ALL CERAMIC CROWNS
WHAT IS AN ALL CERAMIC CROWN?
All ceramic crown presents the best quality and most beautiful prosthodontic teeth restoration. These crowns are made fully of ceramic. Their use has increased for the cases when one tooth or more are missing, in the frontal as well as in the lateral regions of the jaw. When several all ceramic crowns are connected this presents an all ceramic dental bridge.
WHY IS THIS AESTHETICALLY THE MOST BEAUTIFUL SOLUTION IN DENTISTRY?
A more natural teeth appearance, perfect fitting with the rest of the teeth, transparency and ideal light refraction, excellent hardness and long-lasting, are just some of the factors that help choosing this kind of prosthodontic solution.
In addition, a very important factor that we wish to emphasize is the preservation of the soft tissue around the tooth, with no harm to the gums, due to the technically completely different approach in the teeth preparation. For crown to be placed, there is a lot less removal of the tooth substance than for standard metal ceramic crowns. The edge of the all ceramic crown is highly precise, therefore the contact between the crown and gums is perfect. This crown contains a bio-compatible material which suits the mouth tissue really well and has no negative reaction. It is highly polished and with no micro-cracks which prevents dental plaque formation, therefore gums reaction to the presence of the crown practically does not exist.
WHAT IS THE DIFFERENCE BETWEEN METAL CERAMIC (PFM) AND ALL CERAMIC CROWN?
Metal ceramic or porcelain fused to metal (PFM) crowns have a base of metal and in order to achieve quality in aesthetical results, the exterior side of the crown is being covered with ceramic. After a few years, due to the patients’ normal physiological process of aging, if it happens that the gums start to recess, a gray line on the contact edge of teeth and crown may appear. This does not happen with all ceramic crowns, because the body base of the crown is ceramic, having natural teeth color, and there is no metal. In addition, good quality of gums and their preservation, as well as slower recession over the years, is proven both in practice and theory for the all ceramic prosthodontic restoration, for which the filing down is being done up to the edge of the gums. As for the metal ceramic crown the filing down goes up to 2 mm under the gums.
Due to the presence of metal, a standard crown has no tooth transparency, light refraction is difficult, and it is very difficult to match the color of the crown with natural color of the rest of the teeth. With all ceramic crown the light transparency is identical as in natural tooth, so it is almost impossible to see the difference between the crown and the natural tooth.
IS THIS KIND OF DENTAL CROWN FOR ME?
All ceramic crown is an ideal choice for every patient who wishes to restore the loss of individual teeth, or who wishes to change the current aesthetically inadequate teeth and make them perfect. This kind of teeth restoration is possible given that the position of teeth in the jaw has no drastic anomalies. These dental crowns can be done in both frontal and lateral region of the jaws. They do not tolerate excessive distances between the carriers, so it is very important, prior to the setting of the therapy, to accurately measure the patient’s wishes and his actual condition in the mouth, when potential dental bridge carriers are in question.
These all ceramic crowns can also be done on implants, but this requires special ceramic suprastructures (abutments) so that the aesthetic result can be fully accomplished.
ARE THERE ANY CONCERNS AND WHAT IS THE EXPERIENCE OF THE PATIENTS?
Very often we face the question of whether it is possible to do all ceramic crowns if the patient had already done metal ceramic crowns and now wishes to change them? The answer is yes, it is possible, but there are some concerns. If you have read this carefully, you already know that the method of tooth preparation is completely different for the all ceramic and metal ceramic crown. This means that after the tooth has already been filed down 2 mm under the gums for the metal ceramic crown, the edge for all ceramic crown will also have to be 2 mm. This means that we no longer have that gentle contact of the gums and the all ceramic crown. Therefore, by replacing the crown, it is sometimes possible that the gums respond to the all ceramic crown as they did to the metal ceramic one, reacting with inflammation and mild bleeding when brushing your teeth. Therefore, in addition to the classic toothbrush, it is necessary to include electric dental irrigators in your daily hygiene routine, a tooth cleaning machines using water pressure. This way, every minor problem can be regulated.
