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Crowns date back almost 4,000 years. Skeletons in Asia have revealed golden caps and gold tooth replacements on teeth. Unlike back then dentistry has become more esthetic with patients wanting tooth-colored crowns instead of gold or alloys. Patients prefer people not knowing they have received dental work. A purpose to a crown is to protect the structure of the tooth after the dentist has prepped it permanently. Crowns come in many types of materials that can be fabricated by the dentist or sent out to a laboratory. A laboratory is used when the patient wants a more natural looking tooth or a crown fused to metal. With this method it can take up to a week or two to get the crown back from the laboratory. The second way is having a machine called the CEREC make a crown in the dental office. This has machine been around for decades. The Difference between the traditional crowns and the CEREC is crowns are made fast, easy, and precise. It can all be done from the dental office if the equipment is available. But like all products available there can be pros and cons to CEREC and traditional crowns.
CEREC short for Chairside Economical Restoration of Esthetic Ceramics has been used for many years with great results. This machine has a camera attachment that goes in the patient’s mouth and takes multiple pictures of the tooth that has been prepped by the dentist for a crown. The pictures are then sent to a computer that inputs the information and designs a perfect crown for that patient. In the article ‘What Is CEREC in Dentistry?’ it says, “There is no need for a temporary restoration if the treatment is completed in the dental office”. This is also true because you do not have to make a temporary crown. This is an extra step that would be totally eliminated from the process.
You then choose a block of material that will be carved into the patient’s crown. This block will be made out of a ceramic material. You would first need to know what color shade your patient’s teeth are to best match them. The great things about CEREC crowns are they are fabricated same day. Patients really appreciate this because they do not have to wait a week or two to get it back from the laboratory. In the article ‘Advantages and Disadvantages of Same Day CEREC Crown’, it says, “If you are a very busy person, multiple visits to a dentist for a dental crown are the last thing you want. Same day CEREC crowns make the process less complicated and a lot faster”. That is a big plus for the patient and the office because instead of two appointments they only need one.
CEREC crowns are used most often for posterior teeth but can be used anywhere else in the mouth. It all depends on the patient and the dentist opinion. You typically would not want a CEREC crown for an anterior tooth because of how unrealistic the material can look. The ceramic materials for anterior teeth are not esthetically pleasing and would look un-natural to the naked eye. Since the crown is done in one appointment it will be more cost effective to the patient. CEREC does not have the ability to make metal crowns. This is a reason they can be less durable because they can only be made out of ceramic material. This is a big reason why CEREC crowns are less durable and can last a patient less time than a traditional laboratory crown.
Traditional laboratory fabricated crowns are still used a lot in dentistry. If done correctly a lab-fabricated crown can be made out to look the most natural in a patient’s mouth. There are a few reasons why a crown is needed on a tooth for example, protect it from decay, keep the tooth from breaking, or to restore a broken tooth etc. Lab fabricated crowns tend to be more expensive like the article ‘CEREC or Lab Made Crowns? Pros & Cons’ it says, “Lab-made crowns are a traditional and effective method for teeth restoration. They are made of a combination of porcelain and metal. The pros are that traditional crowns are durable and look like natural teeth. Typically, the fit of these crowns are well-aligned with your natural bite”. Traditional crowns are made with both metals and porcelain making them stronger than CEREC crowns.
When a crown has metal attached to the porcelain it will add to the expense, but to the durability as well. This type of crown is called porcelain fused to metal crown. These crowns have both the durability and esthetic you would want in a crown. On the outside they look like a normal tooth and on the inside, they have metal, which bonds to a tooth structure very well. Traditional crowns are made from metals and ceramics and other materials as well. The increase of strength is also because the variety of material options a lab has. With CEREC you can only use ceramic material that comes in ceramic blocks. Traditional crowns are made by different choices of porcelain and metals and painted by skilled hands to mimic that natural appearance of the patients nearby teeth. This allows the crown to look natural in appearance.
The process of sending out a patient’s information to the laboratory is a procedure that has to be followed to detail. This will ensure your patient will get the best crown back from the laboratory. The dental assistant will first take a shade of the patients tooth while the patient is waiting for the anesthesia to take effect. The second step would be to take a preliminary impression of the tooth that will be getting that crown. This step is very important because you will be making a temporary crown with this impression. The temporary crown will be seated like the name says, temporarily waiting for the final crown to come back from the laboratory. You also want to take an impression of the opposing arch to have a centric occlusion of the patient’s mouth. The lab technician uses this information for the final crown adjustments. With all of this you will also be sending a bite registration, which will also be used by the lab techs to help them make final modifications to make the crown perfect for the patient. All this information will be sent over with a slip filled out for the laboratory. There are many steps to follow with traditional crowns unlike the CEREC. Traditional crowns are especially important when you are working with a patient’s front tooth. Since this is the first impression someone makes you want the front teeth to look the most natural and appealing. An advantage of a traditional crown is that they are much stronger. The strength is much higher because the lab can have a combination of metals and porcelain that can be utilized. The metals bond to the tooth a lot stronger. For that reason, they are more resilient to fracture making them tough.
From the diagram below you could tell the majority of people preferred the PRM (porcelain fused to metal). This crown has both the durability and the esthetics patients really like. When you are paying for a crown, it is important to also note the force that is applied in that area. The dentist will make that a big factor of what crown will best suit your situation. After reviewing all my information gathered on these two types of crowns a lot of factors play a role. If I were a busy person, I would most likely go with the CEREC crown because it would complement my schedule. Yet, I would have to recognize the area where that crown would go. You are getting what you pay for so, knowing that a CEREC might not last as long I would preferably go with the porcelain fused to metal crown. Like I said before you get both the durability and the esthetic appeal. The great aspects of dentistry are understanding you have options on your choice of materials, durability, and compatibility. Every person has a different situation and depending on yours choosing what best fits you, it’s what truly matters.
Works Cited
- ‘Advantages and Disadvantages of Same Day CEREC Crowns’. Judy Mejido DMD PA Miami Florida, 15 July 2018, http://a1care.org/blog/advantages-and-disadvantages-of-same-day-cerec-crowns/
- Peak Dentistry. ‘CEREC or Lab Made Crowns? Pros & Cons’. Peak Dentistry, 15 Nov. 2019, http://peakdentistrync.com/blog/cerec-or-lab-made-crowns/
- StackPath, www.dentistryiq.com/dentistry/restorative-cosmetic-and-whitening/article/16348313/what-you-said-about-restorative-materials
- ‘What Are the Differences Between CEREC and Lab Made Dental Crowns’. Sutra Dental Spa, www.sutrads.com/practice-news/what-is-the-difference-between-cerec-and-lab-made-dental-crowns/
- ‘What Is CEREC in Dentistry?’ Colgate® Oral Care, www.colgate.com/en-us/oral-health/basics/dental-visits/what-is-cerec-in-dentistry
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