"How many dentist visits for a Dental Crown?"

Dr. Kyle Hornby

Dental Crown Preparation

Historically, Dentists would prepare your tooth for a Dental Crown, take an impression, and book you for a crown delivery weeks later. During the intervening 2 week period, a dental laboratory would make your custom crown using impressions from your first appointment. However, a new technology (CEREC) allows Dentists to make their crowns "in-house" or in their office. Patients love this because they get 2 appointments worth of Dentistry take care of in 1 visit. But, it might not always be the best option for you. So, this week, let's look at some information about dental crowns, figure out what's best for you, and figure out how many appointments it should take to get a Dental Crown!

Same-Day (CEREC) Dental Crowns

Some Dentists have purchased machines that can make custom crowns in 1-2 hours at their office. This is truly amazing technology. But, there are limitations.

These machines can make all-porcelain and tooth-coloured zirconia crowns, but they cannot make Porcelain-Fused-Metal (PFM) crowns. This is important to know because PFM crowns have been the most durable option for premolar and molar crowns for a long time.

So, if you place an all-porcelain or zirconia crown on a premolar or molar, that crown will be less durable. It will also be less fracture-resistant compared to the standard of care, a PFM crown.

So, are Lab-Made Dental Crowns better than CEREC crowns?

Laboratory-Made Dental Crowns

When you choose to have your dental crown made by a dental laboratory, you retain the flexibility to have that crown make of the best material for the job! If that happens to be gold, you can do it. If it's porcelain-fused-to-metal for a molar tooth, you can do it. You lose flexibility to choose the strongest material when your crown is made right there in the dental office. So keep that in mind.

Additionally, a Dental Lab Technician can custom-shade your dental crown to match neighbouring teeth. This is especially important for patients that have teeth where different regions have a different shade. It is also important for patients that have characteristic markings on their teeth. Dental crowns made by an "in-house" crown milling machine are less able to add subtle features to your crown.

What are CEREC Dental Crowns Made Of?

CEREC Dental Crowns are typically made of either Porcelain or Zirconia. These are excellent materials for front teeth like incisors and canines, but they lack the durability that molars and premolars demand.

Are CEREC Crowns Worth the Money?

Many people wonder if same-day, CEREC crowns are worth it? Are CEREC crowns any good?

Well, for front tooth crowns that would be made out of pure porcelain traditionally, using a CEREC same-day approach will allow you to still use the appropriate material. If you're looking for a molar or premolar crown, however, the CEREC approach will force your Dentist to use a less durable material because this technology cannot produce the gold standard porcelain-metal crown.

Of course, we live in a world where most people prioritize convenience. One trip to the Dentist is better than two. However, we've seen many CEREC crowns on molar teeth break and require a remake, sometimes after only a couple of years.

As with any dental treatment, patients deserve to know about the pros and cons that come with any treatment. The CEREC process is no different: patients need the relevant information to decide if avoiding an additional 30-minute crown delivery appointment is worth the compromise in crown durability.

Can a CEREC Dental Crown be Repaired?

Typically, any crown that breaks or fractures cannot be repaired. This goes for laboratory-made, non-CEREC crowns, too. The fact that CEREC-made molar and premolar crowns are more likely to fracture means you have a greater risk of needing a replacement crown compared to lab-made crowns.

Pros & Cons of CEREC Dental Crowns

Pros:

  • quick turnaround and same-day delivery of dental crown
  • fewer appointments

Cons:

  • limited materials available (i.e. cannot make porcelain-fused-metal (PFM) crowns)
  • less esthetic (dental labs can produce crowns with colour and translucency variability to mimic a real tooth)
  • CEREC makes a dental crown that is 1 shade all over (less realistic looking)
  • less durable crowns on molars and premolars
  • not good for patients who grind their teeth (increased risk of crown fracture)

Summary

Years ago, I reached a point where I had enough patients to merit purchasing a machine to make in-office crowns. And yet, I never bought one. The reason is that, if I was providing crowns made of the proper material for a given situation (i.e. PFM crowns on every molar that needed a crown), the economics no longer made sense. Did I want to make every crown from porcelain so that purchasing a crown-milling machine was a good financial decision? Well, I still don't own a CEREC crown-milling unit. I use a dental laboratory to make my crowns. This gives me the flexibility to choose the best material for any given case.

So, ultimately, you can have your dental crown made in a single appointment. In some cases, you will still get a crown made of an appropriate material for the circumstances. And, there will be value in the convenience of having your crown after only one appointment!

In other cases, however, you may get something of insufficient durability because that's all that can be made with the "crown-making machine". Under those circumstances, it might have been better for your to make 2 trips to the Dentist to get a durable crown made by a local Dental Lab.

If you'd like to read more about Dental Crowns, please visit my Definitive Guide to Dental Crowns.

You can also find useful information about Dental Crowns on the Canadian Dental Association's website, here.

Thank you for reading!

By Dr. Kyle Hornby, Kitchener Dentist

If you would like to discuss dental crowns, gain a second opinion or schedule a no-charge Meet & Greet appointment, give us a call at (519) 576-8160 or request a consult with me here.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your Kitchener Dentist or other qualified healthcare provider with any questions you may have regarding a dental condition or treatment.

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