Re: Lava, zirconia, procera crowns

ADVANTAGES AND DISADVANTAGES OF ALL-PORCELAIN AND ALL-CERAMIC CROWNS

Let’s compare all-porcelain with porcelain fused to metal.
All-porcelain is generally not as strong as porcelain fused to metal. It has to be bonded to the tooth in order to have adequate strength for oral function. The bonding technique is very demanding and is not fully taught in dental schools. We recommend that you only have an expert cosmetic dentist place this type of crown.
With porcelain fused to metal, the porcelain has to be opaque in order to block out the appearance of the metal underneath. They all also eventually develop an unsightly dark line at the margin where the edge of the crown meets the tooth.
Some of the all-ceramic systems that have an inner ceramic core with an outer layer of porcelain baked on require more tooth reduction. Grinding away more of the tooth is often not desirable.
Some of the ceramic materials that are very tough and fracture resistant are also quite abrasive against the opposing teeth. Of the crowns listed above, the Empress is the kindest to the teeth it chews against.
GENERAL RECOMMENDATIONS FOR ALL-CERAMIC CROWNS
There are several factors that need to go into the selection of a crown material: strength requirements, esthetic requirements, the abrasivity of the material against the opposing teeth, and the skills of the dentist. There is not a single crown that is clearly superior for all situations. Many cosmetic dentists will have several types that they will use, each for a different situation.
It is generally a poor idea for a patient to go to a dentist and request a specific type of all-porcelain or all-ceramic. We have received many e-mails from patients who have done this and have been very disappointed with the results, because they were pushing their dentist to use a material the dentist was not comfortable with, and many dentists will try very hard to conceal from patients any discomfort they feel with a procedure. There is also the factor of the dental ceramist, whom you will most likely never meet. The material that is used for the crown should be intimately familiar to the dentist and to the ceramist for the best results.
You cannot learn, as a patient doing online research, which crown is best. First of all, there simply isn’t one all-ceramic material that is always best. Second, in a web page such as this, we can’t list all the properties of all them. Third, in evaluating these crowns, there is a great deal of background information needed in order to evaluate which research claims are fully established and which claims should be questioned.
Our recommendation, at mynewsmile.com, is that you find a cosmetic dentist you can trust and that understands your needs and is passionate about creating beautiful dentistry. Then ask that expert cosmetic dentist to use the technique that he or she is most comfortable with in creating the all-ceramic crown that will be best for you. The choice of the material is secondary to the skills of the dentist and of the ceramist in working with that particular material. There are subtleties in working with all of these all-porcelain and all-ceramic materials that need to be mastered by the dentist and the ceramist to produce the most beautiful result.