All Ceramic Crowns – E-MAX™ and BRUXZIR™
Patients today have many more options for restoring decayed or missing tooth structure. Gold is still “the gold standard”. You may have heard, “nobody uses gold anymore!” Yet, many restorations are still fabricated in gold which wears like enamel, allows for no breakage of the restoration and also allows for minimal loss of tooth structure in preparation. Sometimes esthetics comes into play, and in that case, there are other alternatives that can be beautiful and acceptable and last a long time.
What are all ceramic crowns or E-MAX™ crowns?
E-MAX crowns are the latest in esthetic quality restorations in the mouth that are appropriate for esthetic areas where a crown is needed where heavy grinding and function is not the primary concern. E-MAX crowns are all porcelain, thus allow more light through the crown vs. a traditional PFM (porcelain fused to metal crown) making the crown look more natural and life-like. They are traditionally bonded to the tooth, (the best method for cementation), thus giving greater strength and longevity to the crown or restoration. There are other crowns called BRUXZIR™ that are stronger but less esthetic.
What are the benefits of all ceramic or E-MAX™ crowns?
Many who need dental crowns often consider their aesthetic quality. This is where an E-MAX™ crown comes to the picture. Its top-of-the-line material makes it one of the best matches to the color of one’s natural teeth. Since the crown does not use any metal alloy as base, patients often comment on the flawless, natural look of the crowns as seen around the gum line. Because of the structure of these crowns, they are showing to be long lasting and less likely to get fractured by pressure than previous all porcelain crowns.
Who is a good candidate for E-MAX™ Crowns?
The best candidate for an E-MAX crown is a patient that has excellent home care (brushes and flosses regularly and has healthy gum tissue) and someone that has minimal tooth wear and not a heavy grinder or bruxer. Also the previous cavity or restoration (filling) should not be deep below the gum-line, which would compromise bonding the restoration to the tooth.
What can I expect from my E-MAX™ crown fitting?
Before undergoing the procedure, patients may need to undergo some preparation, depending on the state of one’s teeth and the amount of work that has to be done. You will need to have an initial consultation with one of our dental experts to examine the tooth that needs treatment. After cleaning, the tooth will be reshaped using a burr, or a small drill, to make way for the E-MAX crown later on. After this, your dentist will take an impression of your tooth with the help of a dental impression material. This will be used to fabricate a customized E-MAX™ crown. You will be required to wear a temporary crown for about two to three weeks while waiting for the final crown to be ready. We will guide you throughout the entire process.
When an E-MAX crown is provided, a conservative preparation is done on the tooth with a rounded smooth surface to the preparation to not create stress areas for the restoration. Once the tooth is prepared, an impression is created of the prepared tooth and sent to a laboratory to create the E-MAX crown. A very thorough evaluation of the color of the adjacent teeth is made to match the restoration as closely as possible to the adjacent teeth for a harmonious result. Once the restoration is received from the lab, it is checked for fit and then BONDED to the tooth for greatest strength. The bonding technique is a critical part of the success of the final restoration.
How long do results last?
There are so many factors that affect the result but with research we know that in a non-stress area an E-MAX crown will last longer than a PFM (porcelain fused to metal crown) pending that the bonding is done properly without contamination of the tooth surface. A PFM has a greater chance of chipping the porcelain off of the metal framework. The tooth may still be functional and sealed but it may be unaesthetic or result in gaps between the adjacent teeth based on a piece of the porcelain being fractured off. A properly bonded E-MAX crown has less chance of fracture based on research studies. The bonding technique is more critical in an E-MAX crown for longevity.
Expected recovery time
Once the crown is bonded in place, the tooth should be ready for chewing and normal function. There is a saying “put the party teeth in the front and the business teeth in the back”. The E-MAX crowns are the “party teeth” for more beauty. The “bruxer” crowns (solid zirconium crowns that are strong but much less aesthetic) or a beautifully fabricated gold crown are the “business teeth”. For greatest strength, gold is “still the gold standard”!
What is “aesthetic”?
Beauty is in the eye of the beholder. Remember that esthetic is not just white! Sometimes, something that is natural or strong can also be esthetic, especially if it preserves some of your natural tooth structure.
What is a BRUXZIR™ crown?
BRUXZIR™ crowns are often used in the molar areas where an all porcelain crown is desired but increased strength is needed. These crowns are “white or tooth colored” but lack some of the custom colors and translucency one might see in an E-MAX™ crown. Also, if any adjustments are made to the crown, it must be sent back to the lab to be re-glazed and sintered so that the moisture does not get into the crown and weaken it and cause increased risk of fracture. If not handled properly, BRUXZIR™ crowns can still fracture, especially with someone who grinds heavily in their sleep. Gold is still “the gold standard” for strength and durability. When this is not an option or consideration for the tooth (due to the patients request) then, we at Deer Park Dental, pride ourselves in providing you the benefits and risks of treatment so that you can make an informed decision for what is right for you.
Porcelain Crown Before and After Photo