881 Bay Street, Plaza Suite

Toronto, ON M5S 3K6

Monday – Friday: 9:30 AM – 7:00 PM

Please note that we are open on alternating Fridays. Call ahead to book an appointment and confirm our hours.

Porcelain and Composite Inlays, Crowns & Bridges

What is the Purpose of Dental Crowns?

When a tooth is cracked, decayed, or damaged, a tooth may need to be prepared to receive a crown. As well, this gives us the opportunity to change the shape, realign existing tooth positions, and alter the shade of a natural tooth using crowns. Most crowns are made with either porcelain, aluminous porcelain, porcelain fused to metal, zirconia, or gold.

Dental Crown

Indications for Crown

  • Teeth that have had root canals become very brittle and are susceptible to fracture. Placement of a crown will enhance the strength and resistance to fracture of the underlying tooth structure.
  • To protect a weak tooth (for instance, from decay) or to reinforce an extensively broken down tooth.
  • To restore a tooth that has been severely worn down due to attrition (grinding).
  • To support a tooth with a large filling when there is a minimal amount of tooth structure remaining.
  • To serve as retainers supporting a dental bridge or partial removable denture firmly in place.
  • To correct a congenitally malformed tooth.
  • To be the final restoration over a dental implant.
  • To make cosmetic modifications. If a filling is sufficiently large and discoloured, we can improve the contour and shade of the tooth through placement of crowns or veneers.

Steps Involved in Preparing a Tooth to Receive a Crown


1st Visit: The dentist will take preliminary impressions of the upper and lower arches. Then the tooth will be shaped in such a way that a crown can be easily seated over the tooth. A temporary crown is fabricated chairside and temporarily cemented over the tooth.


2nd Visit: The temporary crown is removed and an impression of your teeth is taken and sent to a lab where they will fabricate your final crown. In certain circumstances, you may be required to visit the lab in order to take a “custom shade” to match your natural teeth closely. The temporary crown is re-cemented into position again while your permanent crown is being made.


3rd Visit: Your temporary crown is removed once again, and the final crown is placed. The fit is verified by taking a radiograph (x-ray). Once the fit is confirmed, then the crown can be permanently cemented onto the tooth with a special adhesive.

BRIDGES


A bridge is meant to replace one or more missing teeth. It is fabricated by fusing individual crowns on adjacent teeth surrounding the space. Bridges can also be used to improve the appearance and shape of individual teeth.

Dental Bridge

A bridge placed on the 2 abutment teeth

Dental Bridge

A bridge is used to replace several missing teeth

MATERIALS USED IN FABRICATION OF CROWNS AND BRIDGES

Gold Crowns


We can also use precious metals such as gold in the fabrication of crowns. Gold is an extremely durable material and has the least reactivity of all types of metals used in the mouth. It is extremely gentle on the opposing dentition and is well-suited on molars in patients who habitually clench or grind their teeth.

Benefits:

  • Extremely durable and long-lasting
  • Strong even when thin, allowing for preservation of the underlying tooth structure
  • Gentle on opposing teeth when chewing
  • Suitable for the posterior (back) teeth in patients with habitual clenching and grinding habits.
Gold Tooth

Potential Drawbacks:

  • Conducts hot and cold temperatures quickly which may result in some initial sensitivity for a few weeks after placement
  • Visibly different from natural teeth
  • Gold can wear away over a period of years, especially when placed opposite a full porcelain crown or in patients who clench and grind heavily
  • Gold is cast like jewelry from molten metal which can sometimes leave micro-gaps at the margins and can make it more vulnerable to decay
  • Patients with specific metal allergies or sensitivities 
  • Not often used in the front teeth

Full Porcelain

Full porcelain restorations have been considered the most lifelike and natural looking restorations available today. Porcelain is not a conductor of heat and cold very efficiently, so sensitivity to hot and cold is not an issue. However, porcelain can also be brittle and fracture easily when it is too thin or it is habitually flexed through the forces of clenching and grinding. Full porcelain crowns are also somewhat weaker because they lack the metal framework present in a porcelain fused to metal or gold crowns.


In order to safeguard against fractures related to thinness, a full porcelain crown must be thicker all the way around than a gold restoration. Therefore, more tooth structure may need to be removed to allow for more bulk of porcelain to improve overall strength and durability.

Porcelain

Benefits:

  • Produces the most beautiful and lifelike dental crowns 
  • Excellent aesthetics for the front teeth or for other teeth where cosmetic result is a primary concern.
  • Does not conduct heat or cold well, reducing temperature sensitivity
  • A good choice for patients with allergy to metals
Porcelain Crowns

Potential Drawbacks:

  • Fractures more easily than other materials
  • May have a bulky appearance. More tooth structure must be removed than would be necessary for a gold crown

May not be suitable for:

  • Patients who clench and grind due to the brittle nature of porcelain
  • Patients who do not have enough healthy tooth structure available to support the thickness of a porcelain restoration.

Aluminous Porcelain Crowns (Emax® Crowns)

These crowns have a life-like and therefore are used in areas of the mouth where aesthetics are important. This material is very durable and fracture resistant.

Initial Smile

1. Initial smile

Patient wearing temporary crowns

2. Patient wearing temporary crowns

Final Emax® crowns

3. Final Emax® crowns

Porcelain fused to Metal Crowns

A porcelain fused to metal crown is made by layering porcelain on top of a metal alloy base. It is a combination of metal and porcelain offering the advantages of both stability of the metal base coupled with the aesthetics of an outer porcelain shell.


Benefits:

  • Stronger and more durable than full porcelain crowns
  • Better cosmetic option than full gold crowns
  • Metal base still protects the tooth, even if some of the porcelain fractures off


Best for:

  • Patients who already have several porcelain fused to metal crowns
  • Patients who may not be good candidates for an all-porcelain crown


Potential Drawbacks:

  • Opacity caused by metal base makes porcelain look less lifelike
  • Dark metal edge is sometimes visible at the gumline
  • Porcelain may fracture off the metal base


May not be suitable for:

  • Patients with specific metal allergies or sensitivities
  • Patients who clench and grind may chip the porcelain off the metal base.

Inside surface of porcelain fused to metal crown

Inside surface of porcelain fused to metal crown

Porcelain covering the metal base on model

Porcelain covering the metal base on model

Porcelain fused to metal crowns can also be used for anterior teeth (front)

Porcelain covering the metal base on model

Zirconium Dental Crowns

Zirconia crowns are a popular choice due to their durability, strength and translucent life-like appearance. They last longer than all-porcelain crowns but do not possess similar aesthetics.


Benefits:

  • Translucency is similar to natural teeth 
  • Extraordinarily tough. Zirconia is more resistant to wear and tear compared to all-porcelain that can chip and break more easily
  • Less tooth removal required during preparation
  • No unsightly metal line around the gumline like porcelain fused to metal or gold crowns
  • Biocompatible with surrounding tissues
  • Zirconium crowns also provide strength without the bulky appearance that all- porcelain may require


Disadvantages:

  • Certain patients may have sensitivity to zirconium
Crowns used in gum recession to cover exposed root

Crowns used in gum recession to cover exposed root

Zirconium crowns look like natural teeth

Zirconium crowns look like natural teeth

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Dentistry On Bay

881 Bay Street

Toronto, ON M5S 3K6

Hours

Monday – Friday: 9:30 AM – 7:00 PM

Please note that we are open on alternating Fridays. Call ahead to book an appointment and confirm our hours.

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