Other Procedures

The bad news is that you need a crown, however the good news is that you can have a ceramic crown or a porcelain bridge that is very durable, strong,and mimics your tooth color including translucency. The porcelain crowns can  now made extremely strong so there is no fractures and at the same time resembles the beauty of natural teeth.

 

Emax crowns , bridges or inlay onlays, have gained popularity due to bio compatibility beauty and strength.These crowns or limited bridges is made of lithium disilicate, in which the crown fabrication can be done after wax up by the dental technician. Due to durability and strength of the emax, the biggest advantage is that less tooth structure is removed from the tooth, and the porcelain is fracture resistant. Per Dr Mobasser Emax crowns definitely have aided the conservative dentistry (minimally invasive dentistry) however it is NOT indicated for all crowns.
Due to strength of the material it can be harsh to the opposing teeth, meaning it can wear down the opposing tooth especially if the patient is a bruxer or grinder. Emax crowns need to be bonded to the tooth structure, therefore it is more technique sensitive, and the cost is more than conventional porcelain fused to metal crowns, however the strength and esthetics is incomparable. Regular Porcelain crowns are stronger than natural tooth structure causing wear on the opposing natural dentition, emax crowns can be 3 to 5 times stronger than porcelain crowns.

 

Lava or Zirconia crowns and Bridges are made of zirconium oxide, they are very strong compared to regular porcelain, they are of course bio compatible, and they are fabricated via the aid of computer generated machine CAD/CAM. Lava crowns are durable and long lasting, it is not indicated for all types of bridges as of to date, the limitation is up to 4 units. They are extremely difficult to be taken out if there is any reason for redoing the bridge or the crown, they can not bond well with the underlying tooth, however they are cemented on the tooth.The treating dentist must discuss the pros and cons of these types of crowns or bridges to their patient specially if the patient is not having full mouth reconstruction done. Segmental bridges can definitely wear down the opposing dentition, and usually occlusal guard or night guards are highly recommended.

Lava crowns vs porcelain crowns vs emax crowns
So how does the patient know which to use? Per Dr Mobasser the key determining factors are:
1- How many teeth need the treatment, is it full mouth reconstruction or few crowns?
2- Does the patient clench, grinds? is there fractures of crowns or teeth often ?
3- Complete evaluation and bite analysis is a must.
4-Are the opposing teeth crowns ? natural teeth?
5-Is esthetics a factor? or strength ? or both ?
6- Is the opposing space requiring crown limited?

 

A complete evaluation via intra oral photos, xrays, bite analysis, impressions and study casts is a must, to determine which crown best fits the individual’s mouth to resemble beauty, and mimic the form and function needed.