Issue 38.14
The Wall Street Journal released the verdict on one-day crowns last week—although they are a little more convenient they have some limitations over crowns made by the traditional lab-made process. The first part of the same-day crown process is the same as the traditional process, it starts with a numbing and drilling. The difference is that the impression or mold is not needed and the crown is made faster. Instead of the impression and the one to two week wait, a wand scanner is waved over the prepared tooth and a computerized milling unit sculpts the crown from a small block of ceramic while you wait for only an hour or two. The crown is then cemented on to your tooth in the regular way. The equipment costs about $100,000 to $300,000 and is available in about 10% of dentist offices around the country. Although convenient and usually adequate, the milled crowns are not very natural looking, making them less ideal for front teeth where the artistry of the traditional method is superior. The problem is that the small ceramic blocks are usually only one or a blend of two colors; whereas, natural teeth matching requires many layered colors, characterizations, and grades of translucent effects that can only be provided by a ceramist in the traditional lab-made method. Furthermore, lab-made crowns may be better for people who grind and clench their teeth. These patients may prefer the strongest crown available, a gold crown that can only be made by the traditional lab method. Also, sometimes crowns require special attachment features to support other dental work. These patients may prefer the versatility of gold or porcelain fused to metal type crowns made only by the lab method. Although dentist made same-day crowns are intriguing, scientists say that studies comparing them to lab technician-made crowns are needed to search for benefits other than the convenience of only having to wait hours rather than several days. Sometimes strong, esthetic, and versatile crowns are worth the wait.
Dr Rodney Andrus is a specialist in missing and damaged teeth issues including multiple crown reconstruction and is Board Certified by the American Board of Prosthodontics. He practices with a master dental lab ceramist technician at St George Center for Specialized Dentistry in St George, UT. For more information you can call his office at 435-674-3100.