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Question:
I recently had a crown placed on one of my front teeth and I am not happy with the appearance or the fit next to my adjacent tooth.
The crown is porcelain on metal and is too gray looking for me. The tooth was healthy, just had a large chip out of the front.
How difficult / expensive would it be to replace the crown with an all porcelain crown? ... Visitor from PA
Answer:
Restoring a single front tooth with a "cosmetic" natural looking crown restoration is one of the hardest things to do for patients. The reasons are many, and important to consider before ever starting the process to prepare a tooth.
First, the patient must be happy with the current natural shade of their teeth. The reason is that
once a front tooth has had a crown restoration, the shade is locked in and cannot be changed.
Matching the size, shape and contours of the adjacent teeth are other factors that make it very difficult to make a natural looking crown for a front tooth. I think you can imagine that it is much easier to match the shade and cosmetics of a smile if all the front "smile zone" teeth are crowned at the same time. However, many patients do not want or need to have all their front teeth cosmetically restored.
The number one reason that you may not be happy with the results of your front crown is that it is a
porcelain baked to metal crown. The under-casting is a full metal "silver looking" base, with porcelain baked over it. An opaque very white layer is baked onto the metal substructure to "hide" the metal from showing through the porcelain layers.
The next step is to bake additional layers of porcelain over the opaque layer to try to match the shade selected. It is much harder for the porcelain lab artist to try to match the front teeth
shade with a porcelain to metal crown.
Many times a front crown made with a porcelain to metal crown either looks too opaque or white, or it may appear grey or have a dark look, especially at the gum-line area. The best, most natural looking crowns to replace a single front tooth, or all the front teeth in a smile makeover, is a crown made of 100% porcelain.
Since there is no metal to "block" out or hide, the layers of a full porcelain crown look the most eaesthetic and natural looking. Outside light reflects light rays back similar to a natural tooth. Also there is no dark line at the gum-line which occurs on many porcelain to metal crowns placed on front teeth.
To answer your question, it is not that hard to replace a front porcelain to metal crown with a full
porcelain crown, if you have a cosmetic attention to detail. In our practice a full cosmetic porcelain crown is in the range of $1350-$1400, depending on what materials are used to fabricate the crown. If the teeth are planned to be brightened before the porcelain crown is done, then it would be a little bit more of an investment.
TotalConfidenceDentistry.com
Ron Briglia, DMD
Chester County Medical Building
600 East Marshall Street, Suite 201
West Chester PA 19380
(610) 692-4440
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