TOOTH CROWNS – CASE STUDY, CAD/CAM, QUALITY AND PRICE

The purpose of this case study is to show the superiority of CAD/CAM technology in the creation of non-metal crowns and to partially explain how to choose the right dentist when crowns are concerned. We will answer questions regarding the factors that affect the selection of an esthetic dentist, not including the price, and why the more expensive crowns end up being a more favorable long-term investment.
CAD (Computer Aided Design) entails transferring the image of the filed-down tooth in 3D to the computer, using a special scanner. The crown or bridge is then modeled in a special program. The computer then sends information to a special lathe, whose precision is measured to the thousandth part of a millimeter. This phase is called the CAM (Computer Aided Manufacturing). At the Dental Oral Center, we have the latest generation Sirona Cerec Omnicam and a large MC XL lathe. The technique we use also has the latest generation Zirkonzahn CAD/CAM system.
A patient came to our office after a year of wearing metal-ceramic crowns from 3 to 3 in the upper jaw. In addition to the poor esthetic appearance of the crowns, the patient also complained that food was constantly getting stuck, which caused frequent gum inflammation. The reason for this were crowns that were too wide so that food was being trapped beneath them. In the image above, the clumsy and esthetically inadequate metal-ceramic crowns are obvious. The back teeth can barely be seen. There is no width to the smile.
After consulting with the patient, it was decided to do non-metal crowns in the upper jaw from 4 to 4, by using CAD/CAM technology. After removing the inadequate crowns, we noticed that a few millimeters of each tooth was preserved in a visible region above the gum line. In the image below, the black lines represent the border, the natural tooth is above and the non-metal crown below.
The greatest advantage of CAD/CAM technology is its precision, which is ideally presented in this example. If we take a look at the photo below of the finished work without the indicated borders (between the natural part of the tooth and the crown), we can see that the border is unnoticeable, even in high-resolution photos. A properly created dental crown, whether metal ceramic, zirconium or non-metal, should be a natural continuation of the natural part of the tooth, without any sharp edges and steps, with smooth and elegant gradations. The photo below shows an illustration of how an ideal crown lies on the border of the filed-down tooth, as a natural extension. This is especially important when the tooth has to be filed down below the gum line, which is usually the case, so the perfect gradation between the crown and the tooth, without steps and sharp edges, prevents food deposits, enabling normal oral hygiene maintenance just like with natural teeth. This way, we can prevent caries below the crown or in the natural part of the tooth, thus preventing gum inflammation and periodontitis.
The most common reason for damaged dental prosthetics is the deterioration of the carrier teeth. With this approach, they are protected and their lifespan is extended, thus extending the lifespan of the dental prosthetics. Crowns created this way last 10 years or more. When it is time to replace them, we can find a healthy and preserved natural tooth beneath them, making replacement possible with minimal processing. We usually find caries and periodontitis in patients who have worn inadequate crowns for many years, which makes it more difficult to place new crowns.
The price is certainly an important factor when choosing a dentist. Unfortunately, the philosophy “more quantity for a lower price” is becoming more common in Serbian dentistry. Top-quality crowns, like the ones described in this text, require time and dedicated tooth-filing, which is finished under magnifying glasses, down to the tiniest details. It all requires the dentist’s absolute dedication to the specific patient and takes more time than when the fast mass production philosophy is applied. It is logical that the price of one such crown, created with full dedication, has to be somewhat higher, since the dentist is investing more of his time. The use of CAD/CAM technology, which was mentioned above, also affects the price. Finally, there are the top-quality materials by world famous manufacturers Ivoclar Vivadent and Vita.
Dental prosthetics done this way last much longer, they are comfortable and do not cause problems for the patient. It is proportionately a far more favorable financial investment. In the example of the patient whose case we examined here, we can see that she was first exposed to the cost of creating inadequate crowns and then to the additional cost of creating new crowns at our office, and that was just one year later. The minimum unnecessary cost that the patient suffered was 40 EUR per crown and probably much more.
We hope that we’ve provided the right information about dental crowns in this text. We are available for all your questions.

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