What are the best esthetic dental crown materials options in 2021? Be sure and check out all the photos below and you can decide.
The lab we currently use is Paramount Dental Studio. We were introduced to this lab through David Galler. At first, we sent a few cases, with the idea that we love being part of the David Galler Club. Strength in numbers and all of that. As we worked with the lab, it became apparent that they were a true digital dental lab, and they were establishing a digital workflow, a workflow that we wanted to be a part of.
For this particular patient, I was interested in the material options that Paramount offered for anterior cases. A crown on #9 was broken and needed to be replaced. When discussing this case with our lab tech at Paramount Dental, I asked what are my choices for crowns. The lab tech mentioned multiple options, but the three options I was interested in were:
- Esthetic Zirconium
- E-Max or lithium disilicate
- Layered porcelain fused with zirconia
So I reached out to the folks at Paramount Dental Studio and told them what I was thinking.
The Dental Lab Viewpoint
At Paramount Dental Studio, we specialize in the selection of crown materials and the creation of crowns. Regarding the different materials crowns are made from, they generally fall somewhere along this spectrum.
The more opaque material is, the less “pretty” it is; however, the long-term success increases (meaning it won’t break). People do not usually clench and grind too hard on their anterior teeth so the very strong and “less pretty” options are not necessary as they would be for a molar. Dr. Medina told us that he was looking for the right mix of aesthetics and strength for this particular case.
A porcelain-fused-to-zirconia crown is done by hand and is the most esthetic option. We have the most control over the translucency and textural features so we can really make it shine.
Emax is a material that is commonly used for anterior teeth because of how translucent it is. The esthetics of Emax is amazing, but it does lack some strength.
Esthetic zirconium is not quite as translucent as Emax, but it still retains a high level of translucency (esthetics). Esthetic zirconia has the advantage that it is significantly more durable. With the right staining and glazing, esthetic zirconia has proven to be a great solution for anterior cases that require more strength. This material ended up being the Goldilocks material for this patient with the right amount of strength and esthetics.
Paramount recommended Esthetic Zirconium, but I wanted to see all three. I have seen zirconium crowns, Emax crowns, and porcelain fused to zirconium crowns individually, but I have never seen them together. I wanted to know how they look like. Furthermore, I needed to know how they look like in the patient’s mouth? I knew that the shading and the appearance of the crown would drastically differ in the patient’s mouth compared to on my hand. So I gave Paramount the go-ahead to fabricate the same crown three different ways.
Below are the pictures of the three crowns. I have included many pictures taken of the same crown, just to get as much visual information as possible.
My thoughts on what I saw.
- All three crowns were beautiful, all three crowns were esthetically acceptable.
- The crown on #9 seems a bit wider than #8. That should be easy to verify. I asked the lab to make sure that 8 and 9 are exact mirror copies of each other.
- If it were my tooth, and esthetics were my only concern, I would go with EMAX or the lithium disilicate.
- The patient saw all three, and she elected to go with zirconium. She wanted the absolute strongest crown, she was replacing a broken crown and she wanted to go with the strongest option.
- The layered crown or porcelain fused to zirconium (P2Z) crown is beautiful. I will definitely keep this option open in future cases, There are times when I need to match a tooth with multiple colors, a tooth that has a lot of characteristics, the layered crown could be the best option. These crowns do have porcelain, and as we know how porcelain can chip. In certain situations, this could be the more esthetic option, but the patient needs to be aware that it is not the strongest option.
I not only learned the advantages of the materials dental labs offer for anterior cases, but I was able to observe how digital dentistry has changed dentistry as we know it. As a new dental school graduate back in 1994, one of the most challenging tasks would be matching a single upper crown. Getting a good esthetic match could be so frustrating. As a dentist, there is nothing more painful than having to look at a tooth that just doesn’t blend in.
However, now in 2021, we have DIGITAL dentistry. One nice feature that digital dentistry offers is that I can now ask the lab to make an exact mirror copy of a tooth. As a dentist, I know that a big part of a pleasant smile is symmetry. I love the idea that we now have so much more control over how teeth are made. The shape of the tooth can now be a machine-perfect match.
Please let us know your thoughts.
As you can see in the ExoCad design, Paramount was able to match the shape, size, and contours of #9 to be an exact replica of #8. Furthermore, another advantage of Digital Dentistry is that they are able to design and match how the natural tooth was before any preparation is done. A situation like this would arise mainly when I would ask Paramount to retrofit a crown to an existing partial, invisalign, and occlusal guard.
Overall, the year is 2021, and matching a single upper crown is much easier, and we have so many nice options for dental materials
We are a Team!
We are a team at Paramount, and Dr. Medina is truly a member of our team. Working alongside Dr. Medina on several of his cases has been an absolute pleasure. Together, we will continue to help others by providing our patients with a smile they can always be proud of. Thank you again to both Paramount and Dr. Medina for helping in my journey of learning and giving back.
Does your smile need an adjustment? Are you interested in strength and durability? Are you interested in esthetics? We would love to discuss all your options with you. Give us a call at (207) 236-4740.
Teddy Campos is a practice support associate at Paramount Dental Studio. He graduated from the University of Virginia as a double major in Economics and Psychology, as well as taking part in the pre-medical track. Teddy’s dream was to become a doctor because of his desire to help others, as well as his fascination with how technology had brought the medical world forward. Before applying to medical school.
Teddy heard that the dentistry world was changing. He was interested in the intraoral scanner. Teddy saw that this new technology had the potential to bring new life to dentistry. Ever since Teddy started working at Paramount, he has really enjoyed his time in the dental lab world.
Teddy has had the opportunity to learn from the absolute best, such as Paramount’s head lab technicians: Philip Kim and Eric Burgio. Both Philip and Eric were nominated for LMT’s 40-under-40 dental lab technicians for 2021, and Teddy is excited to continue learning from them as much as he can.