Is there any one best type of crown for front teeth or is it something that has to be decided on a case by case basis. I currently have crowns on my front teeth and they are porcelain fused to metal which I am thinking of changing.
Probably not common practice but would there be a better chance of success if a person could visit the dental lab and meet the person who was making the crowns?
For front teeth, best cosmetic result achieved with Procera/Lava/Impress crowns but they are case specific. The advantage of the first two is that the substructure which provides the strength necessary for front teeth is made from a white material called zirconia or alumina thus allowing light to pass through crowns for a more natural appearence. They are the top of the range crowns and the laboratory fees are higher than other crowns because the plaster models have to be scanned (usually in an engineering company the lab uses) and the substructures milled by the crown companies (nobel biocare or 3m), before being sent back to the Lab to have porcelain superstruture placed on them. In some cases I ask patients to visit lab for delicate shade charactaristics but most of my cosmetic work is done by top labs in London and California so it's not practical to visit. Most dentists doing the top end stuff will take close up photos of your teeth from a number of angles and email these to the Lab.
Expect to pay more for these crowns but you will only do this once, also Procera & lava come with gaurantees from the companies who make substructure, you get a little card from them at fit appointment with a serial number and usually the shade.
Anything very well made even porcelain fused to metal is an option, seeing the technician or top class pictures is the way to go.
I like Lava a lot.
Here's one case of 2 crowns(premolars) I've upgraded the camera since.
Very nice bryan....thats quality lab work and good dentistry.
Thanks Fitzgeme,funnily enough the lab is called ,Quality ceramics!
In fairness they seem to make as much effort as they get input and when put to it produce very nice work.
Thanks for all the info. I assume asking your dentist to use one type of crown over another should not be a problem. Back in 2003 he did not offer me a choice of what crown I would like to have but maybe Procera/Lava/Impress crowns were not so common back then?
These crowns are relatively new and are lite years ahead of the old crowns, the substructure as stated is made by the companies who hold the patent eg nobel biocare and 3m, but the porcelain covering is made in a prosthetics laboratory. The really top labs with talented ceramists cost more but the result is worth it in my experience, in most cases no one is able to tell which ones are ceramic, they have all the minute lines and shade variations which occur in natural teeth rather that being monochromatic tic-tac form.
Another follow on question with regards Procera/Lava/Impress crowns
Is it easier to get the bite right with these newer types of crowns?
What I mean by this is when I had crowns placed on my front upper teeth the dentist had to make some adjustments (polishing) to the back of two of the crowns to ensure they would not hit against my bottom front teeth.
Because of this the back of the crown is a bit uneven (but not rough) which I feel with my tongue. I realise it would not cause most people a problem but I am thinking of getting my crowns replaced and this is something I would like to avoid if possible. My current crowns are porcelain fused to metal.
The new crowns, all ceramic crowns have a hardened glass or zirconia substructure, your metal crowns have a metal substructure. The veneering ceramic (ceramic put on top to make it look like a tooth and custom to you) is the same of similar. So the bite is no harder or easier to get correct with them. I do find that they are easier to fit cause they are not as tight.
I am with bryanL on this, a good metal ceramic can look as good or better than a all ceramic crown. Its not what it is made of that matters its how its made and who makes it. You can get crap looking all ceramic crowns too. Good Dentist + Good laboratory + lots of time and attendion to detail = good crown and happy patient.
They look really great. Could you tell use what the ballpark cost would be? Are we talking 500-1000 per tooth or even more?
Depends on where clinic is, I charge €750 per anterior tooth for Lava/Procera/Empress crowns, I have heard of some charging alot more and some a little less. I would like to stress that these are not the standard porcelain crowns and cosmetics are far superior.
So you're probably talking about 1000+ per tooth for the better option?
Davo ...where are you based?
Sorry Mark, anonymity allows me to express opinions on boards which may/may not be popular with viewers and peers. I am happy to give a guide on my fees, but not as an advertisement for my clinic. Thank you for asking though.