Advantages

• They are considered to be the most resistant crowns due to the properties of the metals. For this reason, they are ideal in molar restorations or posterior areas that need to resist high force loads.
• These crowns are characterized by their long life; if properly cared for, they could last up to 15 years.
•   The grinding to use these crowns will be minimal, so they preserve the most tooth structure.
•  These crowns are able to preserve and restore function and health to the tooth in need, so they are excellent for teeth with a great loss of structure.
•  An additional indication for their use is for people who suffer from pathological clenching or bruxism since they will not be deformed by the forces. However, the protection of the opposing natural teeth should be taken into account since they could suffer a certain degree of wear.

Disadvantages

• The lack of esthetics is their main disadvantage since they obviously do not resemble the color of the underlying tooth. Because of their bright, dark color,they are particularly obvious, so their use in front teeth is not recommended.
•  Some people may be allergic to certain metals; more cases have been reported in gold-based crowns.
• As time goes by, metallic materials, due to the action of acids, will begin to reveal a certain degree of porosity, so food retention on their surface may increase. Because of this, you will need more controls throughout the life of the crown, in order to polish it and decrease  porosity.

 

Metal-porcelain crowns

Metal-porcelain or metal-ceramic crowns have a similar structure to metal crowns, but with an aesthetic porcelain covering. These crowns were developed due to aesthetic need without losing strength.

Advantages

•  The esthetics provided by porcelain is good since the scale of colors can match the color of natural teeth.
•   It is considered a long-lasting crown thanks to its metallic component.

They are recommended in teeth with great destruction of their structure and in cases of pontics, where missing teeth must be replaced.

Disadvantages

•   It is often difficult to cover the gum area with porcelain, so when the crown is cemented, it could be slightly noticeable and aesthetics will be slightly compromised.
•  Because of having a metallic base, this type of crown will not be able to imitate all the characteristics of a natural tooth, such as translucency, although it will not be a contraindication for use in anterior teeth. If you are looking for high aesthetics, other crowns  can achieve it.
•   In a vital tooth, it could increase sensitivity due to the greater amount of grinding that will have to be done for the material to adapt correctly in the mouth.

Full porcelain crowns

Also known as ceramic crowns, these are metal-free and the most widely used and well-known type of dental crown due to their natural appearance. Their  translucency  can resemble a  tooth.

Advantages

• It would be a very good choice for aesthetic restorations since it can simulate the color, shape, and size of  natural teeth.
• Obviously, this type of crown will  restore the structure of the affected teeth, i.e.,  their functionality.
• The duration of this type of crows is approximately 15 years, and only with the care indicated by .
• Porcelain is considered a biocompatible material, so allergies are not a concern.
• Eating extremely hard foods can cause porcelain to become detached from the metal.

Disadvantages

•  Its hardness is slightly less than that of metal-porcelain crowns; however, the material is stronger than natural teeth so they may wear down opposing natural teeth.

Zirconium crowns

With the advancement of technology, new biocompatible materials with better properties have been developed for use as crowns. Zirconium is one of the newest materials in dentistry thanks to the introduction of CAD/CAM (digital design) laboratories, which w help to reduce working time.

Advantages

•   It is a material with very hard properties which, thanks to its aesthetic contribution, is the ideal material, together with metal-porcelain crowns, for restoring posterior teeth.
• It is a very resistant material; however, without good support, it could fracture.
• The grinding for a zirconia crown will be less than that needed for porcelain-metal crowns, so it will preserve more tooth structure.
• Thanks to the advent of the CAD/CAM system in the 2000s, these crowns can be placed in a single session.
• Other outstanding features are their biocompatibility and resistance to temperature changes.

Disadvantages

•  Zirconium is a slightly opaque material, so it will affect the translucency needed to restore anterior teeth.
•   Being a harder material than the natural tooth, it can cause some wear on the teeth of the opposite arch with which it contacts; this is known as attrition.

 

E-MAX or Lithium Disilicate Crowns

One of the latest materials now used for the manufacture of dental crowns  is currently gaining great popularity. It is considered to be the most reliable material, using  CAD/CAM technology.

Advantages

•  This crown could be considered as the most aesthetic that exists, so they would be the ideal in anterior teeth thanks to the great translucency  achieved.
•  Being a material used with CAD-CAM technology, these crowns can be cemented in a single appointment. Laboratory work is therefore reduced since the design of the shape and size will be done by a computer system.
• This crown  blends in well with the rest of the surrounding natural teeth.

Disadvantages

•  Like porcelain crowns, whether full, metal or zirconium based, they may cause a degree of wear on the surface of the opposing natural tooth, causing tooth crowding.
•  Although its hardness is greater than that of  teeth, its use will not be recommended in the posterior teeth.You could opt for metal-porcelain crowns or in some cases metal crowns.

What Is The Approximate Cost Of Each Crown?

Once we have an idea of the different crown materials and the cases in which they can be used, it is necessary to know the cost. This will depend upon the material used for a crown’s manufacture; for example, a metal crown will have a relatively lower price than a metal-porcelain crown. In addition, the technology needed will be an issue. Remember that the installation of a crown is the last step of the rehabilitation process since a previous root canal treatment and a post will be needed. Sometimes only a reconstruction with resin of a part of the tooth provides the necessary support structure for the future crown.  Here are the approximate prices per tooth:

·  Metal Crowns: This type of crowns is the most economical, its cost can vary between $600 to $2000. This price range varies depending on the metal used in their fabrication.

·  Metal-porcelain crowns: The price of these crowns can range from $600 to $1500.

·  Full porcelain crowns: The cost ranges from $500 to $1500.

·  Zirconia crowns – E-MAX crowns: like full porcelain crowns, they range in price from $500 to $1500.

Which One Should I Choose?

Depending upon the needs of the patient, your dentist will offer a choice between the best alternatives for the case. In selecting materials, he will consider the following factors:

·  the color of the adjacent teeth

·  the location of the tooth that needs the crown

·  the function the tooth to be crowned will have to fulfill

·  the size of the teeth

·  the shape and position of the gums on the tooth in need of the crown and the neighboring teeth

·  the amount of tooth structure that exists to support the future crown.

In addition, your dentist will listen to any preferences you may have since for some people, aesthetics will be more important, while others will want to regain the function they have lost. It is important to emphasize that economics will be a factor in  making a decision. However, it should not be the main factor since the purpose of rehabilitating a tooth is to be comfortable, functional, and aesthetic, affording great satisfaction at the end of the treatment.

How Long Do They Last And What Care Should I Take?

The duration of the crowns will depend on various factors, but the most important factor is dental hygiene.  Brushing after meals and flossing will help prevent the accumulation of food debris between the tooth or crown and the gum. It is important to know that the accumulation of this debris over a long period of time could cause cavities in the neck of the tooth and the presence of a crown in that area without proper hygiene will increase the risk of plaque accumulation and therefore the risk of cavities.

On the other hand, various materials tend to lose their smooth and shiny surface over the years, so check-ups every 6 months are crucial to ensure that their useful life is not lost. During this consultation, your dentist will perform prophylactic treatments such as the cleaning and polishing of crowns. 

Also, if your dentist diagnoses some kind of alteration in your occlusion, you should think about maintenance splints since  it may show enough tightening to cause fracturing of crowns and natural teeth as well.