Preserving the natural tooth is one of the most important pieces of advice you will hear from dentists. Earlier, when people encountered tooth issues, many used to go in for extraction and considered that to be the best way out. You can notice that most grandparents are missing their teeth and they owe it to extraction. It was a notion that teeth that are completely deteriorated and plagued cannot be treated and are best extracted. But this ideology is a myth and has soon been proven wrong. Preserving the natural tooth is the need of the hour as there is nothing that matters more than what is gifted to us naturally, in this case our permanent tooth.
Our teeth have several incredible functions in the body beyond just aesthetics, chewing or talking. They provide shape and support to the jaws and help in keeping the dental arch in good health. They are important to protect the jaw in case of accidents and also prevent injuries. Dentists no longer go in for extraction until and unless that is the last resort. Even then, many dental experts opt for implants, dental bridges or crowns based on the patient requirement to help fill the gap in a useful manner. Preserving the natural tooth by removing the infected portion and placing a crown or a bridge atop to preserve the leftover tooth is the most important aspect of dentistry today, thanks to all the research that supports preserving them.
Dental crowns are the most used solution or treatment modality in case of tooth preservation. Most patients who come in with tooth related issues usually have one or two infected teeth spread across the mouth and therefore need crowns. It is uncommon that a patient needs a dental bridge where adjacent teeth need treatment and fixing up. Crowns have therefore become the most popular solutions to treat infected or broken teeth and for patients who are looking for a natural yet effective solution for their dental issues.
Dental crowns come in many different forms and they are usually made with different kinds of dental restoration materials. Some of the most common ones are:
Stainless Steel Crowns
Stainless steel crowns are mostly used as a Temporary crown or for children. These crowns are readily available in the market as they are prefabricated and can be used to protect a tooth that has undergone recent treatment until the actual crown is prepared.
Resin Composite Crowns
Resin Composite crowns are also used for children as an aesthetic treatment option for kids who need an esthetically pleasing option. But these crowns also do not have much durability and therefore cannot be used for long periods of time.
Metal alloys such as Gold, Titanium and Silver-gold alloys are used to make crowns. They can either be used for a strong, durable option or as a fashion aesthetic that some people love to own. They are very expensive and therefore not many patients prefer them.
Porcelain Fused to Metal Crowns
Porcelain Fused to Metal was one of the most popular options but with some problems that might make them unsuitable. The metal core gives a grey appearance and the metal lining is visible at the gums. The porcelain exterior is prone to chipping or fracture and the crown is not suitable for patients with metal allergies.
All Ceramic Crowns
All ceramic crowns are the closest to Zirconia crowns. All ceramic crowns are strong, durable and aesthetically pleasing but they are expensive and not as durable or biocompatible as Zirconia. They are also prone to chipping or fracture.
They are the most popular crown options available today that are strong, durable, biocompatible and also aesthetically pleasing. They can be used to protect the natural tooth and to preserve with very little adjustments or contouring requirements.
Metal crowns and Stainless steel crowns are seldom used by young patients as they do not serve the natural and esthetic requirements that they have. They cannot be used for anterior teeth restorations as well. Porcelain Fused to Metal crowns were popular up until the 2000’s but had some major issues such as the metal lining near the gums that were too apparent and the non-compatibility with patients who had metal allergies. Porcelain is also prone to chipping and fracture as the veneer exterior is less durable than the metal core.
Rise of Zirconia Crowns
In the wake of the all ceramic crown era, Zirconia crowns also started becoming more popular. Zirconia was used famously for bone related surgeries as a replacement material but seldom used in dentistry until the early 2000’s. Zirconia ceramic crowns are considered to be similar to ceramic crowns but with significant differences in the material and therefore characteristics. Zirconia dental crowns are much stronger and durable than ceramic crowns. The only area where Zirconia Tooth crown competes against ceramic crown is the appearance. Ceramic crowns come in a more natural, translucent pearl white shade that matches patient preferences whereas Zirconia had a more white, opaque structure that was less natural.
Thankfully, this difference has also been resolved by dental researchers who were able to colour match Zirconia crowns by adding an external glaze that had a slight stain to it which made them more natural and could infact, be matched with the patients’ exact teeth shade for the perfect placement and natural appearance. Today, the amazing features and advantages that these crowns provide are no match for the small cost of Zirconia crowns that patients pay for them. Zirconia crowns cost more than PFM or even some Ceramic crown types but the Zirconia crown price also depends on the type of crown, any additional modifications or customizations that are needed to the crown etc. For the advantages and the pros it offers, the cost of the crowns is justified according to most patients in the USA.
Treating and Conserving Tooth using Zirconia Crowns
Zirconia crowns are used post operative after a patient has been treated for an infected tooth. Sometimes they can be used on teeth that are either fractured, broken or discoloured and therefore need to be removed and fit with a crown. Zirconia crown fitment is done by measuring the exact tooth size using a mould and then the crown is milled using special techniques. Zirconia crowns are milled from Zirconia Oxide blocks using CAD/CAM using special equipment attached to computers.
Treating the Tooth
Once the natural tooth is treated by the dentist, the tooth needs to be prepared by shaving it down. The infected portions are removed and cleaned so that a crown can be fit on top of it.
The tooth cavity is now measured using a mould - the patient needs to take a good bite creating an impression on the mould which is later used for exact measurements for the crown
The Crown is now prepared in the dental lab using specialised software such as CAD/CAM and a block of Zirconium Oxide. Using a computer for designing, the exact measurements are acquired from the mould and they are milled from the block to create a Zirconia crown.
The crown is now ready to be fit on the patient - the crown is tried on and it may be required to be contoured or crimped by the dentist for proper bite and fit. Once the adjustments are done, the crown is cemented using a Glass Ionomer cement. Zirconia crowns are easily adjusted as they are easily moldable unlike other crown materials.
The Dentist will now help the patient to care for the crown post the procedure so that the crown can have durability. These instructions include how to clean the crown, what to do if the crown comes off and how to improve the life of the crown by following simple lifestyle habits.
Using the Zirconia crown, dentists are able to adopt conservative treatment methods to help patients conserve their natural tooth. This helps in preserving the dental arch and its shape and also keeps the natural dental space in use by using a crown to perform all the functions of the natural tooth. Zirconia crowns are extremely strong and durable, perhaps the most durable options available in the market. They are also biocompatible and versatile and therefore can be used by all patients, even those with hypersensitivity and metal allergies.
Since Zirconia crowns are not temperature sensitive unlike metal crowns, they can easily be used in patients who have sensitivity in temperature. Zirconia crowns are very strong and therefore are not prone to chipping or fracture. Since they are not prone to expansion and contraction due to the change in temperature, they remain intact for longer durations, therefore increasing their durability.
Due to the availability of shade matching using the artificial glazing technique, patients can now personalise their crown and match it to the rest of the teeth. This helps in countering the otherwise opaque and white appearance that Zirconia crowns have. This is a great way to create aesthetically pleasing and perfectly natural crowns that look exactly like your original tooth. They also need very less adjustment on the chair side and therefore is a wonderful option.