Dental Advice - All Ceramic vs PFM Crown?

IanGC_2

Hello everyone!

I've just got back from a checkup from the dentist and I've been told I need to get a crown on an upper 1st Molar. It's currently filled with amalgam, but the tooth is apparently giving way.

There aren't any good NHS dentists around here so its with a private dentist. I've had 2 quotes, one for a "Ducera Gold Porcelain Bonded" crown for £408 and another for an "All Ceramic Advanced Crown" for £547. :eek:

I was hoping to get some advice on which one to go for, as I don't want to go for an all ceramic option if it's just going to crack after a few years. But equally, if they are as good as each other I'd probably go for the later option for aesthetic reasons.

I hope someone can give me some advice Before anyone suggests it, I really don't want a gold crown

Toothsmith

I did some Duceragold bridges for my Mum just over 13 years ago. They are still looking and functioning very well.

Duceragold is - rather confusingly - the name of the porcelain. It melts at a lower temperature than conventional porcelain which means it can be fused to a yellow gold alloy, rather than the usual bonding alloys which are silver in colour. this 'yellowness' of the underlying metal means that the final crown/bridge looks more realistic.

A couple of years after I did the work for my Mum, the lab stopped doing Duceragold, as they'd had problems with the porcelain fracturing off the alloy. I haven't heard that this is a major problem with the material though, and it might well have been solved by now.

There are several systems that could be described as 'all ceramic advanced crowns' Procera is one, Lava is another and Empress yet another. All are very good, a bit more advanced than Duceragold really - and very pretty when done nicely.

I'd probably go for Lava if I wanted a tooth coloured crown on a molar. Being a bit old fashioned though, if I had a molar needing crowning, I may well just go for a gold one. Not very 'Hollywood' - I know, but I have seen good gold crowns still in place and looking good after 50 years! I would always go for the proven thing that lasts. The fewer times us dentists have to muck about with your teeth, the better!!!

IanGC_2

Thanks for the reply Toothsmith - I've read some of your other posts on here after I posted that, and you give out some great advice :T So thankyou

I did think about going for gold (excuse the pun ), but I don't know if I would be happy with the look of it and it isn't too easy (or cheap) to swap around.

I'm not sure which all ceramic crown they will use, but if you (as a dentist) would use this option for themself given the choice then I'd probably pay the extra and go for this.

Would you think that the all-ceramic crown could potentially last as long as the PFM (with proper dental hygene?).

Toothsmith

The manufacturers figures seem to suggest that they may well be stronger, and so last longer.

It depends how much you trust the manufacturers though!!!

Personally I only believe crowns will last a long time when I see that the crown has lasted a long time (If you see what I mean!). That's why I like gold.

These new fangled ceramics are new kids on the block.

As I said though, my Mum's Duceragold stuff has lasted well, and if I were doing it today I may well have used Lava, which I have no reason to suppose is any worse, and is very probably better.

Stephb1986_2

hi toothsmith with the nhs banding the highest one i think it was £175 well does that include veneers and stuff like that or not?

many thanks

Steph xx

Toothsmith

All stuff needing something to be made by a technician falls into NHS band 3.

Crowns, veneers, dentures, bridges etc.

Whether or not you'll get any of those things on the NHS though depends on why you need them.

The types of crown we're discussing here would never be available on the NHS.

Oh - and band 3 charge is about £196 now - in England anyway, not sure about Wales, and Scotland and N. Ireland still have the old (pre 2006) NHS dental arrangements.

IanGC_2

Toothsmith wrote: »

As I said though, my Mum's Duceragold stuff has lasted well, and if I were doing it today I may well have used Lava, which I have no reason to suppose is any worse, and is very probably better.

Much appreciated Toothsmith, thanks for the advice :beer:

IanGC_2

Just been to have the preparation done today (it was Procera as far as I remember), and I've got the temporary crown on now.

Any chewing using that tooth though gives me a sudden sharp pain, it's fine normally though but I couldnt chew anything on that side. Do you think I just need to give it a few days to get over the trauma?

Toothsmith

It's not unusual for a tooth to be a bit jumpy for a day or two after the preparation.

Might possibly be that the temporary is a bit loose, but I couldn't say for sure.

See how it goes, and get back if it doesn't improve.

IanGC_2

Thanks Toothsmith, I'll see how it is at the weekend

melbury

I had a gold crown last year - dentist said that gold was really hardwearing. I love it - looks so much nicer than the grey old filling that used to be there. However, if it was a front tooth, I think I would go for the white crown. It cost £280, which wasn't too bad.