The second common question is about the treated teeth that have darkened long time ago, so patients wonder if such dark tooth will make the all ceramic crown look gray. We can say that it will not, and this is the moment when a team of experienced dental technicians takes its place. It is necessary to have photographs of the current state of the patient’s teeth, determining the color of the adjacent teeth, so that the ceramic base of this darkened tooth can be done in 2 shades brighter color compared to the color of adjacent teeth. After the application of ceramics in the final phase and the final glaze there will be no differences between the current living and treated teeth and an aesthetic excellent solution is reached. If this treated tooth has a large tooth mass loss and the all ceramic crown can not be done, then it is necessary to make a reinforcement for which bonding made of glass is used, the so-called fiberglass posts. Such bonding is transparent, very firm and is cemented into the tooth root canal. An impression for the all ceramic crown is taken over it, and you still get to keep the aesthetics.
Molded metal posts which are cemented on the teeth on which we would like to place the all ceramic crowns are not an ideal base for them and no one can guarantee the ideal aesthetics of such solution. It is necessary to consider carefully whether there are any other solutions for this case.
WHICH MATERIALS ARE USED FOR MAKING THE ALL CERAMIC CROWNS?
Even though presently the all ceramic industry has an impressive progress and there are many materials used in making this kind of prosthodontics, the materials proved to be the best and most commonly used are zirconium ceramics and lithium disilicate ceramics. This way we get a crown made of materials very similar to glass, light and transparent, and resistant as much as a natural tooth. Zirconium has very distinguished mechanical properties, it is extremely white and is one of the strongest materials. At the very beginning, it was used in space technology, and later it finds application in some branches of medicine, for example, in orthopedic surgery (heads of the hip prosthetics) and in dentistry. Zirconium is a very hard ceramic and because of its hardness it is most suitable for making lateral dental bridges. It has a bit weaker aesthetic properties when compared to lithium disilicate ceramics. Ceramic implants are also being made from the zirconium.
The aesthetic properties of lithium disilicate ceramics are still impeccable and it is recommended to be used for all frontal teeth from 3 to 3.
HOW ARE THE ALL CERAMIC CROWNS BEING MADE? ARE THEY MADE BY A TECHNICIAN OR A MACHINE?
The first is to discuss with the patient about his expectations regarding the shape, color and appearance of the teeth, all within the limits that would not undermine the basic dental principles. After precise and careful teeth preparation, the dentist must take the highest quality impression of teeth and send it to technicians. The dental technician laboratory should be adequately equipped for this kind of prosthodontics. They start by molding the impression in hard dental cast with high precision, and then the molded model is being scanned by 3d scanner. The result of the scan is inserted in the software and that is when the planning of future all ceramic crowns begins. When all parameters are in order and the device is programmed for laser 3d printing, the production of prosthodontics can start, and after a few minutes we get the all ceramic crown post. Such crown post is then placed on a filed down tooth of the patient, to check if it fits well and if the patient is satisfied with the size and color of the tooth. The glaze (shine) and individual touch for each patient is being done by highly experienced technician and when he is done the all ceramic crown arrives to the dental clinic. The procedure of cementing the all ceramic crown is very demanding and must be respected every step of the way. Special kit for all ceramic crowns cementing is necessary to be used, and our dental clinic uses the Variolink Esthethic LC System Kit.
It takes about 4-5 days from the moment of teeth preparation to completion and handover of the all ceramic crowns. In the meantime, while waiting, the patient will have temporary plastic protective crowns made on his teeth. They protect the filed down teeth from possible irritation within the next few days.
HOW LONG CAN THEY LAST?
All ceramic crowns can last even more than 15 years, as long as the patient maintains an impeccable dental hygiene. The tooth preparation is being done up to the level of the gums, so the very recession of the gums is minimal and is exclusively related to the natural process of the aging of the patient. For the case when the patient has considerable number of all ceramic crowns, we advise wearing of a night guard for grinding (bruxism) which serves as sort of a buffer. This way, mussels are relaxed, the bite height is kept normal and the duration of the prosthodontics is prolonged by preserving each of the crowns.
Treat yourself with a functional and aesthetically the best solution for a perfect smile you have long dreamed about!