Q. What is the best option for dental crowns?

This is the number one question in my line of work. Today I thought it would be helpful to do a Q. and A. to answer the questions I get asked most about Emax and Zirconia crowns.

As a dental technician, it is my job to communicate to the dentists that I work with the best possible options for dental restorations so that they can make the best choice for their patient. In today’s blog post, I am answering one of the questions I get asked the most by both patients and dentists regarding Emax and Zirconia Crowns. Be forewarned, I am a bit of nerd when it comes to teeth, so this may get technical, but hang in there!

Q. What is the difference between Emax and Zirconia crowns?

A. Emax is Lithium Disilicate glass, an all-ceramic system.

• It is one of the most aesthetically pleasing options, porcelain can be layered on it, creating incredible translucency and a very realistic looking tooth that matches with other natural teeth.

Zirconia is Zirconium Dioxide, a white, powdered metal oxide. It is also ceramic.

• It is incredibly strong, resistant to wear, and difficult to crack.

 

 

Q. What is Translucent Zirconia?

A. Due to recent concerns about the lack of aesthetic appeal of zirconia (because of its density), dental supply companies have come out with more translucent zirconia.

This new iteration of translucent zirconia is not as strong as original zirconia, as the material that is added to make it translucent is less strong.

 

 

Q. What material should I use for anterior crowns vs. posterior crowns?

A. It depends. We see dentists use both zirconia and Emax for both anterior teeth and posterior teeth. It should come down to the patient’s bite. Are they a bruxzir? If so, go for zirconia. If not and if there is enough occlusion reduction, Emax may be the more aesthetic choice.

 

Q. Should I use my in-house mill to make anterior crowns and bridges?

A.  Some dentists use in house mills to mill Emax crowns for anterior teeth and bridges, but I don’t generally recommend it, as patients typically want a more aesthetic tooth to match their own natural teeth. Unless you have an in house dental technician who is willing to spend the time to stain and glaze the crowns/bridge to create the perfect shade, there is a risk that the patient won’t like it and  will have to come back (losing you time and money). We understand the value of same day dentistry, which is why we offer same-day turnaround to our clients for these exact cases.

 

Q. What is the best crown for strength AND aesthetics?

A.  Layered Zirconia, because even the weakest form of translucent zirconia is twice as strong as Emax. When we add microlayers to zirconia crowns, we take full contour zirconia, cut out a window on the face of the crown (so as to not compromise the strength of the crown) and overlay it with translucent porcelains which we then bake on. In combination with external stains and porcelain, this achieves incredible results.

Real talk, nobody’s perfect, let’s talk about disadvantages.

 Q. What are the Cons of Emax Crowns?

A. One of the advantages of Emax is that they’ve been used for years now so we know their lifespan. Emax crowns have been shown to fracture in 10-15 years, but this is an issue of how they are treated. Through trial and error, labs have learnt how to prevent fracturing, but as I mentioned earlier, this may be a matter of the pressure that is being put on the crown through grinding and a hard bite.

 Q. What are the Cons of Zirconia crowns?

A. The hesitancy that some dentists may have with zirconia is that because it is so new to the market, there are less long-term observations in terms of how it holds up in comparison to gold, PFM, and Emax crowns. Another concern is the lack of capability to bond zirconia. The biggest problem I see would be cutting them off or drilling through for potential endo treatment (because they are so strong!).

 

We’re here for chairside support!

Q. I’ve got a complex case, how do I know what crowns to use?

A. I know that every patient is different and has unique needs. The best way to meet those needs is to take a tailored approach that is well informed by the experts that are there to help you make that patient leave happy and healthy. So, ask your trusty lab technician! This is what we went to school for and what we do Every. Single. Day.

If you are ever questioning which material would lead to the best restoration for your patient, we are happy to provide in-office consultations.

 

Want to get in touch about a complex case, drop us a line or DM me via Instagram.

-Till